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Salud Pública

Chinedu T Udeh-Momoh1,

  • 1FINGERS Brain Health Institute, Solna, Stockholm, Sweden, Brain and Mind Institute, Aga Khan University, Nairobi, Kenya, Division of Public Health Sciences, Wake Forest University, School of Medicine, Winston-Salem, NC, USA.

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Resumen

Necesidad urgente de modelos de riesgo de demencia en África. El Instituto de Cerebro y Mente de la Universidad Aga Khan (AKU-BMI) identifica factores de riesgo locales únicos y condiciones subdiagnosticadas para una prevención específica.

Palabras clave:
Salud PúblicaDemenciaEnvejecimiento CognitivoFactores de RiesgoÁfricaPrevenciónSubdiagnósticoModelos de RiesgoIntervenciones DirigidasEstudios Epidemiológicos

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Área de la Ciencia:

  • Neurociencia
  • Salud Pública
  • Gerontología

Sus antecedentes:

  • Se proyecta que los casos globales de demencia se tripliquen para 2050, con más del 60% en países de ingresos bajos y medianos (PIM).
  • Las poblaciones africanas requieren modelos de predicción de riesgo de demencia contextualizados.
  • El Instituto de Cerebro y Mente de la Universidad Aga Khan (AKU-BMI) lidera iniciativas para la detección temprana y la estratificación del riesgo de la enfermedad de Alzheimer y demencias relacionadas (ADRD) en adultos mayores africanos.

Objetivo del estudio:

  • Desarrollar y validar herramientas de diagnóstico culturalmente sensibles para la demencia en poblaciones africanas.
  • Identificar y estratificar los factores de riesgo de demencia específicos de los entornos africanos.
  • Facilitar el reclutamiento en el ensayo de reducción del riesgo de demencia Africa-FINGERS.

Principales métodos:

  • Utilización de diagnósticos avanzados: neuroimagen (RM, FDG-PET), biomarcadores de fluidos (sangre, saliva) y evaluaciones neuropsicológicas adaptadas culturalmente.
  • Enfoque en factores de riesgo cardiometabólicos, vasculares y de estilo de vida, incluidas afecciones subdiagnosticadas.
  • Incorporación de investigación etnográfica piloto para identificar factores de riesgo contextuales únicos como la desnutrición, la pobreza y el aislamiento social.

Principales resultados:

  • Los hallazgos preliminares muestran asociaciones entre la presión arterial sistólica elevada, la glucosa en ayunas, el historial de accidentes cerebrovasculares, el tabaquismo y la baja participación social con un mayor riesgo de demencia.
  • Se observó un subdiagnóstico significativo de afecciones cardiometabólicas, lo que resalta la necesidad de intervenciones específicas.
  • Se identificaron factores de riesgo contextuales únicos, que ofrecen información sobre el envejecimiento cognitivo en entornos africanos.

Conclusiones:

  • Los estudios de cohortes epidemiológicas en AKU-BMI son cruciales para identificar a las personas en riesgo para ensayos de prevención de la demencia.
  • Un modelo innovador que integra factores de riesgo locales y globales sienta un precedente para la investigación de demencia adaptada a PIM.
  • Este enfoque escalable y basado en datos proporciona un marco replicable para la prevención global de la demencia, especialmente para poblaciones desatendidas.