Projekt/Project COGDEC

Staranje in kognitivni upad - Aging and Cognitive Decline

Staranje prebivalstva v Evropski uniji

​Poročilo o staranju 2015 - Gospodarske in proračunske napovedi za 28 držav članic EU (2013–2060) / 2015 Ageing Report – Economic and budgetary projections for the 28 EU Member States (2013–2060) napoveduje:

• da se bo leta 2060 ob rojstvu pričakovana življenjska doba pri moških povečala s 77.7 na 84.8 let, pri ženskah pa iz 83.1 na 89.1 let;
• da se bo v enakem obdobju demografsko starostno razmerje (število ljudi starejših od 65 let v primerjavi z mlajšimi v starosti od 15-64 let) v celotni EU povečalo iz 27.8% na 50.1%.

​V EU se bo tako do leta 2060 razmerje med številom delovno sposobnih ljudi in starejšimi od 65 let zmanjšalo iz 4 na približno 2, fiskalni vpliv staranja pa bo predvidoma visok v večini držav članic, učinki pa bodo postali očitni že v naslednjem desetletju. Staranje evropskega prebivalstva ustvarja velike zdravstvene, družbene in gospodarske izzive za gospodarstvo EU.​

Blaga kognitivna motnja

​Starostni kognitivni upad lahko pri posamezniku napreduje v blago kognitivno motnjo in v končni fazi tudi v demenco. Potek blage kognitivne motnje je zelo nepredvidljiv; pri nekaterih bolnikih motnja ostane razmeroma stabilna, pri nekaterih se razvije v demenco, medtem ko se pri nekaterih lahko kognitivne sposobnosti celo izboljšajo zaradi ustrezne terapije vzrokov, ki imajo podobne simptome kot blaga kognitivna motnja (npr. pomanjkanje vitamina B-12). Za učinkovito soočanje je ključnega pomena, da blago kognitivno motnjo čim prej odkrijemo, saj imajo ti bolniki povečano tveganje za razvoj demence.

​Poznamo dve obliki blage kognitivne motnje:

• prvo, ki vpliva predvsem na spomin - amnestični tip in
• drugo, ki vpliva na sposobnost odločanja, oceno potrebnega časa ali zaporedja korakov, ki so potrebni za neko kompleksno opravilo ali pa vpliva na posameznikovo vidno zaznavanje.

​Amnestični tip blage kognitivne motnje je pogosto povezan z razvojem demence, zlasti z Alzheimerjevo boleznijo. Pri 8 od 10 ljudi se amnestični tip blage kognitivne motnje v 7 letih razvije v Alzheimerjevo bolezen (). Pojavnost demence pri osebah z blago kognitivno motnjo, ki so starejše od 65 let, je približno 15% (Neurology 2018, 16; 90 (3): 126–135).​

Demenca

Ocenjeno število ljudi v Evropi z demenco v letu 2015 je bilo 10.5 milijona, po napovedih pa se bo do leta 2050 povečalo na 18.66 milijona. Parkinsonova bolezen z demenco z Lewyjevimi telesci, Alzheimerjeva bolezen in frontotemporalna demenca so najpogostejše nevrodegenerativne bolezni povezane s staranjem. Število bolnikov z demenco je podcenjeno, saj jih večina še nima diagnoze bolezni in zato tudi ne more dostopati do ustrezne nege in zdravljenja (World Alzheimer Report 2016, Improving healthcare for people living with dementia).

***

Ageing of the EU population

The 2015 Ageing Report – Economic and budgetary projections for the 28 EU Member States (2013–2060) forecasts:

• life expectancy at birth for males is expected to increase from 77.7 to 84.8 in 2060 and for females from 83.1 to 89.1 in 2060;
• the demographic old-age dependency ratio (people aged 65 or above relative to those aged 15–64) is projected to increase from 27.8% to 50.1% in the EU as a whole over the projection period.

Thus, the EU will progress from having four working-age people for every person aged over 65 years, to around two working-age persons in 2060, and the fiscal impact of ageing is projected to be high in most Member States, with effects becoming apparent already during the next decade. Ageing of the European population creates significant health, societal and economical challenges for EU economies.

Mild cognitive impairment

Cognitive impairment starts with ageing associated cognitive impairment, progresses to mild cognitive impairment (MCI) and finally to dementia. The course of MCI is unpredictable; in some patients it remains stable, in some patients it progresses to dementia and some patients with MCI regain their cognitive abilities. For effective management, it is crucial to detect MCI as soon as possible, since people with MCI have an increased risk of developing dementia.

Two forms of MCI were identified:

• one that primarily affects memory – amnestic type and
• the other that affects the ability to make sound decisions, judge the time or sequence of steps needed to complete a complex task, or visual perception.

The amnestic type of MCI is most often associated with development of dementia, especially Alzheimer’s disease (AD). 8 of every 10 people with amnestic MCI develop AD within 7 years (https://www.nia.nih.gov/health/what-mild-cognitive-impairment). The cumulative dementia incidence in individuals with MCI older than age 65 is about 15% (Neurology 2018, 16; 90(3): 126–135).

​Dementia

The estimated number of people in Europe with dementia in 2015 was 10.5 million, projected to increase to 18.66 million in 2050. Parkinson’s disease with Lewy body dementia, Alzheimer’s disease and Fronto-temporal dementia are the most common ageing and dementia associated neurodegenerative brain disorders. The number of people with dementia is underestimated since a majority of people with dementia have not received a diagnosis and are thus unable to access care and treatment (World Alzheimer Report 2016, Improving healthcare for people living with dementia).