NEUROMIŠIĆNE BOLESTI U STARIJOJ POPULACIJI

Ivana Basta; Stojan Perić

doi:10.5937/mp75-51539

Ivana Basta Univerzitetski klinički centar Srbije, Klinika za neurologiju, Beograd, Srbija
Stojan Perić Univerzitetski klinički centar Srbije, Klinika za neurologiju, Beograd, Srbija

DOI: https://doi.org/10.5937/mp75-51539

Ključne reči: neuromišićne bolesti, gerijatrijska populacija, bolest motornog neurona, polineuropatije, mijastenija gravis, inflamatorne miopatije

Sažetak

Uvod: Iako na prvi pogled, neuromišične bolesti nisu prva asocijacija kod osoba starijeg životnog doba, rezultati dosadašnjih epidemioloških studija beleže porast incidencije stečenih imunski posredovanih neuropatija, amiotrofične lateralne skleroze (ALS), mijastenije gravis (MG), polimiozitisa (PM) i miozitisa sa inkluzionim telašcima (IBM). Imajući to u vidu, cilj ovog rada je pregled neuromišićnih bolesti kod osoba starijih od 65 godina.

Diskusija: Poznato je da incidencija ALS u svetu iznosi između 1-2/100.000 stanovnika, dok se prevalencija kreće u intervalu između 5-7/100.000 stanovnika. U populaciji osoba starije životne dobi beleži se značajan porast incidencije ovog oboljenja sa pikom oboljevanja između 70. i 80. godine života, što je registrovano i u našoj zemlji. Mijastenija gravis (MG) je heterogeno oboljenje koje se karakteriše slabošću i prekomernom zamorljivošću skeletnih mišića tokom produžene ili ponavljane aktivnosti. Poznato je da MG ima dva pika oboljevanja. Prvi pik se beleži između 20. i 29. godine života, sa češćim oboljevanjem osoba ženskog pola, dok se drugi pik registruje na uzrastu između 60. i 69. godine života sa češćom pojavom bolesti kod muškaraca. Kada govorimo o stečenim imunski posredovanim neuropatijama pokazan je trend porasta incidencije HIDP i disimunih neuropatija u gerijatrijskoj populaciji. Inflamatorne mipatije poput polimiozitisa i dermatomizitisa imaju poseban značaj jer se najčešće javljaju kod pacijenata starijih od 65 godina.

Zaključak: Iako neuromišićne bolesti ne predstavljaju prvu asocijaciju pri razmatranju diferencijalne dijagnoze neuroloških oboljenja kod pacijenata starije životne dobi, ipak se može reći da je ova grupa oboljenja često prisutna u gerijatrijskoj populaciji. Značaj ranog prepoznavanja neuromišićnih bolesti kod pacijenata starije životne dobi je veliki, imajući u vidu da se najvećim delom radi o lečivim neurološkim oboljenjima. Pravovremeno postavljanje dijagnoze i rano započinjanje adekvatnog lečenja predstavlja preduslov za povoljan tok i ishod bolesti kod ovih pacijenata.

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