Diagnostik der Demenzen: Standardisierte Untersuchungsinstrumente im Überblick

Zusammenfassung

Die bei steigender Prävalenz zunehmende Bedeutung demenzieller Erkrankungen schlägt sich auch in den Bemühungen nieder, deren Symptomatik mittels standardisierter Untersuchungen zu erfassen. Um der in den vergangenen Jahren vielfach erweiterten Palette an Instrumenten gerecht zu werden, sind hier über 50 ältere und neuere Verfahren berücksichtigt, die zur Erfassung der Demenz entwickelt wurden. Die Einteilung dieser Skalen, welche im Einzelnen beschrieben und insbesondere im Hinblick auf Validitäts- und Reliabilitäts- sowie zeitökonomische Kriterien bewertet wurden, erfolgte nach ihrem jeweils wichtigsten Bestimmungstyp. Dazu wurden sieben Gruppierungen gewählt, deren Funktion im Hinblick auf den Verwendungsschwerpunkt dieses Skalentyps erläutert wird. Abschließend wird eine Orientierungshilfe zur Auswahl von Testinstrumenten bei spezifischen Fragestellungen der Alzheimer Demenz und ein Ausblick über die absehbare Entwicklung neuer standardisierter Erhebungsverfahren gegeben.

Abstract

The symptoms of dementia refer to a decline in intellectual abilities and to an impairment of general and instrumental activities of daily living (ADL). Beside cognitive decline and loss of ADL's the diagnosis of dementia requires the documentation of changes in social adaptation, psychopathology and behaviour. There are a large number of scales used in the assessment of the various manifestations of the disease. Some scales focus on a particular aspect of the symptomatology, others prefer a comprehensive approach in the detection of dementia symptoms. We present a list of assessment procedures and scales which seem appropriate to detect different aspects of dementia and which are widely accepted in the scientific community. We describe these scales in detail including their methodology and source of informations, psychometric properties regarding validity and reliability as well as time taken to complete the scales. Our synopsis may serve as an orientation mark in the selection of adequate instruments for the assessment of different symptom domains during the process of diagnosis, the observation of the course of dementia and the efficacy of treatment interventions.

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