Thayssen Günther, Püschel Klaus
Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
Institut für Rechtsmedizin, Universitätsklinik Hamburg-Eppendorf, Hamburg, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2024 Aug;67(8):890-895. doi: 10.1007/s00103-024-03920-7. Epub 2024 Jul 16.
Neurology deals with organic diseases of the muscles, the peripheral nerves of the trunk and extremities, and the central nervous system (spinal cord, brain, stem, cerebellum, and cerebrum). Diseases that lead to dysfunction of these structures can cause both physical and cognitive problems. Therefore, neurological diseases can particularly impair personal mobility through both physical limitations and cognitive deficits. Many of the diseases show a significant increase in frequency with age.Physical impairments in mobility primarily manifest as gait disorders. These are found to a relevant extent in two-thirds of people older than 80 years of age and are a common cause of falls, often with considerable sequelae. Driving a car can have negative effects, for example, on reaction speed, braking power, and looking over the shoulder. Parkinson's disease as well as paralysis and sensory disorders in the context of polyneuropathies can be responsible for this.Driving a car is an obvious compensatory mechanism with respect to impaired walking ability. However, the cause of many diseases that affect the fitness to walk lies in the central nervous system, often in the area of the cerebrum. Consequently, cognitive deficits manifest themselves in addition to physical ones, which further restrict mobility through the loss of the fitness to drive. Neurological diseases typical of old age that limit mobility in this way include Parkinson's disease and circulatory disorders of the brain. In addition, epileptic seizures occur more frequently in old age as a symptom of other diseases.
神经病学研究肌肉、躯干和四肢的周围神经以及中枢神经系统(脊髓、脑、脑干、小脑和大脑)的器质性疾病。导致这些结构功能障碍的疾病可引起身体和认知问题。因此,神经疾病可通过身体限制和认知缺陷特别损害个人活动能力。许多这类疾病的发病率随年龄增长显著增加。
活动能力方面的身体损伤主要表现为步态障碍。在80岁以上的人群中,三分之二的人在相当程度上存在这种情况,并且是跌倒的常见原因,往往会带来相当严重的后果。驾驶汽车可能会对反应速度、刹车能力和转头查看等方面产生负面影响。帕金森病以及多发性神经病背景下的瘫痪和感觉障碍都可能导致这种情况。
驾驶汽车是行走能力受损后的一种明显代偿机制。然而,许多影响行走能力的疾病病因在于中枢神经系统,通常在大脑区域。因此,除了身体缺陷外还会出现认知缺陷,这通过丧失驾驶能力进一步限制了活动能力。以这种方式限制活动能力的典型老年神经疾病包括帕金森病和脑部循环障碍。此外,癫痫发作在老年时作为其他疾病的症状更为频繁地出现。