توقف عن التدخين ومارس الرياضة .. كيف تحمي نفسك من الخرف؟
أتفق بشكل كبير مع القواعد الارشادية الأولى الصادرة عن منظمة الصحة العالمية بشأن الحد من مخاطر داء الخرف. وتجمع منظمة الصحة العالمية بين أفضل خبراء الصحة في العالم حيث تصدر مواد مرجعية عالمية، وأنا لديَّ ثقة كبيرة في آراء ونصائح خبراء الصحة بالمنظمة. وقد تم مؤخرًا نشر المنظمة لتوصيات هؤلاء الخبراء في تقرير صدر بعنوان: “الحد من مخاطر التدهور الإدراكي والخرف: إرشادات منظمة الصحة العالمية”. منظمة الصحة العالمية، 2019. (ترخيص رقم: CC BY-NC-SA 3.0 IGO). ويستعرض هذا التقرير توصيات مفيدة للغاية لتقليل خطر الإصابة بداء الخرف، الذي يُعَدُ السبب الرئيسي الخامس للوفاة في العالم.
ففي كل عام، تُكتشف ما يقرب من 10 ملايين حالة خرف جديدة، وقد حذرت منظمة الصحة العالمية من أنه من المتوقع أن يتضاعف عدد المصابين بهذا الاضطراب ثلاث مرات على مدار الثلاثين عامًا القادمة، ويؤدي الخرف إلى تدهور في ذاكرة الإنسان وتفكيره وسلوكه وقدرته على أداء الأنشطة اليومية، حيث يوجد أكثر من 50 نوعًا منه، ويعد مرض الزهايمر الأكثر شيوعًا إلى حد بعيد من بين هذه الأنواع العديدة.
ويُمثل التقدم في العمر أهم عوامل الخطر فيما يتعلق بتراجع القدرات المعرفية والإدراكية، على الرغم من أن الخرف لا يُعد نتيجة طبيعية أو حتمية للشيخوخة، في حين أن العوامل الوراثية يمكن أن تلعب دورا طفيفًا في بعض حالات الخرف، وعلى الرغم من عدم وجود علاج فعال لداء الخرف الذي يصيب نحو 5٪ من سكان العالم ممن تزيد أعمارهم عن 65 عامًا، وتصل نسبة الإصابة به إلى 25٪ بين من تخطوا سن 85 عامًا، إلا أن هناك العديد من الأشياء التي يمكننا القيام بها لتأخير أو إبطاء ظهور وتطور هذا المرض.
ممارسة التمارين الرياضية: بحد أدنى 150 دقيقة من النشاط البدني، أو 75 دقيقة على الأقل من النشاط ذات الوتيرة العالية أسبوعيًا (أو مزيج من الاثنين).
التوقف عن التدخين: يزيد التدخين من خطر التدهور المعرفي والإدراكي والإصابة لاحقًا بالخرف، إضافة إلى مشكلات صحية أخرى.
اتباع نظام غذائي جيد: ينصح باتباع نظام غذائي وهو حمية البحر الأبيض المتوسط، التي تتألف من كمية كبيرة من الحبوب والفواكه والأسماك والبقوليات والخضراوات، ويُنصح بتناول القليل من اللحوم أو منتجات الألبان. ويذكر التقرير بأنه لا توجد فائدة مثبتة فيما يتعلق بالحد من خطر الإصابة بالخرف نتيجة لتناول المكملات الغذائية مثل فيتامين (ب) أو (هـ).
تجنب تناول المشروبات الكحولية بكميات كبيرة: يزيد تناول الكحول بشكل مفرط من خطر التدهور الإدراكي أو الإصابة بالخرف أو الاثنان معا.
العمل على تدريب المخ: يمكن من خلال ممارسة ألعاب الطاولة والكلمات المتقاطعة أن نقلل من خطر التدهور الإدراكي أو الخرف أو كليهما.
