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글 작성자 :  운영자 2006-01-30 16:25:23 | 조회 : 2467 | 추천 : 0

치매 `3多 3不' 예방법

21일은 `세계 치매의 날'의 날이다. 우리나라의 평균수명은 1939년 36세에 불과했으나 1960년에 52.4세, 2000년에는 74.0세로 크게 증가했다.
노인인구 역시 1990년에 5.1%에 불과했으나 2000년에는 7.1%로 증가했으며 2020년에는 13.2%로 추정되고 있다.
이는 과거 어느 나라에서도 볼 수 없는 빠른 속도다.

치매의 5대 증상으로는
▲기억장애 ▲언어장애 ▲방향감각 상실 ▲계산력 저하▲성격 및 감정의 변화 등이 있다.
일반적으로 가장 먼저 나타나는 증상은 기억력감퇴와 하고 싶은 언어 표현이 즉각적으로 나오지 않는 증상이다.

다음으로 방향감각이 떨어지고 계산 실수와 성격 변화 등이 나타나는데 이런 증상들이 나타나면 초기를 넘어섰을 가능성이 많다.
따라서 기억 감퇴 증상이 나타나면 일단 치매 초기를 의심하고 전문기관을 찾아야 한다.

삼성서울병원 나덕렬 교수는 "많은 사람들이 치매가 불치병이라는 생각을 가지고 있지만 이는 틀린 것"이라며 "전체 치매의 약 10~20%를 차지하는 만큼 포기해서는 안된다"고 강조했다.
치매의 공포가 고령화 사회의 현실이 되어 버린 지금, 치매 예방을 위한 평소의생활습관을 정리해 본다.

■ 치매 `3多' 예방법. 많이 읽고, 많이 씹고, 많이 걸어라.

▷ 많이 읽어라 - TV보다는 하루 1시간 이상 독서, 신문읽기가 효과적 세간에 알려진 치매예방법은 무궁무진하다. 고스톱부터 시작해 중국어 공부, 알까기 등등 무궁무진하다. 이들 모두는 결국 두뇌회전을 게을리 하지 말라는 것인데 전문가들은 무엇보다도 독서의 중요성을 강조한다.

세란병원 신경과 박지현과장은 "고스톱 같은 종합적인 지적 능력을 요구하는 놀이도 치매예방이나 노년의 기억장애를 개선하는데 도움이 되지만 하루 1시간 이상 독서를 하는 게 바둑이나 고스톱보다 치매 예방에 더 효과적"이라고 말했다.

또 글을 자주 쓰는 것도 좋은 습관이다. 실제로 편지에 구사된 단어가 다양하고풍부할수록 치매가 적다는 연구결과도 있다.

반면에 원만하지 못한 노년 부부관계나 빨래, 청소와 같은 단순 허드렛일은 오히려 치매 발병을 높이는 것으로 알려져 있다.

▷ 많이 씹어라 - 식사 때 30번씩 꼭꼭 씹어 먹어야 우리나라 치매인구의 절반 이상은 노인성 치매로 불리는 알츠하이머병이 원인이다.

이 병은 나이가 들면서 뇌세포가 급격히 죽어가는 뇌의 노화현상으로 현재로서는 예방만이 최선이다.

뇌세포의 노화를 막으려면 쉬지 않고 뇌를 자극해 주는 것이 가장 중요하다. 그렇다고 어렵게 생각할 필요는 없다. 뇌는 우리가 젓가락질을 하고 음식물을 씹는 동안에도 끊임없이 자극받고 있다. 따라서 치매를 예방하기 위해서는 일상생활의 모든 행동들을 소홀히 해서는 안 된다. 특히 노년기에 접어들수록 먹고, 씹는 행위에특별히 더 신경써야 한다.

치아 상태가 안 좋아져 음식물을 씹는 활동이 줄어든 노인들은 치매에 걸릴 확률이 높아지기 때문이다.

실제로 저작(음식을 씹는 것)이 뇌를 활성화해 치매를 줄일 수 있다는 연구가발표되기도 했다.

