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Fortschritte in der Diagnostik der Alzheimer-Demenz

Advances in the diagnostics of Alzheimer’s disease

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Zusammenfassung

Demenzerkrankungen haben vor dem Hintergrund der demographischen Entwicklung eine zunehmende medizinische wie auch sozioökonomische Bedeutung.

Der Begriff der Demenz umfasst keine einheitliche Krankheitsentität, sondern beschreibt allgemein ein klinisches Syndrom, dem ätiologisch ganz unterschiedliche Erkrankungsprozesse mit unterschiedlicher Prognose und Therapierbarkeit zugrunde liegen können. Der Differenzialdiagnostik der Demenz kommt somit eine entscheidende Rolle zu. Die Alzheimer-Erkrankung stellt die häufigste Ursache einer Demenz dar. Die aktuell gültigen diagnostischen Kriterien gemäß ICD-10 bzw. DSM-IV sind insbesondere klinisch definiert. Das Konzept der leichten kognitiven Beeinträchtigung umfasst kognitive Defizite vor Ausbildung einer manifesten Demenz. Die Alzheimer-Demenz wird somit zunehmend als späteres Erkrankungsstadium eines kontinuierlichen Krankheitsprozesses („Kontinuum-Erkrankung“) verstanden. Im Folgenden möchten wir einen Überblick über aktuelle Fortschritte in der Diagnostik bzw. der diagnostischen Kriterien der Alzheimer-Demenz sowie ihrer Vorläuferstadien geben.

Summary

Due to the demographic developments, diagnosis and treatment, dementia constitutes an increasing medical challenge and is likely to have an increasing socioeconomic impact. Dementia does not reflect a single disease but encompasses a variety of underlying conditions, heterogeneous clinical courses and therapeutic approaches, among which Alzheimer’s disease represents the most common cause. Therefore, a thorough differential diagnosis of dementia is of major importance. To date the current diagnosis of dementia according to ICD-10/DMS-IV is based on clinical criteria. In addition, the concept of mild cognitive impairment comprises early cognitive dysfunction without clinically apparent dementia. Alzheimer’s disease is more and more conceptualized as a disease continuum with mild cognitive impairment as an early and manifest dementia as the later stage of the disease. This review gives an overview on the current diagnostic approaches and the proposed revisions of diagnostic and research criteria for Alzheimer’s disease.

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Correspondence to J. Benninghoff.

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Fiedler, U., Wiltfang, J., Peters, N. et al. Fortschritte in der Diagnostik der Alzheimer-Demenz. Nervenarzt 83, 661–673 (2012). https://doi.org/10.1007/s00115-012-3486-9

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  • DOI: https://doi.org/10.1007/s00115-012-3486-9

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