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La demencia es una de las enfermedades más comunes dentro de la población de adultos mayores. Al hablar de demencia se engloban un conjunto de enfermedades crónicas que llegan  presentar síntomas similares como lo es el deterioro progresivo en habilidades cognitivas. 
El Alzheimer es la causa más frecuente de demencia, la cual se manifiesta por la pérdida progresiva de memoria, además de generar afectaciones en otras áreas cognitivas como el lenguaje, el pensamiento, la orientación y la habilidad para resolver problemas, también se acompaña de trastornos del comportamiento y modificaciones en el estado de ánimo, los cuales repercuten en las actividades diarias de la vida y la funcionalidad de la persona que lo padece.
La enfermedad del Alzheimer se describió por primera vez en 1907 y desde entonces la etiología sigue siendo desconocida, aunque se han identificado alteraciones en las células cerebrales por acumulación de algo llamado placas seniles y ovillos neurofibrilares que generan el deterioro cognitivo, sin embargo, aún se desconoce la exactitud del porqué sucede ésto.  Algunas investigaciones apuntan a que su origen puede derivarse de factores genéticos, fisiológicos, exposición a metales  e incluso factores nutricionales.
La prevalencia de la enfermedad está aumentando drásticamente alrededor del mundo, en gran parte por el aumento en la esperanza de vida de las personas.  En México, la población general de adultos mayores es mayor que la de menores de edad, por lo que se estima que para el año 2050 el número de personas mayores que requerirá de atención por parte de los servicios de salud será mayor, en especial por enfermedades como la demencia. De acuerdo con la OMS se estima que para 2050 las cifras de personas, alrededor del mundo,  con Alzheimer será de 150 millones, mientras que la estimación para la población mexicana es de 3.5 millones o más.
Al hablar de Alzheimer se ha identificado un conjunto de signos y síntomas que permiten identificar los inicios o el desarrollo de la enfermedad. Algunas de las quejas principales por las que se acude a revisión son las siguientes:  
  • Preguntar las cosas muchas veces
  • Fatiga
  • Repiten conversaciones
  • Olvidan las cosas pasadas 
  • Desorientación
  • Alteraciones del ánimo
Si bien, los síntomas anteriores podrían ser identificados como cambios normales del envejecimiento es importante estar atentos a otros cambios o síntomas referidos tanto por el adulto mayor como de los familiares, ya que en ocasiones se podría inferir erróneamente que solo presentan cambios asociados al envejecimiento. 
Otros signos que se llegan a referir en los inicios del Alzheimer:
  • Pérdida de la memoria
  • Dificultad para realizar tareas familiares
  • Problemas en el lenguaje
  • Desorientación en tiempo y lugar
  • Alteraciones del juicio
  • Problemas de pensamiento abstracto
  • Pérdida de objetos
  • Cambios en el humor o comportamiento
  • Cambios en la personalidad
  • Pérdida de  iniciativa
  • Detección temprano y control en los factores de riesgo.
Identificar uno o más de los síntomas mencionados no es suficiente para lograr diagnosticar al paciente, ya que, es necesario diagnosticar al paciente a través de un trabajo en conjunto por parte de un equipo multidisciplinario de profesionales de la salud entre ellos, neurólogos, psiquiatras, neuropsicólogos y psicólogos. Quienes realizan diversos estudios físicos, neurológicos, evaluación neuropsicológica, evaluaciones psiquiátricas y/o psicológicas. 
Así mismo, existen algunos factores de riesgo que se han mencionado en algunos estudios: 
  • Edad mayor de 65
  • Herencia familiar
  • Hipertensión
  • Diabetes
  • Tabaquismo
  • Consumo excesivo de alcohol
  • Inactividad física
  • Exposición al aluminio
  • Lesiones cerebrales traumáticas
  • Comorbilidades asociadas (enfermedad vascular o infección)
  • Antecedentes de depresión
También,  se han logrado identificar factores que fungen como protectores para reducir los riesgos de padecer demencia:
  • Control de enfermedades
  • Actividad física
  • Lectura
  • Realizar ejercicio físico
  • Evitar el consumo de sustancias adictivas
  • Terapias de rehabilitación cognitiva
Aunque no se han logrado identificar tratamientos certeros de la enfermedad o factores que eviten el desarrollo de esta, se utilizan diversos medicamentos que ayudan a mejorar los síntomas y reducir la progresión, así como rehabilitación neuropsicológica que permite entrenar y compensar diversas funciones cognitivas  mediante el uso de estrategias para aumentar la funcionalidad de quien padece la enfermedad. Además, también se recomienda  llevar a cabo un tratamiento psicológico para mejorar la calidad de vida.
El Alzheimer es una enfermedad progresiva, que a la larga genera discapacidad en la persona quien lo padece, por lo que, es necesario con una red de apoyo, cuidadores primarios, así como un conjunto de profesionales de la salud y salud mental, que doten de herramientas a los pacientes y familiares, para permitir que logren desempeñar su vida lo más normal posible o tener la mejor calidad de vida. 
Referencias:
Amstrong, R. (2019). Risk factors for Alzheimer’s disease. Folia Neuropathologica, 57(2), 87-105.  DOI: https://doi.org/10.5114/fn.2019.85929
 Educación para la Salud (19 de Octubre del 2017). Las demencias. 10 Signos de alerta Alzheimer-INCMNSZ-Educación para la salud. [Archivo de video]. YouTube. https://www.youtube.com/watch?v=t61rc-wbxSI  
Instituto Nacional de Neurología y Neurocirugía. (14 de Agosto del 2017). Enfermedad de Alzheimer. Recuperado de http://www.innn.salud.gob.mx/interna/medica/padecimientos/alzheimer.html 
Nourhashémi, F., Gillete, S., Adrieu, S., Ghisolfi, A., Ousset, P., Grandjean, H., Grand, A., Pous, J., Vellas, B. & Albaréde, J. (2000). Alzheimer disease: protective factors. The American Journal of Clinical Nutrition, 71 (2), 643-649.
Organización Mundial de la Salud. (2017). El número de personas que padecen demencia se triplicará en los próximos 30 años. Recuperado de  https://www.who.int/es/news/item/07-12-2017-dementia-number-of-people-affected-to-triple-in-next-30-years 
Universidad Autónoma de San Luis Potosí. (2014). Demencias Una visión panorámica. Simposio de Medicina. Recuperado de http://www.geriatria.salud.gob.mx/descargas/publicaciones/Demencia.pdf 
Vinícius, M., Gomide, C., Vieita, L., Cruz, L., Gomes, K. & Gracas, M. (2019). Alzheimer’s disease: risk factors and potentially protective measures. Journal of Biomedical Science, 26 (33),  1-11. https://jbiomedsci.biomedcentral.com/articles/10.1186/s12929-019-0524-y 

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