Ernährung und Demenz

Zusammenfassung

Die Anzahl von Demenzkranken in Deutschland wird im Rahmen der allgemeinen demographischen Entwicklung in den nächsten Jahrzehnten deutlich zunehmen. Eines der drängendsten Probleme in der Betreuung dieser Patienten ist das der angemessenen Ernährung in den verschiedenen Krankheitsstadien. Es geht hierbei zum einen um die Vermeidung einer frühzeitigen Mangelernährung, welche zusätzliche funktionelle Einbußen bedingen kann. Zum anderen gilt es auch, eine Übertherapie in späten Stadien der Erkrankung zu vermeiden. Demente Patienten sollten in frühen und mittleren Krankheitsstadien auf das Vorliegen einer Mangelernährung gescreent werden. Für durch eine Malnutrition gefährdete Patienten sollten in diesen Stadien inidviduelle Ernährungspläne erstellt werden. Die Einleitung einer enteralen Ernährung in fortgeschrittenen Demenzstadien sollte jeweils Folge einer sorgfältigen Einzelfallentscheidung sein.

Summary

As a consequence of the actual trends in demography the number of patients with dementia will steadily increase during the next decades. One of the most important problems in caring for these patients is to provide adequate nutrition during the different phases of this disease. On the one hand it is essential to avoid early malnutrition which may cause further functional impairment. On the other hand one is to withhold nutritional overtherapy in the final stages of dementia. Patients with dementia should be screened for malnutrition in the early and middle stages of this disease. For patients with risk of or with overt malnutrition individual nutritional plans should be provided. Enteral nutrition in advanced stages of dementia should only be untertaken after a careful and individualized analysis of the situation.

Keywords:

dementia - nutritional screening - enteral nutrition - percutaneous endoscopic gastrostomy - PEG - ethics

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