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2011 | OriginalPaper | Hoofdstuk

64 Vergeetachtigheid

Auteurs : A.W. Wind, H. de Vries, Y.A.L. Pijnenburg

Gepubliceerd in: Diagnostiek van alledaagse klachten

Uitgeverij: Bohn Stafleu van Loghum

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Samenvatting

De grote lijn van de diagnostiek bij vergeetachtigheid en andere cognitieve stoornissen bestaat uit:
  • vaststellen of er sprake is van cognitieve stoornissen;
  • uitsluiten van behandelbare oorzaken, zoals depressie en somatische oorzaken;
  • vaststellen of er sprake is van dementie;
  • nadere diagnostiek bij dementie, gericht op comorbiditeit (somatisch en psychiatrisch), functionele beperkingen en de vorm van de dementie.
De verschillende richtlijnen voor de diagnostiek berusten voor het grootste deel op consensus. Voorheen was dementie van het alzheimertype een diagnose die per exclusionem gesteld werd. De laatste jaren neigt men er meer toe om deze diagnose op ‘positieve’ gronden te stellen: aan de hand van specifieke kenmerken die bij de ziekte passen. Dit vindt men terug in de criteria voor alzheimerdementie. Alert zijn op vroege symptomen komt tijdige opsporing van dementie ten goede.
Bij het vaststellen van cognitieve stoornissen en voor het differentiëren tussen de verschillende oorzaken nemen anamnese en heteroanamnese en het afnemen van eenvoudige bedside cognitieve functietests zoals de MMSE of kloktekenen een centrale plaats in.
Lichamelijk onderzoek en eenvoudig laboratoriumonderzoek dienen om behandelbare somatische oorzaken van vergeetachtigheid op te sporen. De CT-scan is vooral bedoeld om behandelbare intracraniële oorzaken op te sporen; met behulp van MRI kan men specifieke aandoeningen aantonen. Hippocampusatrofie past bij de ziekte van Alzheimer en infarcten passen bij vasculaire dementie. De geïnteresseerde arts kan ver komen met de diagnostiek bij vergeetachtigheid en kan specialisten vragen specifieke diagnostische vragen te beantwoorden. Daarbij is een onderscheid tussen ziektegerichte respectievelijk zorggerichte diagnostiek van belang.
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Metagegevens
Titel
64 Vergeetachtigheid
Auteurs
A.W. Wind
H. de Vries
Y.A.L. Pijnenburg
Copyright
2011
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-313-8364-1_65