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Demenzen

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Klinische Neurologie

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Zusammenfassung

Demenzielle Erkrankungen betreffen ca. 5% aller über 65-jährigen Menschen. In den westlichen Ländern liegt in mehr als der Hälfte aller Fälle eine Alz heimer-Demenz (AD) vor. Die AD ist damit die häufigste Ursache für eine Demenz. Kennzeichnend für die AD sind der schleichende Beginn und die langsame Zunahme einer Kombination verschie dener neuropsychologischer Defizite, insbesonders von Merkfähigkeits- und Orientierungsstörungen. Die Unterteilung der AD in eine präsenile Form (Beginn vor dem 65. Lebensjahr) und eine senile Form (Beginn nach dem 65. Lebensjahr) stellt eine klinische Konvention dar. Das Lebensalter bei Erkrankungsbeginn gibt keine Hinweise auf Besonder heiten bezüglich der Pathogenese oder des Verlaufs. Eine autosomal-dominante Heredität liegt bei we niger als 1% aller AD-Patienten vor. Die Ätiologie der nicht genetisch determinierten, sog. spo radischen AD ist noch nicht vollständig geklärt. Ri sikofaktoren der sporadischen AD sind bestimmte Va rianten des Apolipoprotein-E-Polymorphismus, Schädel-Hirn- Traumen sowie eine positive Fami lienanamnese bezüglich einer neurodegenerativen Erkrankung. Die zweithäufigste Demenzursache nach der AD ist die Gruppe der vaskulären Demenzformen. Vaskuläre Schädigungen liegen ca. 20–40% aller Demenzen zugrunde. Die verbleibenden ca. 10% aller Demenzen haben unterschiedlichste Ätiologien: Frontallappendegenerationen (M. Pick) und Demenzen bei vorwiegend subkortikalen Degenerationen (Demenz bei idiopathischem Parkinson-Syndrom, Huntington-Chorea, progressive supranukleäre Paralyse, Demenz bei Multisystematrophien). Demen zielle Syndrome können schließlich auch als Residuen schwerer zerebraler Metabolismusstörungen (zerebrale Hypoxie, schwere Hypoglykämie) auftreten.

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Authors and Affiliations

  1. Universitätsklinik für Psychiatrie und Psychosomatik, Klinikum der Albert-Ludwigs-Universität Freiburg, Hauptstr. 5, 79104, Freiburg

    M. Hüll (Priv.-Doz. Dr.)

  2. Neurobiologisches Labor, Psychiatrische Universitätsklinik, Hauptstr. 5, 79104, Freiburg

    J. Bauer (Prof. Dr.)

  3. Klinikum Mannheim, Neurologische Universitäts-Klinik, Theodor-Kutzer-Ufer, 68135, Mannheim

    M. Daffertshofer (Priv.-Doz. Dr.)

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  1. M. Hüll
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  2. J. Bauer
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  3. M. Daffertshofer
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  1. Alfried Krupp Krankenhaus, Alfried-Krupp-Str. 21, 45131, Essen

    Peter Berlit

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© 2006 Springer Medizin Verlag Heidelberg

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Hüll, M., Bauer, J., Daffertshofer, M. (2006). Demenzen. In: Berlit, P. (eds) Klinische Neurologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-31176-9_38

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  • DOI: https://doi.org/10.1007/3-540-31176-9_38

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-01982-4

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