[Mild cognitive impairment in old age. Diagnostics and prognostic significance]. / Leichte kognitive Störung im Alter. Diagnostik und prognostische Bedeutung.

Advances in clinical dementia research have made it possible to diagnose prodromal stages of various dementia syndromes. We present here the concept of mild cognitive impairment (MCI) as the most widely used concept for this stage of dementia processes. Necessary diagnostic procedures for MCI are presented, including clinical, neuropsychological and laboratory methods. Particularly in Alzheimer's disease it seems possible to diagnose a prodromal stage by using biomarkers and brain imaging, i.e. before the clinical dementia syndrome of the Alzheimer's type is present. When diagnosing dementia diseases in the stage of a clinical dementia syndrome, irreversible neuropathological processes are advanced. For this reason we should aim for the clinical detection of dementia disorders in the stage of mild cognitive impairment. This will lead to research on how to slow or even halt the progression of prodromal dementia.

[The "Lector"--a testing method to determine verbal educational level]. / Der "Lector"--ein Untersuchungsverfahren zur Bestimmung des verbalen Bildungsniveaus.

Assessment of the educational level is important to prevent false neuropsychological diagnostic decisions. In the German-speaking countries some instruments for this assessment already exist, but there are problems involved in the practical application. There still is no reading test, which is a common standard in international neuropsychological test batteries. The lector investigates how subjects read rare German words or foreign words used in German-speaking countries. Words were selected which are pronounced differently from German pronunciation rules. A subject who does not know the word will pronounce it false, i.e., according to the German pronunciation rule. Norms (percentiles), estimation of reliability, and first data about validity were calculated from three samples with a total of 503 subjects. On the basis of the data presented, the Lector Test can be used as a control variable in research with groups as well as in neuropsychological diagnostics.

[Early diagnosis of dementia]. / Die Frühdiagnose der Demenzen.

Therapeutic interventions for dementia are crucially dependent on the early diagnosis of the case. The question is, how an early diagnosis on the symptom-, the syndrome- and the disease level can be accomplished. The data from epidemiological and clinical studies are described. On the symptom level a disorder of episodic memory, language and visuo-spatial functions have to be assessed in contrast to normal ageing effects and premorbid low cognitive functioning. Simple, clinically practical tests are described like an 10-word learning-test with encoding fascilitation, the semantic fluency (animals) and the clock drawing test. At the syndrome level the dementia syndrome of Alzheimer type has to be differentiated from other dementia syndromes, the senile amnestic syndrome and the delirium syndrome. At the disease level, the attempt to identify clinically the etiological entity is at most not possible with reasonable reliability in senile dementia cases. An improvement of the early diagnosis by prospective longitudinal investigations of the cases seems to be possible in the future.