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Leichte kognitive Störung

Fragen zu Definition, Diagnose, Prognose und Therapie

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Zusammenfassung

Die leichte kognitive Störung ist ein ätiologisch, psychopathologisch und prognostisch uneinheitliches Syndrom. Kennzeichnend sind kognitive Beeinträchtigungen, die über altersbedingte Leistungsverluste eindeutig hinausgehen, aber nicht den Grad einer Demenz erreichen. Die Prävalenz des Syndroms wird auf 17% in der Bevölkerung über 65 Jahre geschätzt Bei 10–15% der Patienten schreitet die leichte kognitive Störung innerhalb eines Jahres zur Demenz fort, in einigen Fällen besteht sie jedoch unverändert weiter oder bildet sich zurück. Mit verschiedenen Methoden ist es möglich, zumindest bei einem Teil der Patienten, bereits im Stadium der leichten kognitiven Störung den neurodegenerativen Prozess der Alzheimer-Krankheit nachzuweisen. Ob Patienten mit leichter kognitiver Störung, oder zumindest diejenigen mit Alzheimer-Krankheit im Prädemenzstadium, von den gegenwärtig verfügbaren symptomatischen Therapiemöglichkeiten einen Nutzen ziehen können, ist noch nicht erwiesen. Unabhängig davon stellen die Patienten mit Frühstadien der AK eine wichtige Zielgruppe für Behandlungsstrategien dar, die auf eine Verlangsamung des neurodegenerativen Prozesses gerichtet sind.

Summary

The syndrome of mild cognitive impairment (MCI) is heterogeneous in terms of aetiology, psychopathology, and prognosis. It is characterised by cognitive deterioration significantly exceeding the decline attributable to aging but not reaching the severity of dementia. The prevalence of MCI is estimated to be 17% in the population over 65 years old. At neuropathological examination, a large proportion of patients with mild cognitive impairment, particularly of the amnestic type, show typical features of Alzheimer's disease. The former progresses to dementia at an annual rate of 10% to 15%. In some cases, however, there is stable impairment or remission. The neurodegenerative process of Alzheimer's disease can be demonstrated in at least some patients using volumetric magnetic resonance imaging, 18-FDG positron emission tomography, or biochemical markers in the cerebrospinal fluid. It is not yet known whether patients with mild cognitive impairment or at least those with predementia Alzheimer's disease can benefit from currently available symptomatic treatments. Patients with early-stage Alzheimer's are an important target group for treatment interventions aiming at slowing the neurodegenerative process.

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Danksagung

Diese Übersichtsarbeit stützt sich auf Ergebnisse einer Studie, die durch den Forschungsfonds des Klinikums rechts der Isar der Technischen Universität München gefördert wurde (KKF Projekt 8765150). Wir danken allen Patienten und Angehörigen, die an dieser Studie mitgewirkt haben.

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  1. Klinik für Psychiatrie und Psychotherapie, Technische Universität München

    A. Kurz, J. Diehl, M. Riemenschneider & R. Perneczky

  2. School of Psychiatry and Clinical Neurosciences, The University of Western Australia Perth

    N. Lautenschlager

  3. Klinik für Psychiatrie und Psychotherapie, Technische Universität München, Möhlstraße 26, 81675 , München

    A. Kurz

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Kurz, A., Diehl, J., Riemenschneider, M. et al. Leichte kognitive Störung. Nervenarzt 75, 6–15 (2004). https://doi.org/10.1007/s00115-003-1568-4

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