Abstract | Demencija kao jedna od najznačajnih bolesti u neurološkoj i psihijatrijskoj znanosti i struci, vezana je najčešće uz kronološku životnu dob i javlja se češće iznad 65 godina. Prema kriterijima Svjetske zdravstvene organizacije, demencija označava smanjenu sposobnost pamćenja, a uz to mogu postojati i druge spoznajne teškoće poput disfazije, agnozije, apraksije, smetnje u orijentiranosti, smetnje u dnevnom odlučivanju i drugo. Od svih bolesnika koji boluju od demencije, Alzheimerova bolest smatra se danas primarnim uzrokom u oko 80% tih bolesnika. U Hrvatskoj je oko 80.000 bolesnika boluje od te bolesti, tj. oko 10% osoba kronološke dobi 65 i više godina. Smatra da su u razvoju te bolesti značajni genetski čimbenici. Oni uključuju mutacije gena APP (amyloid precursor protein) na 21-om kromosomu, mutacije gena za presenilin-1 na 14. kromosomu i gena za presenilin-2 na 1. kromosomu. Vezane su za nakupljanje proteina amiloid-B-peptida (Aβ) 42. Bolest je češća u osoba kronološki starije životne dobi, nižeg stupnja obrazovanja, u onih koji su doživjeli traumu središnjeg živčanog sustava, u ženskog spola, kao i u osoba izloženih prolongiranim stanjima stresa. Kako se na genetsku komponentnu ne može utjecati, treba imati u kontroli kronične bolesti poput arterijske hipertenzije,dijabetesa melitusa, hiperuricemije, dislipoproteinemije, uz konrolu navike pušenja i pretilosti. Mentalna i aerobna tjelesna aktivnost trebaju biti favorizirane, jer mogu odgoditi ili usporiti Alzheimerovu demenciju. Od analize genoma u personaliziranoj medicini očekuju se prava usmjerenja u oblike tjelovježbe prilagođene pojedincu što će pokazati vjerojatno ne daleka budućnost. |
Abstract (english) | Alzheimer,s dementia is one of the most important disease in the elderly in neurological and psychiatric science and practice,connected to the biological ages of 65 or more, but rarely it could be seen and younger patients. According to the criteria of WHO, dementia means loss of memory and associated with other sensory probems: dysphasia, agnosia, apraxia, orientation problems, problems in making of daily decisions and other. Among dementias, Alzheimer,s disease has the most important role because it is the cause of 80 per cent of these diseases. In Croatia there are about 80,000 patients suffering of Alzheimrer,s disease, i.e. about 10 per cent of the whole elderly population. We think today that genetic factors play the most important role in a development of this disease. Those factors include APP (amyloid precursor protein) gene mutations on the 21-th chromosome, gene mutations for preseniline-1 on the 14-th chromosome, and a gene for preseniline-2 on the 1-th chromosome. It is connected to the accumulation of protein amyloid-B-peptide (Aβ) 42. This disease is more frequent int he elderly, with low education level, in those with head trauma, in females, and in persons sufferinf of prolonged stress situations. It is not possible to control the genetic component oft his disease. That is why we have to control some chronic diseases as are arterial hypertension, diabetes mellitus (type 2), hyperuricaemia, dyslipoproteinaemias, beside smoking habits and obesity. Mental and aerobic physical exercise should be at the first place of health activities, because it could delayed or to slow Alzheimer,s dementia. In a ner future we are expecting that genome analysis in personalized medicine will show us the right way about types of physical exercise. |