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Salud Pública

Marie-Jeanne Kergoat1,2, Juan-Manuel Villalpando1,2, Bernard-Simon Leclerc2,3

  • 1Faculte de medecine, Universite de Montreal, Montreal, QC, Canada.

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Resumen
Este resumen es generado por máquina.

Esta revisión encontró que, si bien el diagnóstico de la enfermedad de Alzheimer está cambiando hacia biomarcadores, los criterios clínicos siguen siendo vitales para estudios a gran escala. La estandarización de estos criterios es crucial para una investigación consistente de la enfermedad de Alzheimer en diversas poblaciones.

Palabras clave:
enfermedad de Alzheimercriterios de diagnósticoestudios de cohortessalud públicainvestigación poblacional

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Área de la Ciencia:

  • Neurología; Epidemiología; Gerontología

Sus antecedentes:

  • El diagnóstico de la enfermedad de Alzheimer (EA) está evolucionando hacia definiciones basadas en biomarcadores, y se aleja de los criterios clínicos tradicionales.
  • Una larga fase preclínica en la EA presenta desafíos diagnósticos, particularmente al comparar datos entre diversas cohortes de investigación.
  • Los estudios de cohortes actuales a menudo se basan en metodologías variadas, lo que complica el seguimiento consistente de la progresión de la EA.

Objetivo del estudio:

  • Revisar y comparar sistemáticamente los criterios de diagnóstico utilizados en estudios poblacionales prospectivos del continuo clínico de la enfermedad de Alzheimer.
  • Evaluar la alineación de los criterios de diagnóstico entre cohortes que se centran en adultos mayores con enfermedad de Alzheimer.
  • Identificar tendencias y variaciones en los enfoques de diagnóstico dentro de la investigación de la enfermedad de Alzheimer.

Principales métodos:

  • Revisión sistemática de estudios de cohortes iniciados a partir del año 2000, con un seguimiento mínimo de 3 años en adultos de la comunidad de 50 a 85 años.
  • Se buscaron en las principales bases de datos (MEDLINE, Embase, Cochrane, PsycINFO, Web of Science) estudios originales relevantes.
  • Se evaluó la calidad metodológica utilizando la Herramienta de Evaluación de Calidad de los NIH para Estudios Observacionales de Cohortes y Transversales.

Principales resultados:

  • Se seleccionaron 28 estudios que abarcan 25 cohortes de 3297 artículos iniciales.
  • Se observó convergencia en los criterios de diagnóstico para las etapas posteriores de la enfermedad de Alzheimer, pero persistió la variabilidad para las etapas tempranas.
  • Pocas cohortes (5/25) examinaron el espectro completo de la progresión de la enfermedad de Alzheimer.

Conclusiones:

  • Los criterios de diagnóstico clínico siguen siendo valiosos para la investigación de la enfermedad de Alzheimer, especialmente en entornos a gran escala o con recursos limitados, a pesar de la tendencia hacia el diagnóstico basado en biomarcadores.
  • La adopción de criterios clínicos estandarizados es esencial para estudios poblacionales a gran escala sobre la enfermedad de Alzheimer.
  • La revisión destaca áreas de acuerdo y desacuerdo en los criterios actuales, lo que informa el desarrollo de futuras herramientas de diagnóstico estandarizadas para la enfermedad de Alzheimer.