Subscribe to RSS
DOI: 10.1055/s-0043-113619
Fortschritte in der Demenztherapie – Was ist bereits praxisrelevant?
Therapy of Dementia: State of the ArtPublication History
Publication Date:
04 May 2018 (online)
Abstract
Due to the aging population, dementias represent a growing challenge for the health systems and for the society. This overview summarizes the current state of already practice-relevant therapies and management of dementias. Non-pharmacological approaches have a greater impact than pharmacological treatment. Increasing evidence underlines that consistent management of cardiovascular risk factors has beneficial effects on the progression of at least some, possibly almost all types of dementias. The main pharmacological agents for symptomatic treatment of cognitive deficits in Alzheimer’s and Parkinson’s disease-associated dementias are cholinesterase inhibitors and memantine. In most other dementias, no specific pharmacological treatment is currently available. There is an urgent need for further research on the effective management of dementias.
Aufgrund der demografischen Entwicklung nimmt die Bedeutung der Demenz für Gesundheitssystem und Gesellschaft immer weiter zu. Bei den meisten Demenzerkrankungen ist derzeit aber keine spezifische pharmakologische Behandlung verfügbar. Dafür geben Studien Hinweise, dass die konsequente Therapie und Einstellung von kardiovaskulären Risikofaktoren das Fortschreiten verschiedener Demenzformen verlangsamen kann.
-
Literatur
- 1 Deschaintre Y, Richard F, Leys D. et al. Treatment of vascular risk factors is associated with slower decline in Alzheimer disease. Neurology 2009; 73: 674-680
- 2 Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet 2014; 383: 911-922
- 3 Zhu XC, Yu Y, Waang HF. et al. Physiotherapy intervention in Alzheimer’s disease: systematic review and meta-analysis. J Alzheimers Dis 2015; 44: 163-174
- 4 Denkinger MD, Nikolaus T, Denkinger C. et al. Physical activity for the prevention of cognitive decline: current evidence from observational and controlled studies. Z Gerontol Geriatr 2012; 45: 11-16
- 5 Cass SP. Alzheimer’s Disease and Exercise: A Literature Review. Curr Sports Med Rep 2017; 16: 19-22
- 6 Smallfield S, Heckenlaible C. Effectiveness of Occupational Therapy Interventions to Enhance Occupational Performance for Adults With Alzheimer's Disease and Related Major Neurocognitive Disorders: A Systematic Review. Am J Occup Ther 2017; 71: 7105180010p1-7105180010p9
- 7 Mahler LA, Ramig LO, Fox C. Evidence-based treatment of voice and speech disorders in Parkinson disease. Curr Opin Otolaryngol Head Neck Surg 2015; 23: 209-215
- 8 Dichgans. MEA S1-Leitlinie Vaskuläre Demenzen. 2017 Internet: https://www.dgn.org/leitlinien/3381-030-038-vaskulaere-demenzen-2017 ; Stand: 23.2.2018
- 9 Deuschl G, Maier W. et al. S3-Leitlinie Demenzen. 2017 Im Internet: https://www.dgn.org/leitlinien/3176-leitlinie-diagnose-und-therapie-von-demenzen-2016 ; Stand: 23.2.2018
- 10 Cheng ST, Chow PK, Song YQ. et al. Mental and physical activities delay cognitive decline in older persons with dementia. Am J Geriatr Psychiatry 2014; 22: 63-74
- 11 Romero B, Wenz M. Konzept und Wirksamkeit eines Behandlungsprogrammes für Demenzkranke und deren Angehörige. Ergebnisse aus dem Alzheimer Therapiezentrum Bad Aibling. Z Gerontol Geriatr 2002; 35: 118-128
- 12 Bergeron D, Flynn K, Verret L. et al. Multicenter Validation of an MMSE-MoCA Conversion Table. J Am Geriatr Soc 2017; 65: 1067-1072
- 13 Henderson EJ, Lord SR, Brodie MA. et al. Rivastigmine for gait stability in patients with Parkinson’s disease (ReSPonD): a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Neurol 2016; 15: 249-258
- 14 Zerr IEA Leitlinie Creutzfeldt-Jakob-Krankheit. 2012 Internet: https://www.dgn.org/leitlinien/2417-ll-43-2012-creutzfeldt-jakob-krankheit ; Stand: 23.2.2018
- 15 Kang K, Ko PW, Jin M. et al. Idiopathic normal-pressure hydrocephalus, cerebrospinal fluid biomarkers, and the cerebrospinal fluid tap test. J Clin Neurosci 2014; 21: 1398-1403
- 16 DGPPN, B.K., KBV, AWMF (Hrsg.) für die Leitliniengruppe Unipolare Depression*. S3-Leitlinie/Nationale VersorgungsLeitlinie Unipolare Depression – Langfassung. 2. Auflage. Version 5. 2015
- 17 Gross AL, Jones RN, Habtermariam DA. et al. Delirium and Long-term Cognitive Trajectory Among Persons With Dementia. Arch Intern Med 2012; 172: 1324-1331
- 18 Fick DM, Steis MR, Waller JL. et al. Delirium superimposed on dementia is associated with prolonged length of stay and poor outcomes in hospitalized older adults. J Hosp Med 2013; 8: 500-505
- 19 Morandi A. et al. Delirium superimposed on dementia strongly predicts worse outcomes in older rehabilitation inpatients. J Am Med Dir Assoc 2014; 15: 349-354
- 20 Neufeld KJ. et al. Antipsychotic Medication for Prevention and Treatment of Delirium in Hospitalized Adults: A Systematic Review and Meta-Analysis. J Am Geriatr Soc 2016; 64: 705-714
- 21 Oh ES. et al. Delirium in Older Persons: Advances in Diagnosis and Treatment. JAMA 2017; 318: 1161-1174
- 22 Kratz T. et al. Preventing postoperative delirium. Dtsch Arztebl Int 2015; 112: 89-96