Vol. 12. Núm. 74.
Páginas 4338-4346 (Marzo 2019)

Actualización
Enfermedad de Alzheimer

Alzheimer's disease

D. Barragán MartínezaM.A. García SoldevillaaA. Parra SantiagobJ. Tejeiro Martínezb
Doi : https://10.1016/j.med.2019.03.012
Opciones
Resumen

La enfermedad de Alzheimer es la causa más frecuente de demencia, y una de las principales causas de morbimortalidad en el paciente anciano. El acúmulo de β-amiloide y proteína tau en el cerebro de estos pacientes condiciona un deterioro progresivo e invariable de sus habilidades cognitivas, en especial de la memoria reciente, reduciendo gradualmente su independencia funcional. Se conocen mutaciones en 3 genes capaces de causarla, además de otros factores de riesgo genéticos y ambientales que influyen en su aparición. La edad es el principal, por lo que se espera un incremento en la prevalencia de la enfermedad en el futuro, acompañando al envejecimiento poblacional. En los últimos años, se han actualizado los criterios diagnósticos que, aun siendo fundamentalmente clínicos, pueden apoyarse en pruebas complementarias. El diagnóstico definitivo sigue siendo neuropatológico, pero se ha avanzado en el campo de la genética y se han desarrollado pruebas de neuroimagen capaces de detectar patología amiloide cerebral en vivo. El conocimiento de la clínica, los factores de riesgo, la genética, la neuropatología y la neuroimagen nos ayudarán a comprender la enfermedad y a desarrollar intervenciones preventivas y terapéuticas en el futuro.

Palabras clave
Demencia
Alzheimer
β-amiloide
Tau
Abstract

Alzheimer's disease is the most frequent cause of dementia, and is considered one of the main causes of morbidity and mortality among elderly patients. A progressive and irreversible deterioration in cognitive functions (specially short-term memory loss) is caused by brain β-amyloid and τ-protein deposits that increase gradually functional dependency. Among the causes of Alzheimer's disease, three genes and other genetic and environmental factors have been identified. Because aging is the main trigger cause, an increasing trend in its prevalence is expected in the future. Recently diagnostic criteria have been updated; complementary tests might help the diagnostic, which still remains fundamentally clinical. Definitive diagnosis still relies upon neuropathological findings, however genetic and in vivo amyloid imaging tests have improved significantly. In order to understand the disease and to develop preventive and therapeutic measures, the knowledge of the clinical manifestation, risk factors, genetics, neuropathology and neuroimaging is required.

Keywords
Dementia
Alzheimer's disease
β-amyloid
Tau

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