تقوية العلاقات الاجتماعية: ترتبط المشاركة الاجتماعية والدعم الاجتماعي بشكل قوي بالصحة الجيدة للإنسان وشعوره بالعافية.
المحافظة على الوزن: تشير الدراسات إلى أن السمنة في منتصف العمر تزيد من خطر الإصابة بالخرف.
فحص ضغط الدم: لوحظ أن هناك نمطًا من ارتفاع ضغط الدم خلال سنوات منتصف العمر يتبعه انخفاض سريع في ضغط الدم في وقت لاحق من الحياة لدى الأفراد الذين سيصابون بالخرف.
فحص السكري: هناك ارتباط بين الإصابة بداء السكري في وقت متأخر من العمر وزيادة خطر الإصابة بالخرف، لذا، عليك بإجراء فحوصات السكري مرة واحدة سنويًا على الأقل.
فحص الكوليسترول: ثبت من خلال عدد من الدراسات في علم الوبائيات وجود علاقة وثيقة بين مستويات الكوليسترول المرتفعة وبداية الخرف.
العلاج في حالة الإصابة بالاكتئاب: هناك أدلة جوهرية تربط بين الاكتئاب والتدهور الإدراكي والمعرفي والخرف.
فحص السمع: يرتبط فقدان السمع بتزايد خطر التدهور المعرفي أو الإصابة بالخرف أو الاثنان معا.
يقدم التقرير الصادر عن منظمة الصحة العالمية معلومات قيّمة للغاية في هذا الصدد على الرغم من أنني لا أتفق معهم كليًا في الرأي حول المكملات الغذائية، حيث تعتقد منظمة الصحة العالمية أن فيتاميني (ب) و(هـ) ليس لهما فائدة مثبتة فيما يتعلق بالخرف، ومع ذلك، فقد أظهرت دراسات موثقة بشكل جيد أن فيتامين (هـ) هو جزيء مضاد للأكسدة قوي للغاية يمكنه حماية الخلايا والأنسجة من التلف. لذلك وبشكل عام، توفر مضادات الأكسدة الحماية من الأمراض المزمنة، بما في ذلك الأمراض العصبية التنكسية. وأعتقد بأنه طالما أننا نستخدم المنتجات الطبيعية، فإن تناول مضادات الأكسدة سيكون مفيدًا لصحتنا.
على الرغم من عدم إشارة تقرير منظمة الصحة العالمية للتأثير البيئي، فمن المهم مراعاة التأثير المدمر الذي يمكن أن تلعبه البيئة فيما يتعلق بصحة الإنسان والأمراض التي تصيبه. وقد أوضح تقرير آخر صادر عن منظمة الصحة العالمية بعنوان “أدوات الصحة والبيئة لاتخاذ القرارات الفعالة”، أن بعض العوامل البيئية تمثل سببًا أساسيًا للكثير من حالات الوفاة والإصابة بالأمراض والعجز على الصعيد العالمي عامة وفي البلدان النامية خاصة. وتتراوح هذه العوامل البيئية بين رداءة المياه وضعف سبل الوصول إليها، والأمراض التي تنقلها الحشرات، وتلوث الهواء، مرورًا بالتعرض للمواد الكيميائية السامة كالمبيدات الحشرية، وتغير المناخ، انتهاء بتدني مستوى البيئات الحضرية.
مواقع التواصل وقد ورد في هذا التقرير أن العديد من هذه الوفيات يمكن تجنبها، وأن الكثير من هذه الأمراض يمكن الوقاية منها. وتوثق الدراسات الوبائية بشكل جيد أن التعرض للعوامل البيئية السامة يمكن أن يؤدي إلى اضطرابات عصبية. كما يشكل الحد من التعرض حيزًا مهمًا للوقاية من الاضطرابات العصبية. لذا، فإنني أؤيد تمامًا التوصيات الواردة بالتقرير حول ضرورة ترجمة قاعدة المعرفة العالمية حول الروابط البيئية والصحية إلى أدوات وإجراءات تطبيقية ضمن عملية صناعة السياسات على المستويات الوطنية والإقليمية والعالمية، مع دمج الاعتبارات الصحية والبيئية في القرارات الاجتماعية والاقتصادية والسياسية.
