Die leichte kognitive Beeinträchtigung

Zusammenfassung

Klagen über kognitive Beeinträchtigungen sind ein häufi ges Symptom in der älteren Bevölkerung und werden ent sprechend regelmäßig in der ärztlichen Sprechstunde vor getragen. In diesem Kontext bezeichnet der Begriffjeichte kognitive Beeinträchtigung” ein Syndrom mit diskreten, aber konsistent nachweisbaren kognitiven Defiziten, die je doch noch nicht den Schweregrad einer Demenz erfüllen. Epidemiologischen Studien zufolge ist die leichte kognitive Beeinträchtigung mit einem erhöhten Risiko assoziiert, in den folgenden Jahren eine manifeste Demenz zu ent wickeln. Der vorliegende Beitrag gibt eine Übersicht über aktuelle Konzeptezur Erfassung der leichten kognitiven Be einträchtigung, ihrer Verlaufsdynamik sowie assoziierten neurobiologischen Veränderungen, die auch in der Früh diagnostik einer Demenzerkrankung Relevanz besitzen. Darüber hinaus werden Hinweise für ein strukturiertes Vor gehen in der Diagnostik sowie bezüglich des therapeuti schen Managements dieses für viele Betroffenen mit ho hem Leidensdruck einhergehenden Syndroms gegeben.

Summary

Subjective complaints about cognitive deficits are a frequent symptom among the aged population. Accordingly, physicians are regularly confronted with elderly patients describing themselves as cognitively impaired. In this con text the term mild cognitive impairment (MCI) defines a syndrome with mild but persistent cognitive deficits which do not yet meet the diagnostic criteria for manifest dementia. According to epidemiological studies MCI is associated with an increased risk to develop Alzheimer’s dementia (AD) at follow up. This article reviews current concepts for the diagnosis of MCI as well as its natural course and associated neurobiological findings. The latter are also relevant to increase the sensitivity and specificity of an early (preclinical) diagnosis of AD. Furthermore, recommendations for a structured diagnostic approach and therapeutic management are given.

Schlüsselwörter

Leichte kognitive Beeinträchtigung - Alzheimer-Demenz - Konversion zur Demenz - Sekundärprävention

Keywords

Mild Cognitive Impairment - Alzheimer’s dementia - conver sion to dementia - secondary prevention

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