Pantel J
Institut für Allgemeinmedizin, Arbeitsbereich Altersmedizin, Johann Wolfgang Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt, Deutschland.
Internist (Berl). 2016 Oct;57(10):1029-1036. doi: 10.1007/s00108-016-0097-8.
Neurocognitive disorders (e.g. dementia, mild cognitive impairment and delirium) belong to the most frequently occurring problems in older patients. For most types of dementia as well as for mild cognitive impairment no causal pharmacotherapy is currently available. This also applies to delirium, which should be primarily treated through the identification and elimination of predisposing factors while cautiously using symptomatic therapy with psychotropic drugs. Despite intensive ongoing research efforts the search for disease-modifying drugs for the treatment of Alzheimer's dementia has not been successful. In the prevention and treatment of neurocognitive disorders, rational and evidence-based pharmacological interventions can nonetheless play an important role. Besides the limited benefits of symptomatic treatment with currently available anti-dementia drugs, this includes the strict management of medical risk factors as well as the avoidance of drugs with delirogenic and dementing side effects.
神经认知障碍（如痴呆、轻度认知障碍和谵妄）是老年患者中最常见的问题。对于大多数类型的痴呆以及轻度认知障碍，目前尚无因果性药物治疗方法。这也适用于谵妄，谵妄主要应通过识别和消除诱发因素进行治疗，同时谨慎使用精神药物进行对症治疗。尽管正在进行大量研究，但寻找用于治疗阿尔茨海默病痴呆的疾病修饰药物尚未成功。然而，在神经认知障碍的预防和治疗中，合理且基于证据的药物干预仍可发挥重要作用。除了目前可用的抗痴呆药物对症治疗的有限益处外，这还包括严格管理医疗风险因素以及避免使用具有致谵妄和致痴呆副作用的药物。
