Subjektive und objektive kognitive Störung im Prädemenzstadium der Alzheimer-Krankheit

Zusammenfassung

Subjektive und objektive kognitive Störungen treten bei der Alzheimer-Erkrankung im Vorfeld der Demenz auf. Diese Beeinträchtigungen können genutzt werden, um Personen mit erhöhtem Demenzrisiko zu erkennen. Die leichte kognitive Störung (mild cognitive impairment, MCI) ist gekennzeichnet durch Beeinträchtigungen in kognitiven Tests. Insbesondere unterdurchschnittliche Leistungen in Gedächtnistests mit verzögertem Abruf sind prädiktiv für eine zukünftige Alzheimer-Demenz. Die Gedächtnisbeeinträchtigung mit der höchsten Spezifität für die Alzheimer-Erkrankung ist der Abruf unter Zuhilfenahme von Schlüsselreizen (cued recall). In jüngerer Zeit wurden die subjektiven kognitiven Störungen, die möglicherweise vor einer objektivierbaren Leistungseinbuße bei der AlzheimerErkrankung auftreten, untersucht. Zunehmend weisen Studien auf das gehäufte Vorliegen von Alzheimer-typischen Biomarkerveränderungen bei Personen mit subjektiven Gedächtnisstörungen hin. Zukünftige Standardisierung der Erfassung von subjektiven kognitiven Störungen bei älteren Menschen werden dazu beitragen, die prädiktive Rolle dieser diskreten frühen Veränderungen im Rahmen der Alzheimer-Erkrankung zu definieren.

Summary

There is increasing effort to define at-risk populations by Alzheimer’s dementia. The condition of mild cognitive impairment (MCI) is defined by cognitive impairment on standard tests and experienced cognitive decline. The amnestic subtype of mild cognitive impairment has the highest prediction accuracy for dementia. Among different memory tests the “Free and Cued Selective Reminding Test” is the most specific for Alzheimer’s disease at the pre-dementia stage (prodromal Alzheimer’s disease). Recently, increasing effort has been undertaken to characterize subjective cognitive decline as the first symptomatic manifestation of Alzheimer’s disease. There is increasing evidence that for an overrepresentation Alzheimer’s disease typical biomarker changes in elderly individuals with subjective cognitive decline. Current efforts focus on the standardization of assessment of subjective cognitive decline to elaborate its potential role as a predictor for dementia and Alzheimer’s disease.

Schlüsselwörter

Alzheimer Krankheit - subjektive kognitive Störung - leichte kognitive Störung - Demenz

Keywords

Alzheimer’s Disease - subjective cognitive decline - mild cognitive impairment - prodromal Alzheimer’s Disease - dementia

• Literatur

• 1 Amariglio RE. et al. Subjective cognitive complaints and amyloid burden in cognitively normal older individuals. Neuropsychologia 2012; 50 (12) 2880-6.
• 2 Barnes LL. et al. Memory complaints are related to Alzheimer disease pathology in older persons. Neurology 2006; 67: 1581-85.
• 3 Carrié I. et al. Recruitment strategies for preventive trials. The MAPT study (MultiDomain Alzheimer Preventive Trial). J Nutr Health Aging 2012; 16 (04) 355-9.
• 4 Dubois B. et al. Revising the definition of Alzheimer’s disease: a new lexicon. Lancet Neurol 2010; 09 (11) 1118-27.
• 5 Dubois B. et al. Research criteria for the diagnosis of Alzheimer’s disease: revising the NINCDS-ADRDA criteria. Lancet Neurol 2007; 06 (08) 734-46.
• 6 Erk S. et al. Evidence of neuronal compensation during episodic memory in subjective memory impairment. Arch Gen Psychiatry 2011; 68 (08) 845-52.
• 7 Gauthier et al. Mild cognitive impairment. Lancet 2006; 367 (9518): 1262-70.
• 8 Grober E. et al. Screening for dementia by memory testing. Neurology 1988; 38 (06) 900-3.
• 9 Jessen F. et al. Volume reduction of the entorhinal cortex in subjective memory impairment. Neurobiol Aging 2006; 27 (12) 1751-6.
• 10 Jessen F. et al. Prediction of dementia by subjective memory impairment: effects of severity and temporal association with cognitive impairment. Arch Gen Psychiatry 2010; 67 (04) 414-22.
• 11 Jessen F. et al. AD dementia risk in late MCI, in early MCI, and in subjective memory impairment. Alzheimers Dement. 2013 Jan 30; E-pub ahead of print.
• 12 Peter J. et al. Grey matter atrophy pattern in elderly with subjective memory impairment, Alzheimers Dement. 2013 in press.
• 13 Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med 2004; 256 (03) 183-94.
• 14 Saykin AJ. et al. Older adults with cognitive complaints show brain atrophy similar to that of amnestic MCI. Neurology 2006; 67 (05) 834-42.
• 15 Scheef L. et al. Glucose metabolism, gray matter structure, and memory decline in subjective memory impairment. Neurology 2012; 79 (13) 1332-9.
• 16 Sperling RA. et al. Toward defining the preclinical stages of Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 07 (03) 280-92.
• 17 Stewart R. et al. Neuroimaging correlates of subjective memory deficits in a community population. Neurology 2008; 70 (18) 1601-7.
• 18 Stewart R. et al. Longitudinal neuroimaging correlates of subjective memory impairment: 4-year prospective community study. Br J Psychiatry 2011; 198 (03) 199-205.
• 19 van Harten AC. et al. Cerebrospinal fluid Abeta42 is the best predictor of clinical progression in patients with subjective complaints. Alzheimers Dement. 2012 Dec 8; E-pub ahead of print.
• 20 Vellas B. et al. Long-term use of standardised Ginkgo biloba extract for the prevention of Alzheimer’s disease (GuidAge): a randomised placebo-controlled trial. Lancet Neurol 2012; 11 (10) 851-9.
• 21 Visser PJ. et al. Prevalence and prognostic value of CSF markers of Alzheimer’s disease pathology in patients with subjective cognitive impairment or mild cognitive impairment in the DESCRIPA study: a prospective cohort study. Lancet Neurol 2009; 08 (07) 619-27.
• 22 Wagner M. et al. Biomarker validation of a cued recall memory deficit in prodromal Alzheimer disease. Neurology 2012; 78 (06) 379-86.