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Nervenheilkunde 2005; 24(07): 591-600
DOI: 10.1055/s-0038-1629996
DOI: 10.1055/s-0038-1629996
Originaler Artikel
Morbus Alzheimer – Diagnostik und Therapie
Alzheimer’s disease – diagnostic and therapeutic approachesFurther Information
Publication History
Publication Date:
25 January 2018 (online)
Zusammenfassung
Die Demenz vom Alzheimer-Typ (DAT) ist eine altersabhängige, häufige, neurodegenerative Erkrankung, die eine große sozioökonomische Herausforderung der Gesellschaft darstellt. Bei vorhandenen Therapieoptionen kommt der Früherkennung eine entscheidende Bedeutung zu. Diagnostisch kommt trotz viel versprechender Ansätze mit Labor- und Bildgebungsmarkern weiterhin der sorgfältigen Anamnese und einer ausführlichen neuropsychologischen Untersuchung eine wichtige Rolle zu. Therapeutisch steht eine symptomatische Therapie mit Azetylcholinesterase-Hemmern im Vordergrund, unterstützt durch Vitamin E und in mittelschweren bis schweren Stadien Memantine. Weitere mögliche auch ursächliche Ansätze werden diskutiert. Pharmakologische und im weiteren Sinne psychotherapeutische Behandlungsansätze von Verhaltensauffälligkeiten wie Agitiertheit, Psychosen, Depressionen und Insomnie sind insbesondere im Hinblick auf eine spätere Institutionalisierung von großer Bedeutung.
Summary
Alzheimer’s disease is a frequent, progressive neurodegenerative disease affecting people at older age. It has an enormous impact on socio-economic costs and therefore an early diagnosis and therapy of the disease are crucial. Besides a number of promising findings of biological and neuroimaging markers a carefully taken medical history and an extensive neuropsychological testing are still essential for diagnosis. Therapeutic options include symptomatic strategies for memory enhancement as by means of the gold standard of acetylcholinesterase inhibitors, alpha-tocopherole and memantine. Pharmacological and supportive therapy of behavioural symptoms like agitation, insomnia, depression and psychosis is decisive regarding onset and course of hospitalisation.
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