[Early diagnosis of dementia]

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.