Hukama pakati pemitambo nekuchembera haisi fashoni ichangoburwa: mutsara wehutano hweveruzhinji uyo wakatsikiswa neWHO. Makumi eKukwegura Kweutano (2020-2030)Mumamiriro ezvinhu ekuchinja kwedemographic uye epidemiological, senge yeSpain - ine tarisiro yehupenyu yakanyanya - kugara uchishanda haingofungidzirwe chete, inzira chaiyo yekuchengetedza kuzvitonga uye kunaka kwehupenyu mukukwegura.
Pane kuva nengozi, kurovedza muviri nguva dzose ndiko yakachengeteka kune vese vane hutano uye vasina simba vanhu vakura kana ichienderana nekugona kwavo kushanda. Uyezve, kuzviita muboka, nerutsigiro kubva kune vezera uye varairidzi, kunowedzera kukurudzira uye kutevedzera. Muchikamu chino, tinounganidza mabhenefiti emuviri uye ekuziva, data rakakosha, njodzi dzehupenyu hwekugara uye mazano anoshanda zvichibva pamirayiridzo uye zvidzidzo, kuitira kuti munhu akura wega wega awane nzira yavo yekuchembera.
Zvenyama, zvemanzwiro uye nekuziva mabhenefiti ekurovedza muviri muvakuru vakuru
Kuita kurovedza muviri nguva dzose kunoshandura kuita akawanda mabhenefiti: zvinobatsira ku chengetedza uye uwedzere simba kuchengetedza rusununguko, kupa simba rehupenyu hwezuva nezuva uye kuderedza kuneta, kuvandudza kuenzana uye kuderedza dambudziko rekudonha uye kukuvara kwakabatana.
Kubva pakuona kwekliniki, kufamba nguva dzose kunobatsira kudzivirira nekudzora zvirwere zvinowanzoitika pakukwegura: hosha yemwoyo, sitiroko, chirwere cheshuga chorudzi rwechipiri, osteoporosis, uye marudzi akawanda ekenza (kusanganisira zamu necolon). Inokurudzirawo kurara zviri nani, inoderedza kushushikana uye kufunganya, inogadzirisa uremu hwemuviri, uye inochengetedza blood pressure munzvimbo dzine hutano.
Mhedzisiro yacho haina kuganhurirwa kumuviri. Uchapupu hunoratidza kuvandudzwa kwe mafungiro uye kuderedza zviratidzo zvekuora mwoyoKuita maekisesaizi neshamwari kunopa tsigiro yemanzwiro uye kunosimbisa pfungwa yekudzora. Izvo zvakaonekwawo kuti zvibatsire mabasa ekuziva senge kushandura mabasa nekukurumidza, kuronga zviitiko, uye kuregeredza ruzivo rusina basa.
Chinhu chakakosha chepuzzle chekuziva chinobva kuRush Alzheimer's Disease Center (Memory and Aging Project): mazinga epamusoro ekuita zvemazuva ese anobatanidzwa huwandu hukuru uye kushanda kuri nani kwe synaptic proteins muuropi, izvo zvinodzivirira hutano hwehuropi uye kugona kwekuziva. Complementary kiriniki miedzo inosimbisa kuti kurovedza muviri zvine mwero kunogona kuvandudza cognition uye kwakabatana nekuwedzera cortical ukobvu, nguva dzose ne caveat iyo. kutsungirira nokufamba kwenguva rinosarudza.
Muvanhu vakwegura, kurovedza muviri kunogona kuwedzera marwadzo anoonekwa (exercise-induced hypoalgesia). A 12-vhiki multicomponent chirongwa chakaratidza a kuwedzera kudzvinyirira kurwadziwa chikumbaridzo mu trapezius uye zvigunwe, pamwe nekuderera kwe diastolic pressure uye fragility, uye kuvandudzwa kwebasa kuyerwa neBarthel Index.
Nezvekurara, zvirongwa zvekurovedza muviri zvinowanzoita kuderedza hypersomnia Uye, kunyangwe paine mhedzisiro yekuda kuziva pamhando yekurara mune mamwe masampuli (nekuzvitaura), muviri wehumbowo unonongedza kune zvinobatsira pakuzorora kana kurovedza muviri kuchichengetedzwa nekufamba kwenguva.
Chikamu chemagariro chinowedzerawo: basa reboka rinokurudzira kubatanidzwa kwevanhu uye kugara zvakanaka mupfungwaZvirongwa zvenharaunda uye masangano akaita seYMCA anopa humbowo-hwakavakirwa boka zvirongwa zvekuvandudza kusimba, kuenzanisa, uye kudzivirira kudonha, vachiwedzera iyo tsigiro yerutsigiro inobatsira kuchengetedza maitiro.
