Sind subjektive Gedächtnisstörungen ein Prodromalsyndrom der Demenz?

 

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Zusammenfassung

Subjektive Gedächtnisstörungen (subjective memory impairment – SMI) können definiert werden als das Gefühl der Gedächtnisverschlechterung bei normwertiger Leistung in standardisierten neuropsychologischen Tests. In Querschnittsuntersuchungen bei älteren Menschen wurde häufig ein Zusammenhang von SMI mit Depression, körperlicher Erkrankung und Persönlichkeitsvariablen gefunden, wohingegen der Zusammenhang von subjektiven Beschwerden und kognitiver Leistung meist gering war. Im Gegensatz dazu wurde in der überwiegenden Zahl epidemiologischer Längsschnittuntersuchungen SMI als Prädiktor für zukünftige Gedächtnisverschlechterung und Demenz identifiziert. Entsprechend der Hypothese, dass es sich bei SMI um die erste Manifestation einer Demenz handeln kann, erbrachten neue bildgebende Untersuchungen Hinweise auf eine Atrophie des Gehirns in Bereichen, die insbesondere bei der Alzheimer Krankheit betroffen sind. In dem Artikel wird ein Überblick über den aktuellen Stand der Forschung zu subjektiven Gedächtnisstörungen als mögliches Prodromalstadium einer Demenz gegeben.

Summary

Subjective memory impairment (SMI) can be defined by the feeling of memory decline with normal performance on standard neuropsychological tests. In cross-sectional studies in the elderly, SMI has frequently been related to depression, physical morbidity and personality traits rather than to actual cognitive performance. The majority of longitudinal studies, however, identified SMI as a predictor for future cognitive decline and dementia. In agreement with the hypothesis of SMI as the first manifestation of dementia, recent neuroimaging studies have identified atrophy in regions of the brain, which are affected in early Alzheimer’s Disease (AD). This paper will give an overview on latest research on SMI as a prodromal state of dementia.

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