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Welttag des Gehirns: Neurologische Erkrankungen am Vormarsch › gesundheitsnews.at
Demenz, Parkinson und Schlaganfall: Mit der Lebenserwartung wird auch die Zahl neurologischer Erkrankungen steigen. Deshalb sei ein weiterer Ausbau der Versorgungsnetze und verstärkte Bemühungen in der Prävention unabdingbar, betonten führende österreichische Experten anlässlich des dritten „World Brain Day“.
Anlässlich des von der Weltföderation für Neurologie (WFN) ausgerufenen „Welttag des Gehirns“ am 22. Juli wiesen führende Expertinnen und Experten aus Österreich bei einer Pressekonferenz auf die wachsende Bedeutung der neurologischen Versorgung hin. Die WFN hat ihre auch von der Österreichischen Gesellschaft für Neurologie (ÖGN) unterstützte Initiative in diesem Jahr unter das Thema „The aging brain“ gestellt.
Neurologische Leiden am Vormarsch Schon jetzt sind neurologische Leiden weiter verbreitet als beispielsweise Atemwegserkrankungen, gastrointestinale Störungen oder Krebs. Nach den Angaben des European Brain Council leiden in Europa 220,7 Millionen Menschen an zumindest einer neurologischen Erkrankung, das entspricht der gemeinsamen Einwohnerzahl von Deutschland, Frankreich und Großbritannien.
Risiko für neurologische leiden steigt mit dem Alter Weil das Risiko etwa für Demenz, Morbus Parkinson oder Schlaganfall mit dem Alter ansteigt, würden diese Zahlen aber erst die Spitze des Eisberges zeigen, wie die ÖGN-Präsidentin und Vorständin der Neurologischen Abteilung an der Wiener Rudolfstiftung, Prim.a Univ.-Doz.in Dr.in Elisabeth Fertl, betont:
„Im Jahr 2035 werden rund drei Millionen Österreicherinnen und Österreicher über 60 Jahre alt sein. Das ist in Hinblick auf die steigende Lebenserwartung erfreulich. Allerdings müssen wir uns auch auf die unvermeidlichen Begleiterscheinungen dieser Entwicklung einstellen“.
Vorbildhafte Versorgung in Österreich weiter ausbauen In Europa ist die Dichte an Neurologinnen und Neurologen im Verhältnis zur Bevölkerung je nach Land höchst unterschiedlich. „Österreich ist dabei im internationalen Vergleich hervorragend aufgestellt“, lobt Prim.a Fertl.
Insgesamt stehen hierzulande 970 Fachärztinnen und Fachärzte für Neurologie bzw. für Neurologie/Psychiatrie zur Verfügung. Weniger als die Hälfte, nämlich 441 Neurologinnen und Neurologen, sind im niedergelassenen Bereich in Ordinationen tätig, davon allerdings nur 144 mit Kassenvertrag.
Dazu kommen 38 neurologische Akutabteilungen, die alle mit Stroke Units ausgestattet und für neurologische Notfälle jederzeit verfügbar sind, sowie ein zunehmend dichteres Netz an neurologischen Rehabilitationszentren und anderen Spezialeinrichtungen für die Nachsorge von Menschen mit chronischen neurologischen Erkrankungen.
Dennoch, so Dr. Fertl, „müssen wir dieses hervorragende Versorgungsangebot immer wieder den aktuellen Entwicklungen und Anforderungen anpassen“. Deutlich wird das am Beispiel der Schlaganfallversorgung. Österreich hat ein auch im internationalen Maßstab vorbildliches Netz von spezialisierten Schlaganfall-Überwachungs-Einheiten (Stroke Units).
Kombination von Thrombektomie und Thrombolyse Wie auch internationale Studien zeigen, verbessern diese Spezialeinrichtungen die Versorgungsqualität enorm. Nun gibt es in der Schlaganfall-Therapie neben der intravenösen Thrombolyse, also der medikamentösen Auflösung von Gerinnseln, einen weiteren wichtigen Fortschritt, nämlich die Kombination von systemischer Thrombolyse plus mechanischer Gerinnsel-Entfernung (endovaskuläre Thrombektomie), bei der mittels Katheter der Thrombus aus dem Blutgefäß herausgezogen wird.
„Bei zehn bis 15 Prozent aller Fälle, wenn ein großes Hirngefäß durch ein sehr langes Gerinnsel verstopft ist, funktioniert die Thrombolyse oft nur bedingt“, so Prim.a Fertl. „Das betrifft in Österreich immerhin 2.000 Menschen jährlich. Mit der Kombination von Thrombektomie und Thrombolyse haben wir jetzt eine wirksame und sichere Methode zur Behandlung solcher Großgefa¨ßverschlu¨ssen zur Verfügung.“
Die Überlegenheit der Thrombektomie bei ausgewählten Patientengruppen gegenüber der medikamentösen Standard-Therapie wurde jüngst in mehreren Studien und schließlich auch einer Meta-Analyse aller aktuellen Studien überzeugend belegt. „Bislang können wir diese Methode an elf Stroke-Units mit Interventionsmöglichkeit anbieten. Es werden also weitere Anstrengungen nötig sein, um diese zusätzliche spitzenmedizinische Leistung flächendeckend in ganz Österreich, rund um die Uhr, sicherstellen zu können“, so die ÖGN-Präsidentin.
