Could loneliness be an early sign of Alzheimer's disease?
Subtle feelings of loneliness could warn that Alzheimer's disease is imminent in older people, a new study suggests. Researchers have found that healthy older adults with elevated brain levels of amyloid - a type of protein fragment associated with Alzheimer's disease - are more likely to feel lonely than those with low levels of it.
“Para las personas que tienen altos niveles de amiloide tienen 7,5 veces más probabilidades de estar solos que los no solitarios”, dijo la investigadora principal, la Dra. Nancy Donovan. She es directora del Centro de Investigación y Tratamiento de Alzheimer en el Brigham and Women’s Hospital de Boston. Por otra parte hay estudios que han demostrado que las personas que permanecen socialmente activos tienen menos probabilidades de desarrollar demencia, dijo Donovan. Pero los resultados del nuevo estudio sugieren que esa relación puede funcionar al revés, también – que las personas en las primeras etapas de la enfermedad de Alzheimer podrían ser más propensos a sentirse solos o socialmente separados. “Las personas que están empezando a acumular amiloide pueden no estar funcionando tan bien en términos de percibir, comprender o responder a estímulos o interacciones sociales”, dijo Donovan. “Esto podría ser una señal social temprana del cambio cognitivo [mental]”. Si esto es comprobado, entonces los médicos podrían ser capaces de detectar la enfermedad de Alzheimer prestando más atención a la salud emocional de los pacientes, sugirió. Las placas cerebrales formadas a partir de las pegajosas proteínas amiloides son un sello distintivo de la enfermedad de Alzheimer, la causa más común de demencia, según los Institutos Nacionales de Salud de los Estados Unidos. Estas placas se forman en los espacios entre las células nerviosas del cerebro de los pacientes de Alzheimer, aunque su conexión con la enfermedad no se entiende completamente en este momento. Para examinar la relación entre la soledad tardía y el riesgo de Alzheimer, Donovan y sus colegas examinaron a 43 mujeres y 36 hombres, con una edad promedio de 76 años. Todos estaban sanos, sin signos de Alzheimer o demencia. Los investigadores usaron exámenes psicológicos estándar para medir el grado de soledad de cada persona, y exploraciones de imágenes para detectar la cantidad de proteína amiloide en sus cerebros. Los investigadores se centraron particularmente en los niveles de amiloide en la corteza cerebral, una parte del cerebro que desempeña un papel clave en la memoria, la atención, la percepción y el pensamiento.
People with high levels of amyloid in the cortex were 7.5 times more likely to be classified as feeling lonely, even after the researchers classified them as socially active, as well as if they had suffered from depression or anxiety. Taking into account the extent of the person's social network, Donovan's team showed that seniors who feel isolated or socially separated, even when surrounded by friends or family, could be at high risk for Alzheimer's.
Sin embargo, el estudio no prueba una relación directa de causa y efecto entre los dos. La Dra. Gisele Wolf-Klein, directora de educación geriátrica de Northwell Heatlh en Great Neck, N.Y., dijo que este hallazgo es “muy nuevo” y podría apuntar a nuevas formas de asociar las emociones de una persona con el riesgo de demencia. Sin embargo, este estudio se realizó en un grupo muy pequeño de adultos mayores de Boston, una ciudad donde la gente suele ser mejor educada y puede estar más en contacto con sus emociones, añadió Wolf-Klein. Se necesitan estudios más amplios que involucren a diferentes tipos de personas para validar estos hallazgos, dijo. “Si esto es corroborado por otros estudios más amplios, entonces la pregunta sería, ¿qué tipo de intervención podría resultar?” Dijo Wolf-Klein. “Si pudieras impactar en esta soledad creando intervenciones donde la gente fuera sacada de su soledad y comprometida en eventos sociales, ¿tendrías menos probabilidad de progresión hacia la demencia?” Dean Hartley es director de iniciativas científicas, relaciones médicas y científicas en la Asociación de Alzheimer. Hartley dijo que en las primeras etapas de la enfermedad de Alzheimer, puede haber “cambios de comportamiento que pueden ser un síntoma de deterioro cognitivo leve o demencia”. Los médicos en el futuro pueden ser entrenados para buscar soledad, apatía, cambios de humor o impulsividad social como signos tempranos de la enfermedad de Alzheimer, dijo. “Creemos que éste [el nuevo hallazgo] es importante, y tengo la sensación de que veremos más sobre esto”, dijo Hartley. “A medida que desarrollamos tratamientos para el Alzheimer, cuanto antes diagnostique y cuanto antes se trate, mejores serán los resultados.”