일본 도호쿠(東北)대 연구팀이 센다이(仙臺) 시내에 거주하는 70세 이상 노인 1천167명을 대상으로 치아상태를 조사한 결과 건강한 652명은 평균 14.9개의 치아를 보유한 반면 치매기가 있는 55명은 9.4개에 불과했다.

또 어금니를 뺀 쥐는 길을 잘 찾지 못하는 등 학습과 기억 능력이 떨어지고, 구강 한쪽으로만 씹게 한 쥐는 대뇌 좌우 신경세포 밀도에 차이가 있다는 연구 발표도있다.

세란병원 신경과 박지현 과장은 “음식물을 씹는 저작운동(씹는 행위)은 우리뇌에 신경들과 연결되어 있어 인지 기능을 높여주고 뇌혈류를 증가시킨다. 특히 이런 저작 기능의 80%이상을 어금니가 하므로 나이가 들면 어금니 관리에 특히 신경써야한다”고 말한다.

나이가 들면서 이가 불편하다는 이유로 너무 부드러운 음식만 먹는 것도 좋지않다. 씹는 기능이 약해질 뿐만 아니라 영양의 불균형이 올 수도 있다.

▷ 많이 걸어라 - 꾸준한 운동은 치매 발병 확률을 낮춘다.

치매 예방을 위해서는 독서, 게임 등 정신적인 활동 뿐 아니라 신체적인 활동도중요하다.

특히 운동은 젊었을 때부터 시작하는 게 좋다. 중년에 신체와 뇌 활동을 활발히하지 않으면 치매 걸릴 위험이 3배 정도 증가한다는 연구 결과도 있다.

미국 하버드 대학 보건대학원의 제니퍼 웨브 박사팀의 연구 결과 편안한 걸음으로 꾸준히 걷는 운동을 한 여성은 그렇지 않는 여성에 비해 뇌 인식기능이 훨씬 건강했다.

운동을 하면 치매를 일으키는 독성 단백질인 `Aβ-42'의 축적량이 감소하고 총콜레스테롤 수치도 낮아진다는 것이다.


■ 치매 `3不' 예방법.

▷ 각종 생활 습관병을 없애라 - 고혈압, 당뇨, 비만은 치매의 지름길

치매가 두렵다면 우선 혈관건강부터 점검하자. 치매의 다양한 원인 중 혈관성치매는 알츠하이머병 다음으로 흔한 질병이다.

우리나라의 경우 치매의 40%가 뇌졸중과 관련된 혈관성치매다. 혈관성치매는 뇌졸중이 반복되면서 생기거나 어느날 갑자기 증세가 나타나는데 초기부터 마비나 시각장애, 행동장애를 일으키는 특징이 있다. 하지만 평소 음식조절이나 운동 등으로혈관질환에 주의한다면 충분히 예방이 가능하다는 게 전문의들의 지적이다.

고혈압, 당뇨, 동맥경화 등으로 혈관이 제 기능을 하지 못하게 되면 혈액공급이 중단돼 뇌졸중이 일어나고 결국 뇌세포가 파괴되면서 치매 증상이 나타나는 것이다.

서울대병원 신경정신과 우종인 교수는 "상대적으로 혈관성 치매의 원인에 대한 연구는 적은 편이지만 고혈압, 당뇨, 동맥경화증, 부정맥 등의 심장질환과 뇌혈관질환 위험인자가 뇌손상을 일으키는 것으로 보인다"면서 "특히 고혈압 등 뇌혈관질환의 위험인자들은 혈관성 치매 뿐 아니라 알츠하이머병의 발병에도 영향을 미치는 것으로 보고되고 있다"고 말했다.

비만도 치매에는 치명적이다. 비만인 경우 정상체중보다 치매에 걸릴 확률이 2.5배 높아진다는 스웨덴 대학병원의 연구결과도 있다.

지방세포에서 분비되는 물질들이 혈관에 나쁜 영향을 주거나 혈관의 노화를 촉진해서 치매를 유발하기 때문이다.

그럼 이런 생활 습관병의 예방법에는 어떤 것이 있을까?

