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Salud Pública
Soeren Mattke1, Jiahe Chen2, Eric M Reiman3
1University of Southern California, Los Angeles, CA, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 23, 2025
Resumen
Un programa de prevención primaria para la enfermedad de Alzheimer preclínica (PCAD) muestra un valor significativo al reducir los futuros casos de deterioro cognitivo leve. Se proyecta que esta estrategia de prevención del Alzheimer sea rentable desde las perspectivas del pagador y de la sociedad.
Área de la Ciencia:
- Neurología; Salud Pública; Economía de la Salud
Sus antecedentes:
- Los tratamientos farmacológicos para la enfermedad de Alzheimer preclínica (PCAD) se encuentran en ensayos clínicos en etapa avanzada.; Investigaciones previas indicaron la rentabilidad potencial de los programas de detección y tratamiento de PCAD.; El estudio investiga el valor económico de un programa de prevención primaria para detener el desarrollo de la patología del Alzheimer.
Objetivo del estudio:
- Modelar el valor clínico y económico de un programa hipotético de prevención primaria para la enfermedad de Alzheimer en los EE. UU.; Evaluar la rentabilidad de prevenir la patología del Alzheimer antes de que ocurra el deterioro cognitivo.
Principales métodos:
- Una cohorte de 50 a 70 años con al menos un alelo APOE4 en 2026 se sometería a análisis de sangre anuales para PCAD.; Se proyectó la progresión a PCAD y deterioro cognitivo leve (MCI) durante 30 años, comparando la historia natural con un tratamiento preventivo del 75% de efectividad.; Los cálculos incluyeron reducciones de costos, pérdida de años de vida ajustados por calidad (QALY) y carga del cuidador para los casos de MCI evitados.
Principales resultados:
- La detección de 82 millones de personas en 2026 conduciría a que 12 millones recibieran tratamiento.; Durante 30 años, se podrían evitar 410.000 casos de MCI, con un número necesario a tratar de 37.; El programa mostró un costo neto por persona examinada de $9,400, pero resultó en reducciones significativas en los costos directos, la pérdida de QALY y la carga del cuidador.
Conclusiones:
- Un programa hipotético de prevención primaria para la enfermedad de Alzheimer demuestra un valor clínico y económico sustancial.; Se proyecta que el programa sea rentable para 2052 (perspectiva del pagador) y 2048 (perspectiva de la sociedad).; Se necesita más investigación para determinar las condiciones específicas bajo las cuales esta estrategia de prevención es más rentable.
Palabras clave:
Enfermedad de AlzheimerPrevención primariaSalud públicaAnálisis costo-beneficioDeterioro cognitivo leveApolipoproteína E4Economía de la saludAños de vida ajustados por calidadProgresión de la enfermedadSalud públicaMás Videos Relacionados
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