Demencija je karakterizirana višestrukim kognitivnim
deficitima koji uključuju oštećenja pamćenja.
Najčešće se javlja u starijoj životnoj dobi. Prevalencija je oko
1% u dobi od 60 godina i raste dvostruko svakih pet godina.
U tretmanu osoba s dijagnosticiranom demencijom Alzheimerova
tipa danas se najčešće rabe inhibitori kolinesteraze.
Najčešće nuspojave pri terapiji inhibitorima kolinesteraze jesu
sa strane gastrointestinalnog trakta, umor, glavobolja i
vrtoglavica. U bolesnika s demencijom u Alzheimerovoj bolesti
(AD) u 80% slučajeva u kliničkoj slici prisutna je agresivnost
i agitacija. U tim slučajevima opravdana je upotreba
stabilizatora raspoloženja, antipsihotika i benzodiazepina.
Dvije trećine dementnih bolesnika u kliničkoj slici imaju depresivne
simptome Čija prevalencija u AD je 25-30%. Uporaba
antidepresiva nužna je u tim slučajevima, a to se posebno
odnosi na selektivne inhibitore ponovne pohrane serotonina
(SSRI). U kliničkoj procjeni uspješnosti terapije potrebno je
uz klinički pregled bolesnika uzeti u obzir i heteroanamnestičke
podatke dobivene od članova obitelji, odnosno
skrbnika. Neuropsihologijska procjena, kao i skale opće
kliničke procjene, dobri su pokazatelji učinkovitosti provedene
terapije. Na temelju toga donosi se odluka o daljnjim
oblicima tretmana.Dementia is characterised with multiple cognitive
deficits which include memory impairment. It is most
common in the elderly. The prevalence is around 1% in the
age of 60 and increases twice every five years. Inhibitors of
acetylcholinesterase are used in the treatment of Alzheimer’s
disease (AD) presently. Most common side-effects in therapy
with inhibitors of acetilcholinesterase are gastrointestinal
side-effects, tiredness, headache and dizziness. Agressiveness
and agitation are present in 80% of AD cases. Benzodiazepines,
mood stabilizers and antipsychotics are aproved in
these cases. Two thirds of patients suffering from dementia
have depressive symptoms. The prevalence of depressive
simptoms in patients with AD is 25-30%. Treatment with antidepressants
is necessary in these cases and the first line of
treatment are selective serotonine reuptake inhibitors.
Beside clinical examination, it is very important to take into
consideration hetheroanamnesis obtained from the members
of the family and caregivers. Neuropsychological estimation,
as well as the scales of general clinical estimation, are good
indicators for efficacy of the therapy. Based on this, decisions
for further therapeutical procedures are made