우선 운동과 식이요법은 필수이다. 혈관에 안 좋은 포화지방보다는 생선이나 야채를 충분히 섭취하는 것이 좋다. 또 유전적 내력이 있다면 검진을 통해 자신의 상태를 미리미리 체크해야한다. 무엇보다도 중년이 될 수록 늘 자신의 뱃살관리에 신경 써야 한다. 불룩하게 나온 뱃살은 각종 성인병의 지름길이다.

▷ 지나친 음주, 흡연을 피해라 - 음주와 흡연은 뇌세포를 파괴한다.

한때 흡연이 치매 예방에 좋다는 연구가 발표돼 애연가들을 흐뭇하게 한 적이 있었다. 그러나 곧 여러 실험을 통해 흡연이 혈관 및 신경세포에 악영향을 준다는게 증명됐다. 결국 흡연이 백해무익임이 다시 한번 증명된 것이다.

흡연은 기억 중추를 마비시킬 뿐 아니라 혈관에 치명적인 악영향을 준다. 흡연이 각종 혈관 질환을 일으키는 주요 원인이라는 것은 이미 많이 알려진 사실이다.

흡연의 각종 유해성분들은 고혈압, 동맥경화를 일으킨다. 또 담배의 니코틴 성분이뇌혈관을 수축시켜 뇌의 혈액순환을 막아 버린다.

흡연량이 많을수록 기억력 감퇴가 두드러진다는 보고도 있다. 특히 하루 20개비이상을 피우는 사람에게는 인지기능 저하가 더 심하게 나타난다고 한다.

과음이나 습관적인 음주도 뇌의 노화를 촉진시킨다. 습관적인 과음은 뇌세포를파괴해 알코올성 치매를 일으키게 된다. 과도한 음주는 뇌에 단기기억을 저장하는해마 뿐 아니라 전두엽이나 측두엽 부위를 손상시키기 때문이다. 물론 적당한 음주는 치매 예방에 효과적이라는 보고도 있다. 하루 1~3잔의 알코올 섭취는 치매 위험도를 절반으로 낮춰준다. 그러나 6잔 이상을 마시는 사람은 술을 전혀 마시지 않은사람에 비해서 치매 발병 위험이 1.5배 이상 증가하게 된다.

습관적인 음주로 인한 알코올성 치매는 비교적 젊은 나이인 40~50대부터 나타나기도 한다. 따라서 적당한 양을 조절하지 못할 바에는 차라리 술을 끊는 게 바람직하다.

▷ 노인성 우울증을 경계해라 - 치매와 우울증은 불가분의 관계 노인성 우울증은 노인들에게 매우 흔한 질병이지만 치매로 오해 받을 때가 많다.

실제로 치매를 의심해 병원을 찾는 노인 환자 10명 중 4명은 치매가 아닌 노인성 우울증이라는 보고도 있다.

기억력 장애나 집중력 저하 등 치매와 비슷한 증세를 보이기 때문에 `가성치매'로 불리기도 하는 노인성 치매는 적절한 시기에 치료가 이뤄진다면 비교적 회복률이높은 질환이다.

문제는 노인들의 초기 우울증 증세를 단순한 노화현상이라고 생각하고 치료시기를 놓치면 치매와 다름없는 무기력한 상태로 진행된다는 점이다. 노인성 우울증이치매의 또 다른 원인으로 작용되는 것이다.

또 치매 환자의 약 40% 정도가 우울증 증세를 함께 보이는데 이 경우에는 활동장애나 지적 장애가 더 심하게 나타난다고 한다. 물론 노인성 우울증이 치매와 함께나타날 때도 치료가 가능하다. 때문에 치매와 노인성 우울증은 처음부터 끝까지 불가분의 관계임을 명심해야 한다.

(도움말 : 삼성서울병원 신경과 나덕렬 교수, 서울대병원 신경정신과 우종인 교수, 세란병원 신경과 박지현 과장)

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건강일반(18) | 한방건강(3) | 잘못된 상식(7) | 총게시물 28건
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