Zusammenfassung
Wenn man sich mit der Behandlung der Demenz befaßt, muß man zunächst klären, wie man diese Funktionsstörung definieren will. Früher wurde die Demenz als eine dauernde, irreversible und progrediente Störung intellektueller Funktionen und der Persönlichkeit angesehen. Diese Betrachtungsweise ist zumindest im angloamerikanischen Sprachraum aufgegeben worden, nachdem gezeigt werden konnte, daß es eine nicht unbeträchtliche, auf 10–30% geschätzte Zahl von potentiell reversiblen Demenzformen gibt (Marsden u. Harrison 1972; Freemon 1976; Cummings et al. 1980). Für diese Demenzformen kommen eine ganze Reihe von Ursachen in Betracht, die einmal im Gehirn selbst liegen können, zum anderen auf metabolischen, toxischen, entzündlichen und kreislaufabhängigen Einwirkungen beruhen können (Tabelle 1). Zweifellos läßt sich darüber diskutieren, ob es zweckmäßig ist, diese symptomatischen, psychoorganischen Funktionsstörungen als reversible Demenz zu klassifizieren. Es ist jedoch nicht zu verkennen, daß eine solche Differenzierung dazu beitragen kann, große diagnostische Sorgfalt walten zu lassen und einem therapeutischen Nihilismus entgegenzuwirken. Das erscheint in der überwiegend betroffenen höheren Altersgruppe von erheblicher Bedeutung. Das therapeutische Vorgehen wird sich in diesen Fällen soweit wie möglich auf die Ausschaltung der Demenzursache richten. Auf die im einzelnen zu ergreifenden Maßnahmen und die jeweiligen Erfolgsaussichten soll hier nicht näher eingegangen werden.
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Schneider, E., Fischer, PA., Jacobi, P. (1984). Therapeutische Konzepte bei verschiedenen Demenzformen. In: Fischer, PA. (eds) Parkinson plus. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-69839-2_12
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