- Resistance mabasa akadai kufamba, kuchovha bhasikoro kana kutamba Vanosimudza kurova kwemwoyo uye kusunungura zvinhu zvinovandudza mafungiro.
- Miitiro yemuviri-pfungwa yakadai se yoga uye tai chi Ivo vanosanganisa zvimiro, kufema uye kuzorora nezvakanaka mukuenzanisa uye kugadzikana.
- Sarudza zviitiko zvaunofarira (kurima bindu, tenisi, kutamba nevazukuru): kutevedza inovandudza kana basa racho richinakidza.
Njodzi dzehupenyu hwekugara uye maitiro ekudzidzira mitambo zvakachengeteka
Kusaita muviri chinhu chikuru chine njodzi: avo vasingafambi zvakakwana vane a 20% -30% njodzi yepamusoro yekufa kupfuura vanhu vanoshingaira zvakakwana. Muvanhu vakuru, mararamiro ekugara akabatanidzwa nehuwandu hwekufa kubva kune zvose zvinokonzera uye kubva kune kenza kana chirwere chemwoyo, pamwe chete nehuwandu hwehuwandu hwechirwere cheshuga chechipiri uye chirwere chemwoyo.
Kuita maekisesaizi kwakachengeteka muzviitiko zvakawanda, asi ipfungwa yakanaka kuongorora contraindications. Usati watanga chirongwa, bvunza chiremba wako, kunyanya kana uine nhoroondo ye Chirwere chemoyo chevalvular chakakomba, kutadza kwemoyo, angina isina kugadzikana, infarction ichangobva kuitika, embolism ichangoburwa, kusadzora arrhythmias, acute kutapukira, hypertension isingadzoreki (> 180/> 110 mmHg), myocarditis, pericarditis, inoshanda kana ichangoburwa endocarditis, aortic dissection, malignant ventricular arrhythmia. kana chirwere cheshuga chisingadzoreki, kana kuti wakavhiyiwa mumwedzi mitatu yapfuura.
Pamusoro pekugadzirisa kusimba (kudzivisa kuedza padhuze nepamusoro uye kuisa pamberi pakati nepakati), chengetedza nharaunda: kugadzirisa imba yako kudzivirira kudonha kunoita mutsauko. Kune vakwegura vanoshandisa hypnotics, kuvaongorora nachiremba wavo vachitevera maitiro akakodzera kunogona kuita kuti kurovedza muviri kubudirire. yakachengeteka uye inoshandaUye yeuka: rutsigiro kubva kuboka uye nyanzvi dzinokwanisa dzinowedzera kutevedzera.
Mamwe madhairekitori anoshanda anoratidza kuti, kubva pazera re65, chiitiko chinofanira kuitwa ne simba riri pakati nepakati kana rakaderera uye pasina kusvika pakuedza kwakasimba. Neshangu dzakanaka, hydration, kufambira mberi zvishoma nezvishoma, uye kuzorora kwakakwana, njodzi yezviitiko inoderera zvakanyanya.
Kurudziro, zvirongwa zvinoshanda, uye izvo humbowo hunotaura
Nhungamiro dzeWHO dzinokurudzira zvishoma Maminitsi 150 ekuita zvine mwero pasvondo (kana maminetsi makumi manomwe neshanu ekurovedza muviri kwakanyanya), kuwedzera maekisesaizi ekusimbisa tsandanyama mazuva maviri pasvondo uye kuderedza nguva yekugara. Kune avo vasingasvitse izvi zvishoma, chero kuwedzera kunokosha: basa rese rine basa.
Mukuita, kusanganisa zvikamu zvinokunda: kutsungirira, simba, kuenzanisa, uye kuchinjika. Multi-component kudzidziswa kwakaratidza kuti inonyanya kushanda muvakuru vakuru kune kudzivirira sarcopenia, kushanda uye kuenzanisa kugadzirisa, and the modulation of inflammatory process zvine chekuita nemarwadzo.
Chiyereso chirongwa che "Vivifrail", chinoronga zvirongwa muzvikamu zvitatu: kudziyisa (≈20 min) nekufamba uye basa rakareruka remoyo; kusimbisa (≈20 min) iyo inofambira mberi maererano nemamiriro ezvinhu; uye kuzorora (≈10 min) ne flexibility and balance exercises. Iyo inochinjika nehuwandu hwekushanda uye njodzi yekudonha, uye kunyange ine zvishandiso zve kuongororwa uye kunyorerwa kutsanya.
