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Leitlinien

Diagnostik und Therapie von Gedächtnisstörungen

Published Online:November 29, 2010https://doi.org/10.1024/1016-264X/a000020

Abstract

Diagnostik: Die Untersuchung von Gedächtnisstörungen erfordert mindestens ein Verfahren zur Erfassung der Gedächtnisspanne und des Arbeitsgedächtnisses sowie je ein Verfahren zur Untersuchung der unmittelbaren und verzögerten Reproduktion verbaler und figuraler Informationen. Darüber hinaus wird eine Untersuchung des Lernprozesses im Rahmen eines Lernparadigmas (z. B. Wortlisten-Lernen) empfohlen (A). Für die Untersuchung des für den Alltag so relevanten prospektiven Gedächtnisses sind vor allem die Verhaltensbeobachtung und die systematische Befragung z. B. mit Hilfe von Fragebögen von Bedeutung (B). Therapie: (1) Am Anfang der Therapie in der Frühphase steht häufig das Orientierungstraining. (2) Bei Patienten, bei denen die Diagnostik Hinweise auf eine erhaltene Konsolidierung gibt und bei denen der Rehabilitationsverlauf noch offen ist, wird empfohlen, internale Gedächtnisstrategien intensiv zu üben, um die Enkodierungsleistung zu verbessern (A). Für die Wirkung eines übenden Funktionstrainings, bei dem möglichst viele Informationen «auswendig gelernt» werden müssen, gibt es hingegen keine Evidenz. (3) Darüber hinaus ist die Behandlung der Gedächtnisstörung an den Alltagsanforderungen des Patienten zu orientieren und für spezifische gedächtnisrelevante Situationen sind Kompensationsstrategien zu erarbeiten (A). Ob die Patienten lediglich lernen können, auf externe Hilfen, die sie von Angehörigen oder Pflegepersonen erhalten, adäquat zu reagieren, oder ob sie diese selbstständig nutzen können, muss im Einzelfall im Therapieverlauf entschieden werden.

Evidenzgrad II

Evidenzgrad IIa

Evidenzgrad III

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