„Unter den bekannt schwierigen ökonomischen Rahmenbedingungen wird es nicht ganz einfach sein, diese Ressourcen zu schaffen. Letztlich muss sich die Gesellschaft hier der Frage stellen, ob sie sich eine optimale medizinische Versorgung, insbesondere auch ihrer älteren Mitglieder, leisten will.“
Motivation für den Neurologennachwuchs Es gibt also Handlungsbedarf, um eine gute neurologische Versorgung auch für die Zukunft sicherzustellen. Viele Neurologen werden in den kommenden zehn Jahren in Pension gehen. „Wir haben uns daher vorgenommen, die nachrückende Ärztegeneration verstärkt für unser interessantes und vielfältiges Fach zu begeistern“, betont Prim.a Fertl. „Unter anderem werden wir mit einer Informationsoffensive unter dem Motto ‚Neurologie – mein Fach!’ bereits Medizinstudenten ansprechen, um sie für eine neurologische Facharztausbildung motivieren.“
So verändert sich die Kognition mit dem Alter Ebenso wichtig wie die Behandlung bereits Erkrankter sicherzustellen, betonte Univ.-Prof. Dr. Reinhold Schmidt, Präsident Past der ÖGN und Leiter der Klinischen Abteilung für Neurogeriatrie an der Grazer Universitätsklinik, sei es, dafür zu sorgen, dass möglichst viele Menschen ihre kognitiven Fähigkeiten bis ins hohe Alter behalten.
„Wir gehen viel zu oft davon aus, dass Hinfälligkeit und Defizite zwangsläufige Begleiterscheinungen sind. Dabei ist die Annahme, Demenz sei eine unvermeidliche Folge des Alters, zum Glück schlichtweg falsch: Die Hälfte der Menschen im Alter von 90 Jahren haben keine Gedächtnisstörungen“.
Welche Faktoren den sehr unterschiedlichen Abbau der kognitiven Fähigkeiten beeinflussen, versucht Prof. Schmidt – wie andere Forschergruppen in aller Welt – gerade in intensiven Untersuchungen herauszufinden. Dabei zeigte sich, dass in der Altersgruppe zwischen 45 und 75 Jahren bereits bei 67 Prozent altersbedingte Veränderungen der weißen Hirnmasse („white matter leasions“) zu beobachten sind. Bei den Über-90jährigen ist das schon bei mehr als 90 Prozent der Fall.
Auswirung der Veränderung der weißen Hirnmasse „Wenn solche Läsionen im Gehirn derart häufig auftreten, ist die Frage, welche Auswirkungen sie auf die kognitiven Fähigkeiten haben, natürlich von besonderer Relevanz“, erklärt Prof. Schmidt. „Wie Studien zeigen, gibt es bis zum etwa 60. Lebensjahr diesbezüglich kaum Unterschiede. Stärkere Funktionsverluste sind erst zwischen 75 und 80 Jahren zu erwarten. Aber auch dann geht es mit den Gehirnfunktionen nicht notwendigerweise weiter rapide bergab: Etwa die Hälfte aller 81-jährigen hält ihren Leistungsstandard über weitere sieben Jahre unverändert“.
Wie weitere Studien belegen, findet im alternden Gehirn eine sehr komplexe Interaktion zwischen vaskulären und degenerativen Prozessen statt. Sie verstärken einander und potenzieren das Risiko für kognitiven Abbau, wenn sie gemeinsam auftreten. Finden sich beispielsweise zugleich Alzheimerpathologie und Infarktareale im Gehirn, ist das Demenzrisiko gegenüber Menschen ohne solche Veränderungen sechsfach erhöht.
Können auch noch sogenannte Lewy-Körperchen, also Einschlüssen im Gehirn, die typisch für die neurodegenerativen Prozesse bei Parkinson sind, nachgewiesen werden, steigt das Demenzrisiko bereits auf das 16fache.
So bleibt das Gehirn gesund Trotz dieser wachsenden Einsichten ist ein unmittelbarer Durchbruch etwa in der Alzheimertherapie bislang nicht in Sicht. Umso wichtiger, betonten die Experten, sei es, die Prävention zu fördern. Dabei gilt es vor allem, eine der faszinierendsten Fähigkeiten unseres Gehirns zu stärken: Die sogenannte „Kognitive Reserve“, also die gerade im Gehirn sehr ausgeprägte Fähigkeit, Schädigungen zu kompensieren und so die klinischen Auswirkungen von Erkrankungen zu minimieren.
