Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Feb 2022
[Non-pharmacological interventions in dementia: an overview with special consideration of digital offerings].
Non-pharmacological interventions such as cognitive therapy, physical activity, and creative art approaches are important components of appropriate care for persons with dementia and their relatives. Although relationships and interpersonal interactions undoubtedly play an important role in all these activities, digital technologies have increasingly established themselves in this area in recent years. ⋯ When using them, it should therefore be borne in mind that although they may represent a valuable supplement, they can never replace human attention. Furthermore, limitations in their practical application, such as unfamiliarity when using digital technologies or excessive demands of cognitively limited users, as well as important ethical aspects (e. g., data protections, personality rights, dignity and self-determination in old age) should not be ignored.
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It is part of the natural aging process that cognitive performance declines and the speed of information processing slows down. However, if brain function deteriorates significantly, spatial and temporal disorientation, speech and recognition disorders, as well as behavioral and psychological symptoms of dementia (BPSD) such as apathy, anxiety, depression, social withdrawal or even strong emotional fluctuations with agitation and apathy may occur. ⋯ The current article focuses on the pharmacotherapeutic treatment of the most common dementia syndromes, such as Alzheimer's dementia, vascular dementia, Lewy body dementia, Parkinson dementia, and frontotemporal dementia. Furthermore, pharmacological treatment of accompanying psychopathological symptoms are highlighted.
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Dtsch. Med. Wochenschr. · Feb 2022
Case Reports[Late neurological consequences of a SARS-CoV-2 infection].
Persistent neurological late symptoms of SARS-CoV-2 infection are common and require regular follow-up treatment. In order to establish uniform therapy concepts, it is necessary to evaluate individual therapeutic approaches for long COVID and post-COVID-19 syndrome. ⋯ Whole body and brain FDG PET can be helpful in long COVID and post-COVID-19 syndrome patients with neurological symptoms of unknown origin. These patients benefit from systematic rehabilitation. Glucocorticoids and colchicine appear to accelerate symptom reduction. The rehabilitative therapy should be continued on an outpatient basis.
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For initial cognitive diagnostics in the practice, various screening tools in the form of short paper-pencil-tests are available. Such initial screenings take between 5 and 15 minutes, but do not replace detailed neuropsychological diagnostics. Of the screening-tools reviewed, DemTect is suitable for suspected early onset dementia, while MMSE and MoCA cover other cognitive domains in greater detail. ⋯ A more comprehensive diagnosis of dementia is not possible with the screening tools reviewed. However, they can help to decide whether a detailed dementia analysis is necessary or whether one can wait with it. The screening methods reviewed are freely available on the internet.