Zusammenfassung
Die Anzahl von Demenzkranken in Deutschland wird im Rahmen der allgemeinen demographischen
Entwicklung in den nächsten Jahrzehnten deutlich zunehmen. Eines der drängendsten
Probleme in der Betreuung dieser Patienten ist das der angemessenen Ernährung in den
verschiedenen Krankheitsstadien. Es geht hierbei zum einen um die Vermeidung einer
frühzeitigen Mangelernährung, welche zusätzliche funktionelle Einbußen bedingen kann.
Zum anderen gilt es auch, eine Übertherapie in späten Stadien der Erkrankung zu vermeiden.
Demente Patienten sollten in frühen und mittleren Krankheitsstadien auf das Vorliegen
einer Mangelernährung gescreent werden. Für durch eine Malnutrition gefährdete Patienten
sollten in diesen Stadien inidviduelle Ernährungspläne erstellt werden. Die Einleitung
einer enteralen Ernährung in fortgeschrittenen Demenzstadien sollte jeweils Folge
einer sorgfältigen Einzelfallentscheidung sein.
Summary
As a consequence of the actual trends in demography the number of patients with dementia
will steadily increase during the next decades. One of the most important problems
in caring for these patients is to provide adequate nutrition during the different
phases of this disease. On the one hand it is essential to avoid early malnutrition
which may cause further functional impairment. On the other hand one is to withhold
nutritional overtherapy in the final stages of dementia. Patients with dementia should
be screened for malnutrition in the early and middle stages of this disease. For patients
with risk of or with overt malnutrition individual nutritional plans should be provided.
Enteral nutrition in advanced stages of dementia should only be untertaken after a
careful and individualized analysis of the situation.
Keywords:
dementia - nutritional screening - enteral nutrition - percutaneous endoscopic gastrostomy
- PEG - ethics
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Korrespondenzadresse:
Dr. Jürgen Bauer
Institut für Biomedizin des Alterns der FAU Erlangen-Nürnberg
Med. Klinik II - Klinikum Nürnberg
Heimerichstr. 58
90419 Nürnberg
Email: bauer_j@klinikum-nuernberg.de