نحن في معهد قطر لبحوث الطب الحيوي، التابع لجامعة حمد بن خليفة، عضو مؤسسة قطر، نولي أهمية كبيرة لإجراء البحوث المتعلقة بداء الخرف، إضافة إلى أمراض أخرى. ويتعاون معهد قطر لبحوث الطب الحيوي مع جامعة وايل كورنيل للطب – قطر، ومؤسسة حمد الطبية، في دراسة للتعرف محليًا على طبيعة داء الخرف. علاوة على ذلك، يكمن جانب مهم من هذا التعاون في تحديد العلامات الحيوية التي تم اكتشافها مؤخرا للمساعدة في التشخيص المبكر والتنبؤ بالإصابة بمرض الزهايمر. ووفقًا لتقديرات الأمم المتحدة، فإن أكثر من 400,4 شخص فوق سن 60 عامًا في قطر مصابون بداء الخرف.
ونفتخر في معهد قطر لبحوث الطب الحيوي للغاية بمركز بحوث الاضطرابات العصبية لدينا، والذي لعب دورًا كبيرًا في إرساء المعهد كمؤسسة ريادية إقليمية تعمل على الأبحاث المتعلقة بالخرف. إضافة إلى ذلك، يتعلق جانب مهم من عملنا بتحديد المؤشرات الحيوية الجديدة للمساعدة في تشخيص الاضطرابات العصبية النمائية مثل التوحد والأمراض العصبية التنكسية مثل باركنسون وكيفية التكهن بها.
أطلقت وزارة الصحة العامة خطة قطر الوطنية للخرف في العام الماضي، وتحدد الخطة سبعة مجالات عمل تتناول محاور تتعلق برعاية مرضى الخرف سيكون لها التأثير الأكبر على تحسين جودة الرعاية المقدمة لمرضى الخرف وتجربتهم العلاجية.
وتمثل الخطة خطوة أولى على طريق تحقيق الهدف الوطني لأولوية شيخوخة صحية ضمن الاستراتيجية الصحية الوطنية 2018-2022 التي تتمثل في السعي إلى “زيادة سنوات العمر الصحية للسكان فوق 65 عامًا بمقدار سنة واحدة”. كما تحدد الخطة رؤية قطر نحو تطوير وتوسيع الخدمات المقدمة في المستقبل للأشخاص الذين يعانون من الخرف.
أؤمن أن أفضل علاج لأي مرض هو الوقاية منه، ونحن في معهد قطر لبحوث الطب الحيوي، نوصي بتوفير استراتيجية جديدة للطب الوقائي على مستوى دولة قطر والمنطقة. ونحتاج في هذا الشأن إلى زيادة الوعي العام والتواصل مع المدارس والأسر، حيث يمثل الغذاء نقطة البداية نحو اتباع نمط حياة صحي، ولذلك نحن بحاجة إلى تشجيع الجميع على تبني أنماط حياتية صحية.
ولا يعني اتباع نظام غذائي صحي ببساطة تقليل كمية الأطعمة الدهنية والكربوهيدراتية التي نتناولها، إنما نحن بحاجة أيضًا إلى الحصول على ما يكفينا من العناصر الغذائية المهمة، كما يجب أن نتجنب المشروبات الكحولية والتدخين بكل أنواعه، كما نحتاج أيضًا إلى بذل كل ما في وسعنا لاتباع نمط حياة صحي، وهذا يعني أنه بالإضافة إلى تناول الغذاء بشكل جيد، يجب علينا ممارسة الرياضة، وتجنب الأطعمة والمواد الضارة، والحصول على قسط كافٍ من النوم، وتجنب التوتر والضغط العصبي.
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