„Wollen wir kognitive Abbauprozesse günstig therapeutisch beeinflussen oder ihnen wirksam vorbeugen, dann ist es entscheidend, jene Faktoren zu entschlüsseln, die diese kognitive Reserve erhöhen oder vermindern“, so Prof. Schmidt.
Inzwischen ist eine ganze Reihe davon bekannt. So zeigte sich etwa, dass negativer Stress, Einsamkeit und Depression, einzeln und erst recht gemeinsam auftretend, sich ebenso negativ auf die Entwicklung der kognitiven Fähigkeiten auswirken wie Bluthochdruck oder ungünstige Blutfett- und Blutzuckerwerte.
Vorbeugend wirkt hingegen, das Gehirn mit immer neuen Reizen in Schwung zu halten. Wie eine im New England Journal of Medicine publizierte Studie zeigt, verringern häufige Brettspiele das Demenzrisiko um 74 Prozent, intensives Lesen um 35 Prozent, das Spielen eines Musikinstruments um 69 Prozent und das Lösen von Kreuzworträtseln um 41 Prozent.
Zudem zeigte eine mehr als 20jährige Beobachtung von 1.100 Priestern, Mönchen und Nonnen, dass selbst Menschen mit Alzheimer-typischen pathologischen Veränderungen im Gehirn, ihre kognitive Fähigkeiten kaum verlieren, wenn sie in (real existierende) soziale Netze eingebunden sind.
Wie die kontrollierten Interventionsstudien FINGER (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) aufzeigten, trägt auch der Lebensstil zur geistigen Gesundheit im Alter bei. Eine multimodale Intervention bestehend aus Ernährungsempfehlungen, regelmäßiger Bewegung, kognitivem Training und einer engmaschigen Kontrolle von vaskulären Risikofaktoren trug nachweisbar dazu bei, die kognitive Funktion von Menschen mit einem hohen Demenzrisiko zu erhalten oder zu verbessern.
„Wer sich also gesund ernährt, Körper und Geist trainiert sowie kontaktfreudig und sozial aktiv bleibt, hat deutlich bessere Chancen, auch im hohen Alter geistig gesund zu bleiben“, fasst Prof. Schmidt zusammen.
Alter nicht als Last begreifen „Ein wichtiges Anliegen ist, dass in Diskussionen über die demographische Entwicklung das Altern und ältere Menschen nicht immer nur als Last und als Kostenfaktor dargestellt werden“, betonte Univ.-Prof. Dr. Wolfgang Grisold, Generalsekretär der Weltföderation für Neurologie und Vorstand der Neurologischen Abteilung im Sozialmedizinischen Zentrum Süd, Wien. „Hier müssen wir Neurologen als Anwälte der Interessen unserer Patientinnen und Patienten auftreten.“
Palliativ-Neurologie gewinnt an Bedeutung Neben einer ausreichenden neurologischen Akutversorgung werde eine zunehmend wichtige Rolle der noch vergleichsweise jungen Disziplin der Palliativmedizin zukommen. Prof. Grisold: „Oft wird darunter nur die Begleitung Sterbender verstanden. Das Konzept der Palliativmedizin reicht aber viel weiter und kann auf die neurologischen Auswirkungen eines unheilbaren Krankheitszustands auch über längere Zeiträume eingehen und Behandlungskonzepte bieten.“
Globale Ungleichheiten beseitigen Die Gesundheitspolitik aller Länder wäre jedenfalls gut beraten, wenn sie der Neurologie Priorität zukommen lässt, die der Bedeutung neurologischer Krankheiten entspricht, so WFN-Generalsekretär Grisold: „Die Möglichkeiten dafür sind allerdings weltweit höchst ungleich verteilt. Nach wie vor haben zu viele Menschen auf der ganzen Welt entweder keinen oder nur unzureichenden Zugang zu neurologischer Versorgung.“
Die Zahl der Krankenhausbetten pro 100.000 Einwohner, zum Beispiel, ist in den WHO-Regionen Afrika (0,23 pro 100.000) und Südostasien (0,28 pro 100.000) am niedrigsten. Die Zahl der öffentlichen Krankenhaus-Betten für Neurologie-Patienten ist in den Weltregionen mit niedrigem Einkommen im Vergleich zu jenen mit hohem Einkommen deutlich geringer.
„Diese erschreckenden Ungleichheiten dürfen wir nicht hinnehmen. Insbesondere, wenn wir bedenken, dass bereits im Jahr 2025 rund 80 Prozent der älteren Bevölkerung in weniger entwickelten Weltregionen leben werden. Die WFN wird sich daher zukünftig noch vehementer für eine gerechtere Verteilung der globalen Ressourcen einsetzen“, so Prof. Grisold.
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Quelle:
¹ World Brain Day 2016 – der Weltgehirntag
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