10 early signs of Alzheimer's disease:
Are you worried about your mental acuity? Or maybe that of a loved one? Mild forgetfulness can be a normal part of aging. If you have trouble remembering someone's name but it comes to you later, that is not a serious memory problem. But if memory problems are seriously affecting your daily life, they could be early signs of Alzheimer's disease. While the number of symptoms you have and how strong they are vary, it is important to identify the early signs. You have to ask yourself some tough questions.
1. Memory loss This is the most common symptom. Do you easily forget the information you just learned? Lost track of important dates, names, and events? Are you forgetting important things that have happened? Do you ask for the same information over and over again? Relying heavily on memory aids like post-it notes or reminders on your smartphone?
2. Problem planning and troubleshooting Having trouble making plans and sticking with them? Is it difficult to follow a recipe, even one that you have used many times? Is it difficult to focus on detailed tasks, especially if they involve numbers? For example, can you keep track of your bills and balance your checkbook?
3. Daily tasks are challenging Even familiar things can get difficult. Are you having trouble driving to a place you go often? Can you complete a normal task at work? Forget the rules of your favorite game?
4. Times and places are confusing Can you fully understand something that is not happening right now? Are you disoriented? Is it easily lost? Did you forget where you are? Do you remember how you got there?
5. Changes in vision Is it harder to read the words on the page? Do you have trouble judging the distance? Can you distinguish the colors? This is important because it can affect your driving.
6. Words and conversations are frustrating The vocabulary becomes difficult. Can you find the correct word you are looking for? Or do you call things by the wrong name? Conversations can be a struggle. Avoid joining? Are you able to move on? Do you suddenly stop in the middle of an argument because you don't know what to say? Do you keep repeating yourself?
7. You lose things Everyone shifts things from time to time, but can you retrace your steps to find them again? Do you put things in unusual places, like your watch on the refrigerator? Do you accuse people of taking things?
8. Judgment lapse Have you made bad decisions lately? Do you make mistakes with money, like giving it away when you normally wouldn't? Are you showering frequently? Do you take care of yourself less? Do you dress for the weather?
9. Social retreat Are you cutting back on your projects at work? Are you less involved with your favorite hobbies? Do you lack motivation? Are you watching television or sleeping more than usual?
10. Humor changes Are you more easily upset? Are you feeling depressed, scared, or anxious? Are you suspicious of people?
See your Doctor If you notice these signs, talk to your doctor. They will evaluate your physical and mental health. They will examine your medical history and perform a mental status test, which will test your memory, simple problem solving ability, and thinking skills. You can also do blood or brain imaging tests. Your doctor may then refer you to someone who specializes in Alzheimer's, such as a neurologist (a doctor who specializes in treating the brain and nervous system), psychiatrist, psychologist, or geriatrician (a doctor who specializes in treating older people). . You can also find a specialist through your local Alzheimer's Association or the Centers for Alzheimer's Disease.
Bibliography:
Nancy Donovan, MD, professor, neurology, Harvard Medical School and director, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston;
Gisele Wolf-Klein, MD, director, geriatric education, Northwell Health, Great Neck, NY;
Dean Hartley, Ph.D., director of science initiatives, medical and scientific relations for the Alzheimer's Association; Nov. 2, 2016, JAMA Psychiatry, online
Alzheimer's Association: "10 Early Signs and Symptoms of Alzheimer's," "Diagnosis of Alzheimer's Disease and Dementia," "What Is Dementia?"
University of California San Francisco: "Alzheimer's Disease Signs and Symptoms."
National Institute on Aging: “Forgetfulness: Knowing When To Ask For Help.”
American Psychological Association: “Aging: When should I be concerned about a senior’s forgetfulness?”
Reviewed by Neil Lava, MD on January 15, 2015
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