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Salud Pública

Márlon Juliano Romero Aliberti1,2,3, Thiago J Avelino-Silva1,4, Kenneth E Covinsky4

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|December 23, 2025
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Resumen
Este resumen es generado por máquina.

La demencia no diagnosticada en etapas moderadas a graves aumenta significativamente el riesgo de mortalidad intrahospitalaria. El diagnóstico e intervención tempranos son cruciales para mejorar los resultados en adultos mayores con demencia.

Palabras clave:
demenciamortalidaddiagnósticoatención médicaadultos mayores

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Área de la Ciencia:

  • Medicina Geriátrica; Neurología; Salud Pública

Sus antecedentes:

  • La demencia impacta significativamente la atención aguda, pero las consecuencias de la falta de diagnóstico en todas las etapas de la enfermedad no se comprenden completamente.; Investigaciones previas no han aclarado la relación entre la demencia no diagnosticada y la mortalidad intrahospitalaria, particularmente cómo varía según la gravedad de la enfermedad.

Objetivo del estudio:

  • Evaluar la asociación entre la demencia no diagnosticada y la mortalidad intrahospitalaria en adultos mayores ingresados en hospitales.; Determinar si esta asociación difiere según la etapa de la demencia (leve, moderada o grave).

Principales métodos:

  • Un estudio de cohorte prospectivo que involucró a 766 pacientes de 65 años o más con demencia en 43 hospitales de cinco países.; Se administró una evaluación geriátrica integral y la Clinical Dementia Rating (CDR) para evaluar la gravedad de la demencia (CDR≥1) y el estado del diagnóstico.; Se utilizaron modelos de regresión logística multinivel para analizar la asociación entre la demencia no diagnosticada y la mortalidad intrahospitalaria, con términos de interacción para la etapa de la demencia.

Principales resultados:

  • El 37% de los pacientes no tenían diagnóstico previo de demencia, siendo la demencia no diagnosticada más común en etapas leves (67%).; La mortalidad intrahospitalaria general fue del 18%; la demencia no diagnosticada no se asoció significativamente con un aumento de la mortalidad (aOR=1.47).; La etapa de la demencia modificó significativamente la asociación: la demencia no diagnosticada casi triplicó las probabilidades de mortalidad en etapas moderadas/graves, pero no en etapas leves.

Conclusiones:

  • El impacto de la demencia no diagnosticada en la mortalidad intrahospitalaria depende de la etapa, con riesgos significativamente mayores en las etapas moderadas a graves.; Abordar las disparidades socioeconómicas y fortalecer los sistemas de salud son vitales para mejorar el diagnóstico de la demencia, la atención aguda y los resultados de los pacientes.