Inoshandiswa muboka uye inotungamirwa neve physiotherapists, chirongwa che12-vhiki (zvikamu zviviri / vhiki, 60 maminetsi) yakagadziridza misiyano mikuru muvasati vasina kusimba uye vanozvimirira vakwegura: yakadzikira diastolic pressure, fragility shoma uye kushanda kukuru (Barthel Index). Kudzvinyirira marwadzo zvikumbaridzo mu trapezius neminwe yakawedzera; maererano nehupenyu hwehupenyu (GENCAT), hutano hwepfungwa, kukura kwemunhu, hutano hwemuviri, kuzvisarudzira, kodzero, uye kubatanidzwa kwevanhu kunovandudzwa. Paive neshanduko dzakanaka mu hypersomnia uye mhedzisiro inokatyamadza mumhando yekurara (self-report), iyo inokoka kumwe kutsvagisa. Sezvakaita chero chidzidzo chehupenyu chaihwo, pakanga paine zvisingakwanisi (diki saizi yemuenzaniso, hukuru hwevakadzi, hapana boka rekutonga, uye low adhesion), asi muenzaniso wakajeka: multi-component inoshanda.
Gait kumhanya-chiratidzo chine simba chekiriniki-inowanzo kuvandudza nekupindira uku uye yakabatanidzwa nayo hupenyu hurefu uye kuderera kwechiitiko kuremara muhuwandu hwevanhu.
Kupfuura purogiramu imwe chete, zvidzidzo zvepasi rose tsigira kubatana pakati pekurovedza muviri uye kugona kwekuziva muvakuru vakura, mune vanhu vasina kukanganisa uye vane MCI kana dementia, munharaunda uye masangano, ane mapuroteni anogara 1 kusvika 12 mwedzi uye mafambisirwo e1 kusvika ku5 masesheni / vhiki:
- France (Albinet et al.): aerobic exercise uye kutambanudza (3 / vhiki, 60 min, 3 mwedzi; 65-78 makore pasina kukanganisa). Kuvandudzwa kwemabasa makuru akaongororwa nemabasa akadai seWCST.
- USA (Anderson-Hanley, Barcelos, Barella, Barnes, Smiley-Oyen, Ruscheweyh, Williamson): kuchovha bhasikoro pamwe uye pasina kukurudzirwa kwepfungwa, kufamba, kusanganiswa kwekurovedza muviri uye mabasa ekuziva, uye kuenzanisa nekutambanudza kana dzidzo. Shanduko mundangariro, kutarisisa, kumhanya kwekugadzirisa, uye mabasa makuru (ADAS, RAVLT, Stroop, DSST, TMT), ine mabhenefiti emuviri akayerwa nemiedzo yakadai seSenior Fitness Test, SPPB, uye kumhanya kwekufamba.
- Spain (Kanzura): Zuva rega rega rakamira bhasikoro rinoshandiswa muvarwere vane masangano ane dementia (15 min kwemavhiki gumi nemashanu). Migumisiro pakuziva basa (MMSE, FOME) uye kufamba (TUG).
- Japan (Cheng, Maki, Nouchi, Satoh, Suzuki): Tai Chi, kufamba nekuyeuka kudzidziswa, aerobics nemimhanzi therapy uye mapurogiramu akabatanidzwa; kuvandudzwa kwakaonekwa mukati ndangariro inonzwisisika, kutarisisa, mabasa makuru uye kushanda kwemuviri (BBS, TUG, simba rechibhakera, kukurumidza kufamba).
- Brazil (Christofoletti, Nascimento): Kurovedzera muviri kunopesana nekutonga muMCI kana dementia yemasangano. Migumisiro mucognition (MMSE, MoCA) uye chiyero (BBS).
- Sweden neIreland/Italy (Eggenberger, Forte): mitambo yemavhidhiyo yekutamba, kufamba mundangariro, uye kurongeka/kugona. Kuvandudzwa mukutonga kwekutonga, kukurumidza kufamba, uye simba remhasuru.
- Germany (Klusmann): Kuenzanisa kosi yekombuta nekurovedza muviri kunoratidza kubatsirwa zvinokonzerwa nekuita zvemuviri muvakadzi vane makore 70-93 makore.
- China (Lam)Yakasanganiswa yemuviri, yekuziva, uye yemagariro chiitiko kupindira muMCI inoratidza zvakanaka mhedzisiro paMMSE, ADAS-Cog, uye mashandiro (DAD-IADL). Mune varwere vane masangano, tai chi versus kutambanudza / kuramba kunopa ruzivo rwekuziva.
