Methoden zur Erfassung von Krankheitseinsicht bei Alzheimerdemenz – eine kritische Übersicht

 

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Zusammenfassung

Anliegen Patienten mit Alzheimer-Demenz zeigen oft eine beeinträchtigte Krankheitseinsicht (Anosognosie). Methode Literaturübersicht über Methoden zur Beurteilung verminderter Krankheitseinsicht bei Alzheimerdemenz. Ergebnisse Diagnostische Instrumente für Anosognosie sind wenig etabliert. Mögliche Erfassungsmethoden sind das klinische Urteil, der Vergleich der Angaben von Patienten und Angehörigen bzw. der Vergleich der Selbsteinschätzung eines Patienten mit seiner Leistung. Schlussfolgerungen Neben dem diagnostischen Nutzen einfacher Methoden geben umfangreichere Forschungsansätze Aufschluss über die Hintergründe der Anosognosie.

Abstract

Objective Impaired insight (anosognosia) is frequently present in Alzheimer's disease. However, established instruments for diagnosing anosognosia are lacking. Method This article reviews the literature on impaired insight in Alzheimer's disease with a focus on assessment methods that have been applied to its study. Results The primary methods for assessing anosognosia are clinical judgment, comparison of patient and caregiver reports, and comparison of patients' self-assessment and task performance. Conclusions While simple approaches such as expert rating scales can be appropriate for clinical practice, more elaborate procedures in research may shed light on the cognitive mechanisms involved in anosognosia. Previous results have shown that unawareness of deficits affects cognitive and emotional domains as well as activities of daily living, thus any diagnostic instrument should capture these different aspects. However, methodologial issues such as the objectivity of caregiver reports or patients' ability to assess their own performance need to be considered in order to obtain reliable data.

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Dipl.-Psych. Hanna Leicht

Gedächtnisambulanz, Klinik für Psychiatrie, Universität Leipzig

Semmelweisstraße 10

04103 Leipzig

Email: Hanna.Leicht@medizin.uni-leipzig.de