Neuropsychologische Untersuchung von Patienten bei Demenzverdacht

Zusammenfassung

Eine neuropsychologische Untersuchung sollte das erste Diagnoseverfahren bei Verdacht auf eine beginnende demenzielle Erkrankung sein. Sie umfasst Anamnese, psychischen Befund und Testuntersuchung. Kurzverfahren wie der Mini- Mental-Test dienen vor allem zur Schweregradbestimmung einer bereits deutlicheren demenziellen Symptomatik, bei beginnenden Demenzerkrankungen und noch unklarer Diagnose sind aufwändigere Testserien angezeigt. Die neuropsychologische Testuntersuchung beantwortet die Frage, ob ein objektives Defizit vorliegt, identifiziert das Profil der gestörten kognitiven Leistungen, ordnet es gegebenenfalls einem Grundtyp der Demenz zu und trägt so zur Differenzialdiagnose bei. Neben Demenzerkrankungen ist auch die Diagnose einer “leichten kognitiven Beeinträchtigung” von Bedeutung, die vielfach das Vorlaufstadium von Demenzen darstellt, vor allem in Hinblick auf die erhoffte künftige Verfügbarkeit von Medikamenten, die die Progression dieser Erkrankungen verlangsamen.

Summary

A neuropsychological examination should be the first step when a dementing illness is suspected. It encompasses history taking, psychological assessment and testing. Screening tests like the Mini-MentalStatus-Examination are mainly useful for the staging of established dementias, while the work-up of early and unclear cases requiresa more elaborate series of tests. The neuropsychological examination confirms or excludes the presence of an objective cognitive deficit, identifies the profile of impaired and preserved abilities, assigns it to one of several types of dementia and thereby assists in the making ofa diagnosis. The diagnosis of mild cognitive impairment, frequentlya prodrome of dementia, is equally important, namely with regard to the expected future availability of disease-modifying drugs.

Schlüsselwörter

Demenz - Neuropsychologie - Diagnostik

Keywords

Dementia - neuropsychology - diagnostic

• Literatur

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