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Manifestaciones Clínicas

Ying Wang1, Joel Reisman2, Brant Mittler3

  • 1Wentworth Institute of Technology, Boston, MA, USA.

Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 26, 2025
PubMed
Resumen
Este resumen es generado por máquina.

Este estudio estima la progresión de la enfermedad en el deterioro cognitivo leve (MCI) y la demencia de Alzheimer (AD) utilizando la Escala de Actividades Instrumentales de la Vida Diaria (IADL). El deterioro funcional a etapas graves ocurre dentro de 13 años para MCI y 9 años para AD.

Palabras clave:
deterioro cognitivo levedemencia de Alzheimeractividades instrumentales de la vida diariaprogresión de la enfermedadtrayectoria de la enfermedadpuntuaciones de IADLdeterioro funcionalenfermedades neurodegenerativas

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Área de la Ciencia:

  • Gerontología
  • Neurología
  • Medicina Clínica

Sus antecedentes:

  • Investigaciones previas propusieron la estadificación de la enfermedad para el deterioro cognitivo leve (MCI) y la demencia de Alzheimer (AD) utilizando la Escala de Actividades Instrumentales de la Vida Diaria (IADL) de Lawton-Brody.
  • Se estableció un cruce entre el IADL y el Mini-Mental State Examination (MMSE) para la estadificación.
  • Este estudio tuvo como objetivo estimar la trayectoria de la enfermedad utilizando puntuaciones de corte de IADL propuestas para las etapas de la enfermedad de Alzheimer.

Objetivo del estudio:

  • Estimar la trayectoria de la enfermedad en pacientes con MCI o AD basándose en puntuaciones de corte de etapa de IADL propuestas.
  • Analizar la transición de etapas de la enfermedad a lo largo del tiempo utilizando modelado estadístico.
  • Proporcionar una medida alternativa de la progresión de la enfermedad utilizando puntuaciones de IADL.

Principales métodos:

  • Se identificaron pacientes diagnosticados con MCI o AD de la base de datos administrativa del Sistema de Atención Médica de Asuntos de Veteranos de EE. UU. (2016-2024).
  • Se derivaron puntos de corte de IADL utilizando medias de mínimos cuadrados lineales, definiendo etapas para la enfermedad normal, MCI, leve, moderada y grave.
  • Se empleó modelado estadístico de efectos mixtos para estimar la transición de etapas de la enfermedad a lo largo del tiempo, controlando la demografía y permitiendo tendencias no lineales.

Principales resultados:

  • El estudio incluyó a 90.114 pacientes (edad media 80,2 años; 97,5 % hombres).
  • Se estimaron tiempos de transición aproximados de 13 años desde MCI a etapas graves.
  • Se estimaron tiempos de transición aproximados de 9 años desde AD a etapas graves.

Conclusiones:

  • El deterioro funcional en la demencia de Alzheimer y el deterioro cognitivo leve progresa a etapas graves en 9 y 13 años, respectivamente.
  • Las estimaciones de trayectoria utilizando IADL proporcionan una medida valiosa del deterioro funcional que corresponde a la deterioración cognitiva.
  • La escala IADL es una evaluación ampliamente utilizada en la práctica clínica para evaluar el deterioro funcional en enfermedades neurodegenerativas.