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Demens vid Alzheimers sjukdom

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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 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. CT 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, professor och överläkare, Geriatriska kliniken, Karolinska universitetssjukhuset
  • Anna Nager, med dr och specialist i allmänmedicin, Karolinska institutet