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      Promoción y prevención del deterioro cognitivo y demencias en personas mayores Translated title: Promotion and prevention of cognitive deterioration and dementia in older people

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          Abstract

          Resumen El envejecimiento poblacional a nivel mundial ha llevado a un aumento de la prevalencia de enfermedades neurodegenerativas, presentándose como un desafío para los equipos de salud. El objetivo de este trabajo es analizar evidencia científica relacionada con la prevención del deterioro cognitivo y demencias, a nivel nacional e internacional en personas mayores. Método: Revisión de evidencia científica disponible. Resultados: Se seleccionaron 15 artículos, de los cuales 1 es nacional, donde se realiza una reseña de los factores protectores y de riesgo para la presentación de demencias en personas mayores. Los otros 14 estudios son internacionales, 7 son estudios experimentales donde se aplica a los sujetos de estudio un programa de actividades en la comunidad que resultaron positivas para el desempeño cognitivo. Los otros 7 estudios son observacionales donde se analizan factores protectores para la prevención de la demencia. Conclusión: Los factores de riesgo para la presentación de deterioro cognitivo leve y demencias son similares a otras enfermedades crónicas no transmisibles, el trabajo sobre factores protectores, permitiría mejorar el rendimiento cognitivo y retardar el avance de las demencias en etapas iniciales. Se requieren estudios locales y a largo plazo para observar la realidad nacional.

          Translated abstract

          Abstract Population aging worldwide has led to an increase in the prevalence of neurodegenerative diseases, presenting itself as a challenge for health teams. The objective of this work is to analyze scientific evidence related to the prevention of cognitive impairment and dementias, nationally and internationally, in older people. Method: Review of available scientific evidence. Results: 15 articles were selected, of those 1 is national, where made review of the protective and risk factors for the presentation of dementias in older people is made. The other 14 studies are international, 7 are experimental studies where a program of activities in the community that were positive for cognitive performance is applied to the study subjects. The other 7 studies are observational where protective factors for the prevention of dementia are analyzed. Conclusion: The risk factors for the presentation of mild cognitive impairment and dementias are similar to other chronic non-communicable diseases, the work on protective factors, would improve cognitive performance and delay the advance of dementias in the initial stages. Long-term and local studies are required to observe the national reality.

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          Total daily physical activity and the risk of AD and cognitive decline in older adults.

          Studies examining the link between objective measures of total daily physical activity and incident Alzheimer disease (AD) are lacking. We tested the hypothesis that an objective measure of total daily physical activity predicts incident AD and cognitive decline. Total daily exercise and nonexercise physical activity was measured continuously for up to 10 days with actigraphy (Actical®; Philips Healthcare, Bend, OR) from 716 older individuals without dementia participating in the Rush Memory and Aging Project, a prospective, observational cohort study. All participants underwent structured annual clinical examination including a battery of 19 cognitive tests. During an average follow-up of about 4 years, 71 subjects developed clinical AD. In a Cox proportional hazards model adjusting for age, sex, and education, total daily physical activity was associated with incident AD (hazard ratio = 0.477; 95% confidence interval 0.273-0.832). The association remained after adjusting for self-report physical, social, and cognitive activities, as well as current level of motor function, depressive symptoms, chronic health conditions, and APOE allele status. In a linear mixed-effect model, the level of total daily physical activity was associated with the rate of global cognitive decline (estimate 0.033, SE 0.012, p = 0.007). A higher level of total daily physical activity is associated with a reduced risk of AD.
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            Feelings of loneliness, but not social isolation, predict dementia onset: results from the Amsterdam Study of the Elderly (AMSTEL).

            Known risk factors for Alzheimer's disease and other dementias include medical conditions, genetic vulnerability, depression, demographic factors and mild cognitive impairment. The role of feelings of loneliness and social isolation in dementia is less well understood, and prospective studies including these risk factors are scarce. We tested the association between social isolation (living alone, unmarried, without social support), feelings of loneliness and incident dementia in a cohort study among 2173 non-demented community-living older persons. Participants were followed for 3 years when a diagnosis of dementia was assessed (Geriatric Mental State (GMS) Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT)). Logistic regression analysis was used to examine the association between social isolation and feelings of loneliness and the risk of dementia, controlling for sociodemographic factors, medical conditions, depression, cognitive functioning and functional status. After adjustment for other risk factors, older persons with feelings of loneliness were more likely to develop dementia (OR 1.64, 95% CI 1.05 to 2.56) than people without such feelings. Social isolation was not associated with a higher dementia risk in multivariate analysis. Feeling lonely rather than being alone is associated with an increased risk of clinical dementia in later life and can be considered a major risk factor that, independently of vascular disease, depression and other confounding factors, deserves clinical attention. Feelings of loneliness may signal a prodromal stage of dementia. A better understanding of the background of feeling lonely may help us to identify vulnerable persons and develop interventions to improve outcome in older persons at risk of dementia.
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              Social isolation and loneliness: relationships with cognitive function during 4 years of follow-up in the English Longitudinal Study of Ageing.

              This study aims to evaluate the impact of social isolation and loneliness, individually and simultaneously, on cognitive function in older adults during a 4-year period, using data from the English Longitudinal Study of Ageing, and to evaluate if these associations are moderated by educational level.
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                Author and article information

                Journal
                ene
                Ene
                Ene.
                Martín Rodríguez Álvaro (Santa Cruz de La Palma, La Palma, Spain )
                1988-348X
                2020
                : 14
                : 3
                : e14304
                Affiliations
                [1] Calca orgnameUniversidad Andrés Bello orgdiv1Facultad de Enfermería Chile layala@ 123456ucm.cl
                Article
                S1988-348X2020000300004 S1988-348X(20)01400300004
                12ad6420-bfbc-4080-bccc-88d33bdd63ea

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 01 February 2020
                : 01 October 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 18, Pages: 0
                Product

                SciELO Spain

                Categories
                Artículos

                Anciano,Dementias,Prevention,Prevención,Cognitive Dysfunction,Demencias,aged,Disfunción Cognitiva

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