Demenz und Malnutrition – vom Frühsymptom zur therapeutischen Herausforderung

Zusammenfassung

Ein häufiges Symptom von Demenzerkrankungen ist ein progressiver Gewichtsverlust. Die Ursachen des oft bereits Jahre vor Diagnosestellung der Erkrankung einsetzenden Gewichtsverlusts sind bisher nur unzureichend untersucht. Die ungünstigen Auswirkungen von Gewichtsverlust und Mangelernährung lassen sich jedoch durch eine frühzeitige und adäquate Ernährungstherapie vermeiden. Daher sollte bereits bei der ersten Diagnosestellung der Demenz gezielt nach einem vorausgegangenen Gewichtsverlust gefragt werden und ein regelmäßiges Screening des Ernährungszustands aller Demenzpatienten erfolgen. Sinnvolle Therapieansätze im Falle von Gewichtsverlust und Malnutrition sind Angehörigenberatung, Umgebungsgestaltung, Unterstützung bei der Nahrungsaufnahme, Anbieten von energiereichen Lebensmitteln, Zwischenmahlzeiten und Fingerfood, die Anreicherung der Nahrung und die Gabe von Trinksupplementen.

Abstract

Progressive weight loss is a frequent symptom in dementia. The reason for this weight loss, often preceding the onset of dementia, is not completely understood. Yet, the serious consequences of weight loss and malnutrition in dementia could be counteracted by an early detection of weight loss and an adequate therapy. Therefore, by the first diagnosis of dementia, a recent weight loss should be recognized and a regular screening of the nutritional state of all patients with dementia should be performed. Therapeutic interventions for malnutrition with a proven effect on weight loss in dementia are counselling of relatives and caregivers, optimising meal ambiance, help with oral intake, providing energy dense meals, between-meal snacks, finger-food, caloric enrichment of meals and the provision of oral nutritional supplements.

Schlüsselwörter

Demenz - enterale Ernährung - Gewichtsverlust - Malnutrition - perkutane endoskopische Gastrostomie

Keywords

dementia - enteral nutrition - weight loss - malnutrition - percutaneous endoscopic gastrostomy

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