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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.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 23, 2025
Resumen
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.
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.
Palabras clave:
enfermedad de Alzheimercriterios de diagnósticoestudios de cohortessalud públicainvestigación poblacionalMás Videos Relacionados
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