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Alzheimer, algo más que despistes de memoria

Pérdida de memoria, esa es la característica principal de la enfermedad de Alzheimer. Esto hay que entenderlo como la dificultad para recuperar los recuerdos, incluso aunque nos ayuden con pistas para intentar recordarlos. Cuando la gente habla de pérdida de memoria, suele ser más bien dificultad para centrarse en lo que le dicen o para organizar los pensamientos para almacenarlos bien y luego poder evocarlos.

A la pérdida de memoria hay que añadir la dificultad para encontrar palabras. Esto es algo muy frecuente en el propio proceso de envejecimiento. En el Alzheimer hay una progresiva sustitución del léxico por palabras ómnibus, tipo «el éste», «la cosa aquella…», tal y como nos explican las doctoras Miriam Eimil Ortiz y María José Gil Moreno, de nuestra Unidad de Demencia.

Prevención

La aparición del Alzheimer se puede retrasar modificando el estilo de vida: con ejercicio intenso, que sea al menos tres veces a la semana durante unos 40 minutos y cansándose; ejercicio mental: iniciar tareas nuevas, complicadas, tener aficiones que no sean rutinarias (es más creativo tejer que hacer sopas de letras); comida sana del estilo de dieta mediterránea; controlar los factores de riesgo vascular: tensión arterial, azúcar en la sangre, el corazón…

Para poder llegar a un diagnóstico, se cuenta con diversos elementos. La primera sospecha de la familia y/o del paciente se debe confirmar por la impresión clínica del médico, que se basará en un interrogatorio clave a la familia y una exploración al paciente.

Diagnóstico

«En el interrogatorio al entorno indagaremos en si el paciente ha cambiado en los últimos tiempos respecto a su carácter, su capacidad para gestionar sus asuntos, su sentido común o capacidad de juicio, si son reiterativos o hay que repetirles las cosas, si no aprenden tareas nuevas, si han descuidado aficiones o su autocuidado», explican nuestras neurólogas, quienes añaden que «una vez valorada con esto su situación funcional pasaremos a explorar al paciente y a  hacer unos test de cribado rápido, que tienen una buena fiabilidad si sabemos elegir el test adecuado a nuestro paciente. Con ellos exploraremos sobre todo la memoria; la memoria «de verdad», la capacidad de grabar, pero también otras funciones. Hay muchas ocasiones en que en este punto ya podemos diagnosticar a nuestro paciente de una demencia tipo Alzheimer».

A partir de aquí se piden análisis de sangre para descartar causas trade la enfermedad y según la impresión que de la exploración y del interrogatorio, se solicitarán pruebas para ver el cerebro, TAC cerebral o bien resonancia magnética. Si hay dudas, se recurrirá a pruebas más avanzadas de medicina nuclear o en líquido cefalorraquídeo, y estudios neuropsicológicos más complejos que el test de cribado inicial.

Con respecto al tratamiento, queda mucho por hacer. Los fármacos disponibles tienen un efecto muy modesto sobre la vida del paciente o de los familiares. «No podemos olvidarnos en el manejo de la terapia cognitiva, los centros de día y la terapia ocupacional, destinada a mantener autónomo al paciente el mayor tiempo posible», aseguran doctoras Miriam Eimil Ortiz y María José Gil Moreno.

En este sentido, las investigaciones se centran en las vacunas, que suelen dirigirse a potenciar que el propio organismo del paciente se defienda del depósito de esas proteínas asentadas donde no tendrían que estar.

Cuidados compartidos

Los familiares, que suelen ser los cuidadores, no deben esperar a estar agotados para pedir ayuda. Nuestras especialistas recomiendan compartir con familia y amigos el cuidado de su ser querido y las emociones que genera, que tengan tiempo para su propio disfrute, que no se sientan culpables en los malos días en que no saben gestionar situaciones complicadas.

Demencia

Sin duda es una situación dura, pero tiene momentos, incluso en fases avanzadas, en que se puede disfrutar de y con el ser querido que padece Alzheimer. No va a ningún sitio pensar en lo que podría ser (sano, disfrutando de la vida) y lo que es (ver a nuestro familiar enfermo, discapacitado, «que ya no es él»), sino que hay que pensar que nuestro paciente aún mantiene capacidad de disfrute, que es mucho más sencilla que la nuestra, de percibir cariño y de hacernos sentir bien.

En fin, que el Alzheimer, que es cierto que es una involución tremenda de la persona, nos quitará el raciocinio, pero no nos robará la capacidad de mantenernos conectados al mundo por medio de las emociones.

Contenido validado por la Dra. Miriam Eimil Ortíz y Dra. María José Gil Moreno, neurólogas en la Unidad de Demencial del Hospital Universitario de Torrejón.



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