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Manifestaciones Clínicas

Alexandra J Weigand1, Fareshte Erani2, Caitlin M Terao3

  • 1Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA.

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

Los adultos mayores cognitivamente sanos muestran patrones cognitivos distintos. La función ejecutiva baja se relaciona con problemas cerebrovasculares, mientras que la memoria baja puede indicar riesgo de enfermedad de Alzheimer a través de caminos separados.

Palabras clave:
fenotipos cognitivosadultos mayoresfunción ejecutivamemoriaenfermedad cerebrovascularenfermedad de Alzheimer

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Área de la Ciencia:

  • Neurociencia
  • Gerontología
  • Psicología Cognitiva

Sus antecedentes:

  • Los adultos mayores cognitivamente sin deterioro (CU) exhiben riesgos variados de enfermedad de Alzheimer y demencias relacionadas (ADRD).
  • Identificar fenotipos cognitivos tempranos en individuos CU es crucial para intervenciones oportunas.
  • El estudio Atherosclerosis Risk in Communities (ARIC) proporciona una cohorte valiosa para examinar la heterogeneidad cognitiva.

Objetivo del estudio:

  • Clasificar fenotipos cognitivos distintos entre adultos mayores CU (cognitivamente sin deterioro) mediante un enfoque basado en datos.
  • Investigar la asociación entre los fenotipos cognitivos identificados y los resultados de demencia relacionada con el Alzheimer (ADRD) / cerebrovasculares.
  • Explorar las diferencias en neuroimagen y biomarcadores entre los fenotipos cognitivos.

Principales métodos:

  • Análisis de perfiles latentes de 10 puntuaciones z neuropsicológicas ajustadas demográficamente de 4737 adultos mayores CU del estudio ARIC.
  • Comparación de fenotipos basada en demografía, síntomas depresivos y factores de riesgo vascular (VRF).
  • Análisis de hiperintensidades de la sustancia blanca (WMH), volumen del hipocampo (HV) y biomarcadores plasmáticos (Aβ42/40, ptau181, NfL, GFAP) en un subconjunto.

Principales resultados:

  • Se identificó una solución de 6 clases que definió fenotipos cognitivos distintos (p. ej., Promedio General, Memoria Baja, Ejecutiva Baja).
  • Los fenotipos difirieron significativamente en demografía, síntomas depresivos, factores de riesgo vascular (VRF), hiperintensidades de la sustancia blanca (WMH), volumen del hipocampo (HV), Aβ42/40 y ptau181.
  • Fenotipos específicos mostraron asociaciones: Ejecutiva Baja con WMH alta, Memoria Baja con Aβ42/40 baja y ptau181 alta.

Conclusiones:

  • Existe heterogeneidad cognitiva incluso en adultos mayores CU, lo que sugiere diversas trayectorias de riesgo.
  • El rendimiento ejecutivo bajo se correlaciona con cambios cerebrovasculares.
  • La memoria deteriorada se asocia con biomarcadores relacionados con el Alzheimer, lo que indica vías distintas hacia el deterioro cognitivo.