Vaskuläre Demenzen - Diagnostik, Prävention und Therapie

Henrike Wolf; Hermann-Josef Gertz

doi:10.1055/s-2004-828378

Psychiatrische Praxis, Table of Contents

Psychiatr Prax 2004; 31(7): 330-338
DOI: 10.1055/s-2004-828378

Übersicht

Vaskuläre Demenzen - Diagnostik, Prävention und Therapie

Vascular Dementia - Diagnosis, Prevention and TreatmentHenrike Wolf¹ , Hermann-Josef Gertz²

¹Karolinska Institutet, Neurotec, Abteilung für Klinische Geriatrie, Huddinge, Schweden
²Klinik und Poliklinik für Psychiatrie der Universität Leipzig

Die Arbeit wurde unterstützt durch das Interdisziplinäre Zentrum für klinische Forschung (Leipzig, IZKF C8). H. W. erhielt Stipendien der Gun och Bertil Stohnes Stiftelse und Demensstiftelse (Schweden)

Abstract

Zusammenfassung

Anliegen: Die vorliegende Arbeit gibt einen Überblick über aktuelle Trends auf dem Gebiet der vaskulären Demenzen (VaD). Methode: Ausgehend von Definition und Pathophysiologie der VaD werden diagnostische Ansätze und aktuelle Ergebnisse aus Studien zur Prävention und Therapie der VaD dargestellt. Ergebnisse: Erste randomisierte Interventionsstudien belegen die Wirksamkeit präventiver Strategien bei VaD. Für die medikamentöse Therapie der manifesten VaD hat bisher keine Substanz eine Zulassung erhalten. Schlussfolgerungen: Die langfristige Kontrolle vaskulärer Risikofaktoren vor dem Auftreten einer Demenz ist die wichtigste Maßnahme zur Reduzierung der Inzidenz vaskulärer Demenzen.

Abstract

Objective: In this article, current trends in diagnosis, prevention and therapy of vascular dementias (VaD) are summarized. Methods: Based on the conceptual background and pathophysiology of VaD, current diagnostic approaches and results from recent large-scale randomised preventative and therapeutic studies are reviewed. Results: Epidemiological cohort studies and first intervention trials with anithypertensive drugs demonstrated the usefulness of antihypertensive drugs in the prevention of dementia. For the treatment of manifest VaD, no pharmaceutical substance has been approved to date, despite positive results in controlled studies with acetylcholinestere inhibitors. Conclusions: Long-term control of vascular risk factors before dementia has occurred appears to be the most important strategy to reduce the incidence of VaD.

Full Text

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Dr. Henrike Wolf

Karolinska Institutet · Neurotec

Karolinska Sjukhus Huddinge, B 84

14155 Huddinge · Schweden

Email: henrike.wolf@neurotec.ki.se