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Ist die Lebensqualität von Demenzpatienten messbar?

Ein kritischer Diskussionsbeitrag

Critical observations on measuring quality of life of persons suffering from dementia

 

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Zusammenfassung

Die Forderung nach Erfassung der Lebensqualität (LQ) von Demenzpatienten wird zunehmend von Gesundheitsbehörden vorgetragen, insbesondere auch für medikamentöse Interventionsstudien [6, 70]. Von klinisch-psychiatrischer Seite hat eine kritische Diskussion über die Möglichkeiten, die LQ von Demenzpatienten zu erfassen, bisher kaum stattgefunden. Ausgehend von den spezifischen Defiziten, die das Demenzsyndrom definieren, wird analysiert, in wie weit eine demenzkranke Person zur Bewertung ihrer eigenen LQ in der Lage ist. Obwohl die subjektive Bewertung den Goldstandard der LQ-Messung darstellt [12, 56, 72], sind die Möglichkeiten von Demenzpatienten, zu einer zuverlässigen subjektiven Einschätzung der LQ zu kommen, sehr begrenzt. Beim derzeitigen Kenntnisstand scheint es sinnvoll zu sein, sich an objektiv erhebbare Daten zu halten. Die Frage der Lebensqualität von Demenzpatienten muss normativ gesellschaftlich gelöst werden und kann nicht auf subjektiven Bewertungen von kognitiv kranken Menschen beruhen.

Summary

The assessment of quality of life (QoL) in patients suffering from dementia is increasingly called for by public health authorities, particularly for pharmacological intervention studies. From a clinical point of view, until now a critical discussion about determining the QoL of dementia patients has scarcely taken place. The extent to which a demented patient may be able to assess his or her own QoL is analysed with regard to the specific deficits associated with the dementia syndrome. Although a subjective assessment represents the gold standard of Qol measurement, the capacity to provide a reliable subjective QoL estimation is limited in dementia patients. Given the present state of knowledge, it seems reasonable to adhere to objectively measurable data. The question of QoL in dementia must be solved normatively and cannot be based on the subjective assessment of cognitively impaired persons.

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Danksagung

Der vorliegende Artikel wurde unterstützt durch das Interdisziplinäre Zentrum für Klinische Forschung (IZKF), Medizinische Fakultät der Universität Leipzig.

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    H.-J. Gertz & M. Berwig

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Gertz, HJ., Berwig, M. Ist die Lebensqualität von Demenzpatienten messbar?. Nervenarzt 79, 1023–1035 (2008). https://doi.org/10.1007/s00115-008-2530-2

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