Biomarcadores no convencionales en demencia a través del examen neurológico: una revisión de la literatura
DOI:
https://doi.org/10.17533/udea.iatreia.294Palabras clave:
Atención Primaria de Salud, Biomarcadores, Demencia, Diagnóstico Precoz, Disfunción Cognitiva, Examen NeurológicoResumen
Introducción: los biomarcadores en sangre y líquido cefalorraquídeo han tomado fuerza para el diagnóstico de demencia, pero no siempre están disponibles.
Objetivos: describir los biomarcadores no convencionales durante el examen neurológico.
Métodos: revisión narrativa, realizando búsqueda sobre deterioro cognitivo en relación con biomarcadores no convencionales en las bases de datos PubMed, EMBASE y SciELO, incluyendo estudios originales y secundarios que describieran esta relación, además de las herramientas para su evaluación en la clínica.
Resultados: los síntomas neuropsiquiátricos son una de las primeras manifestaciones y un marcador de progresión que está presente en aproximadamente el 97% de los pacientes. Depresión, ansiedad y apatía son tres posibles, evaluables con base en experticia clínica, escalas o nuevas tecnologías. Otros marcadores son bradipsiquia y alteración en la función ejecutiva, la cual afecta en un 8-13% los parámetros de función motora. Con relación a los pares craneales, puede haber alteraciones en nervio óptico y retina, cambios en los movimientos oculares e hipoacusia. El examen motor es uno de los más prometedores con la doble tarea, velocidad de la marcha y fuerza de agarre. Se ha estimado que puede influenciar más de un 50% la ocurrencia de demencia. También pueden verse alteraciones sensitivas respecto a la percepción del dolor. Por último, la aparición de dos o más reflejos de liberación frontal es un marcador de deterioro cognitivo.
Conclusiones: se encontró evidencia que soporta el uso de biomarcadores no convencionales, los cuales pueden ser una alternativa para detectar tempranamente deterioro cognitivo.
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