- Australia (Lautenschlager): Kudzidzira kweAerobic mu ≥50 makore (ane uye pasina MCI) nekuvandudzwa muADAS-cog uye maitiro ekuita basa (CHAMPS).
- Netherlands neFinland (van Uffelen, Prick, Kivipelto): mafambiro ari pakati nepakati, zvirongwa zvakasiyana-siyana (kurovedza muviri, kudya, kukurudzira kwekuziva, kutungamira kwemoyo) uye psychoeducational protocol inoratidza mabhenefiti pakuziva uye basa remuviri.
WHO yepasi rose data inoenderana nekukurumidzira: iyo 31% yevakuru uye 80% yevachiri kuyaruka havakwanise kuita zvinokurudzirwa mazinga. Chinangwa chepasi rose ndechekuderedza kusaita ne10% ne2025 uye 15% ne2030 (ichienzaniswa ne2010). Kutadza kuita chinhu kunofungidzirwa kuti kunodhura 300.000 bhiriyoni USD (≈27.000 gore negore) pakati pe2020 ne2030 yehutano hwehutano.
Maitiro anoratidzawo 5 muzana yekuwedzera kwekusaita zvichienzaniswa ne2010 uye misiyano nebonde (vakadzi vari paavhareji 5 muzana mapoinzi mashoma ekushanda) uye zera: Mushure memakore makumi matanhatu, basa rinowira mose muvakomana nevasikana. Chikamu che81% chevechiri kuyaruka vane makore gumi nerimwe kusvika gumi nemanomwe vari pazasi pezvisungo, vasikana (85%) vane mwero wakaderera wekuita pane vakomana (78%).
Chii chingaitwa nenyika nemaguta? WHO Global Action Plan inokurudzira mitemo yekusimudzira kushingaira kuenda (netsoka, bhasikoro), kuwedzera mikana muzvikoro, mabasa, kuchengetwa kwevana, uye utano, uye kuvhura mukana kumitambo yakakurumbira nenzvimbo dzakachengeteka dzeveruzhinji. Zvinoda kurongeka kwepakati (hutano, zvekufambisa, dzidzo, basa, mitambo, varaidzo, uye kuronga kwemadhorobha) uye kudyidzana kwenzvimbo kunoisa pamberi kudzikisira kusaenzana mukuwana.
- Mhinduro yeWHO inosanganisira: uchapupu-based based guidelines; kutsigira mutemo national; ruzivo-kusimudza uye kuongorora kwehupfumi; zvishandiso zvehunyanzvi uye kudzidziswa; alliance coordination; uye kufambira mberi kwekutevera kuna 2030.
Mazano anoshanda ehupenyu hwezuva nezuva: sanganisa chiitiko mukufamba kwako (famba, simuka imwe nguva yakamira nekukurumidza, shandisa masitepisi), putsa mararamiro ekugara Kusimuka kwemaminetsi 1-3 awa yega, tanga nekudzikama uye kufambira mberi, pfeka shangu dzakakodzera uye ugovane maitiro ako nemumwe munhu (kambani inowedzera chishuwo).
Zviitiko zvemunharaunda iancho yakanaka. Mumwe muenzaniso ndewe Amavir's Golden Mile muAlcorcón, nhangemutange yemhemberero ine zvikamu zvakagadziridzwa (vanhu vakwegura vari muwiricheya, vanhu vane vanofamba, nhengo dzemhuri, vashandi, vavakidzani, vana), iyo inoitika mangwanani uye inounza pamwe mazana evatori vechikamu pamusoro pekuita basa rekuita uye kushamwaridzana.
Kana iwe uchitsvaga zviwanikwa, masangano akadai se YMCA Vane zvirongwa zveboka zvevakuru zvinotsigirwa nehumbowo, uye masangano akadai se CDC uye iyo NIA/NIH pachayo inopa ruzivo rwakavimbika uye rwechizvino-zvino kuitira kuti sarudzo yako yekufamba igare yakatsigirwa.
Kuita maekisesaizi nguva dzose, pakusimba chaiko uye nezvikamu zvekutsungirira, simba, kuenzanisa, uye kuchinjika, ndiko kudyara kwakanakisa: inoderedza fragility uye diastolic pressure, inovandudza kushanda, mararamiro ehupenyu, uye mamwe maitiro ekurara uye kurwadziwa, asi kuwedzera hutano hwehuropi. Nerutsigiro rwekugarisana, zvirongwa zvakanyatsogadzirwa, uye sarudzo diki dzezuva nezuva dzekufamba zvakanyanya, kurovedza muviri kunova shamwari yechokwadi yekukwegura nekuzvimiririra kukuru uye kugara zvakanaka.
