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Manifestaciones Clínicas

Elif Pinar Coskun1,2, Shawn T Caudill3, Lauren Bojarski4

  • 1University of Kentucky, SBCoA, Lexington, KY, USA.

Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 25, 2025
PubMed
Resumen
Este resumen es generado por máquina.

Este estudio desarrolló una herramienta rápida de detección de demencia para atención primaria utilizando el recuerdo diferido de 5 palabras del MoCA y la prueba de denominación de animales. Este enfoque práctico ofrece alta precisión en la identificación del deterioro cognitivo.

Palabras clave:
demenciadetecciónatención primariaMoCAdeterioro cognitivoNeuropsicologíaancianos

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Área de la Ciencia:

  • Neurología
  • Gerontología
  • Medicina de Atención Primaria

Sus antecedentes:

  • El cribado del deterioro cognitivo y la demencia en atención primaria consume mucho tiempo.
  • Las herramientas existentes como el Mini-Mental State Examination (MMSE) y el Montreal Cognitive Assessment (MoCA) carecen de validez ecológica debido a limitaciones de tiempo.
  • Existe la necesidad de herramientas de cribado rápidas, sensibles y específicas para la demencia en entornos de atención primaria.

Objetivo del estudio:

  • Identificar combinaciones óptimas de herramientas de evaluación cognitiva existentes para la detección eficiente de demencia en atención primaria.
  • Desarrollar un método de cribado práctico y preciso adecuado para el entorno de atención primaria de ritmo rápido.
  • Reducir la carga sobre los médicos de atención primaria manteniendo una alta precisión diagnóstica para el deterioro cognitivo.

Principales métodos:

  • Los participantes del Centro de Investigación de la Enfermedad de Alzheimer del Reino Unido (ADRC) se sometieron a pruebas neuropsicológicas completas.
  • Se emplearon modelos de regresión logística y curvas características operativas del receptor (ROC) para modelar la probabilidad de demencia en función de las puntuaciones de las pruebas.
  • Se utilizó el estadístico J de Youden y la lógica booleana para determinar los puntos de corte óptimos y las combinaciones de pruebas para maximizar la sensibilidad y la especificidad.

Principales resultados:

  • Una batería neuropsicológica completa arrojó un Área Bajo la Curva (AUC) de 0.90.
  • Un cribado de 3 minutos que utiliza el recuerdo diferido de 5 palabras del MoCA y la denominación de animales logró un AUC de 0.87.
  • Puntos de corte específicos y combinaciones de lógica booleana demostraron alta especificidad (98.41%) o sensibilidad (94.59%) con excelentes valores predictivos.

Conclusiones:

  • El cribado eficaz de la demencia en atención primaria se puede lograr de manera práctica y precisa en una fracción del tiempo de una evaluación completa.
  • La combinación del recuerdo diferido de 5 palabras del MoCA y la denominación de animales ofrece una herramienta de cribado muy precisa y eficiente en el tiempo.
  • Se están llevando a cabo estudios de validación adicionales en entornos de atención primaria para confirmar la utilidad de este enfoque de cribado rápido.