Demens vid Alzheimers sjukdom
Senast uppdaterad: Senast reviderad:
Sakkunnig:Lars-Olof Wahlund
Definition:
Förvärvad kronisk neurodegenerativ sjukdom där diagnosen bygger på kliniska kriterier.
Förekomst:
I Sverige beräknas cirka 130 000–150 000 personer ha en demenssjukdom, varav de flesta antas ha Alzheimers sjukdom.
Symtom:
Gradvist progredierande minnessvårigheter och försämrade kognitiva funktioner som påverkar det dagliga livet.
Kliniska fynd:
Kognitiv svikt som visas med kliniska bedömningsinstrument; MMSE-SR i kombination med klocktest , alternativt MoCa eller RUDAS (vid annat modersmål/kulturell bakgrund eller låg utbildning).
Diagnostik:
Bedömning av kognitiv svikt med kliniska bedömningsinstrument (se ovan). Anhörigintervju. Strukturerad utredning av funktions- och aktivitetsförmåga. DT hjärna och blodprover för att utesluta reversibla orsaker till kognitiv svikt. Vid eventuell utvidgad utredning görs neuropsykologiska test och ibland lumbalpunktion och/eller ytterligare bilddiagnostiska undersökningar av hjärnan.
Behandling:
Huvudsaklig behandling är organiserade stödåtgärder, personcentrerad omvårdnad och multiprofessionellt omhändertagande. Läkemedelsbehandling med kolinesterashämmare rekommenderas vid mild till måttlig Alzheimers sjukdom samt memantin vid måttlig till svår Alzheimers sjukdom.
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- Lars-Olof Wahlund, seniorprofessor och överläkare, Geriatriska kliniken, Karolinska universitetssjukhuset
- Anna Nager, docent och specialist i allmänmedicin, Karolinska institutet