Die Schwierigkeit der Vorhersage von Alzheimer

LONDON – Die Alzheimer-Krankheit ist die bei weitem häufigste Ursache für Demenz und international eine der meistgefürchteten Krankheiten. Bis 2050 werden weltweit 135 Millionen Menschen an Alzheimer leiden – eine Verdreifachung des heutigen Wertes – wobei drei Viertel aller Fälle in Ländern niedrigen und mittleren Einkommens auftreten werden. Die Vorhersage des Ausbruchs von Alzheimer - von Prävention oder Heilung ganz zu schweigen - bleibt eine immense Herausforderung.

Die Alzheimer-Krankheit wurde vor mehr als einem Jahrhundert aufgrund von Autopsie-Ergebnissen entdeckt, die charakteristische Hirnläsionen zeigten -  so genannte „amyloide Plaques“. Bei lebenden Personen ist die Krankheit schwieriger zu diagnostizieren. Ärzte sind auf die Beobachtung von Gedächtnisverlust und anderen geistigen Defiziten (wie logisches Denken oder Sprachverständnis) angewiesen – Zeichen, dass sich im Gehirn bereits Plaques abgelagert hat. Ein Heilmittel müsste allerdings verabreicht werden, bevor sich Plaques bildet und  bereits Jahre bevor die Symptome der Demenz auftreten.

Man könnte Alzheimer leichter vorhersagen, wenn Wissenschaftler über Zeit und Ressourcen verfügten, viele Jahre lang weitreichende Längsschnittstudien durchzuführen. Im Rahmen derartiger Studien würde man idealerweise an tausenden Personen jüngeren und mittleren Alters Blutuntersuchungen, bildgebende Verfahren, Gedächtnistests und medizinische Untersuchungen durchführen sowie die Studienteilnehmer detaillierte Fragebögen zur Lebensqualität beantworten lassen. Man würde die Probanden jahrzehntelang begleiten, um herauszufinden, ob sie die Krankheit entwickeln und welche Tests vor der Alzheimer-Diagnose positiv verliefen.

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