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Científicos demuestran que dormir mal puede predisponer a padecer alzhéimer Dormir mal puede predisponer al alzheimer
La ciencia sabía hasta ahora que la calidad del sueño influía en las funciones cerebrales, ahora un estudio de la Fundación Pasqual Maragall demuestra que dormir mal puede ser un factor clave para desarrollar algunas demencias Dormir mal no solo nos predispone a pasar un mal día, sino que puede ser un factor de desarrollo de alzhéimer, una dolencia que en España afecta a 800.000 personas. Con una esperanza de vida en aumento, si no se encuentra un tratamiento para prevenir o frenar el curso de la enfermedad, los casos podrían triplicarse en 2050 , como apunta el último informe de World Alzheimer. Por ello, cualquier recurso dedicado al conocimiento de la enfermedad, su tratamiento, hoy por hoy, inexistente, y su prevención es especialmente valioso.
En este contexto, destaca un nuevo trabajo del BarcelonaBeta Brain Research Center (BBRC), el centro de investigación de la Fundación Pasqual Maragall, que se publica en la revista Alzheimer’s Research and Therapy, y que ha contado con el impulso de la Fundación La Caixa. Según este estudio, las personas con insomnio presentan cambios en el rendimiento cognitivo y la estructura cerebral , especialmente en la sustancia blanca y algunas regiones que se afectan en etapas tempranas de la enfermedad de Alzheimer.
Nuevos maneras de investigar Hasta el momento, algunos estudios previos en el campo de las demencias encontraron una asociación entre la baja calidad del sueño, ya sea como factor de riesgo o como manifestación temprana de la enfermedad. El estudio de la Fundación Pasqual Maragall va algo más lejos. Para el doctor Oriol Grau, uno de los responsables del estudio, “la investigación sobre el alzheimer tiene que abordarse desde distintas perspectivas. Hasta ahora se ha hecho desde una perspectiva epidemiológica o desde el punto de vista de los marcadores. Nuestra investigación cuenta con un número muy grande de participantes: 1.683 personas sin alteraciones cognitivas, 615 con insomnio y, de ellas, 400 personas a las que se ha sometido a varias resonancias magnéticas . Su media de edad ronda los 60 años y tienen familiares con Alzheimer. Son pacientes sanos con los que hemos podido investigar”. Y los resultados han sido reveladores.
Por un lado, los investigadores analizaron el rendimiento cognitivo de las personas con insomnio y lo compararon con el de personas con un sueño normal. Como conclusión, el insomnio se relaciona con un peor resultado en pruebas cognitivas . Especialmente se ha descrito una reducción en algunas funciones ejecutivas, como por ejemplo la memoria de trabajo.
Por otro lado, el estudio demuestra, gracias a las imágenes de resonancia magnética, que los participantes con insomnio presentan un menor volumen en algunas regiones cerebrales . Entre ellas se encuentran el precúneo o el córtex cingulado posterior, que se encuentran afectadas en etapas tempranas de la enfermedad. Los resultados apoyan las investigaciones que relacionan la presencia de insomnio con una elevada vulnerabilidad a la enfermedad de Alzheimer.
De nuevo, la enfermedad inflamatoria
Cualquier persona interesada en los temas de salud encuentra en la literatura médica un concepto habitual: la inflamación. Muchas patologías están relacionadas con procesos inflamatorios recurrentes. Grau es prudente respecto a la incidencia de la neuroinflamación con el Alzheimer: “no me atrevo a dar pautas concretas. Algunos estudios decían que las personas que tomaban anti-inflamatorios padecían menos demencias, pero a día de hoy no hay nada concluyente . Por otra parte la actividad cerebral es muy compleja y a veces algunos procesos requieren cierta inflamación. No podemos generalizar”.
Sin embargo, las resonancias magnéticas que forman parte del estudio muestran cambios en la sustancia blanca cerebral que sugieren la presencia de procesos de inflamación cerebral y que, según este especialista, “podrían tener un papel clave en la asociación entre la calidad del sueño y el alzheimer ”. Esta conclusión abre la puerta a una nueva línea de investigación que hasta ahora no ha sido explorada para entender la relación entre la neuroinflamación, el sueño y la demencia.
Finalmente, los investigadores analizaron la relación entre el insomnio y la variante genética APOE-ε4, la que tiene un riesgo más elevado de desarrollar Alzheimer. Los resultados del estudio demuestran que los efectos del insomnio sobre el cerebro están potenciados en personas portadoras de APOE-ε4. Estas personas serían las que tienen más riesgo de desarrollar la enfermedad.
Objetivo: la detección precoz Este estudio establece los fundamentos de una nueva línea de investigación que permitirá analizar de forma más exhaustiva la calidad del sueño y de incorporar nuevos biomarcadores que puedan detectar precozmente el Alzheimer. “El insomnio provoca el acúmulo de ciertas proteínas que pueden desencadenar la enfermedad”, afirma Oriol Grau. Antes de alcanzar algún resultado concluyente, ¿hay algunas pautas que podamos adoptar desde ya para prevenirla? Los expertos se muestran prudentes. “Los patrones de sueño cambian durante toda la vida. No dormimos las mismas horas de niños que de adultos y conforme cumplimos años dormimos menos y peor. Pero esto no significa que todas las personas con insomnio o que duerman mal vayan a padecer alzheimer . De hecho, el peso específico entre alteración de sueño y esta enfermedad es pequeño”, explica Grau.
Aunque la magnitud del sueño no sea un factor decisivo, sí es valioso porque permite que todos, a escala doméstica, podamos intervenir para mejorarlo. “Todos podemos establecer cambios para lograr un sueño mejor, es un hábito saludable que revertirá en una mayor calidad de vida”, afirma el investigador. Dormir bien, junto a las pautas habituales de un estilo de vida sano (dieta mediterránea, ejercicio y ausencia de tabaquismo, fundamentalmente) forman las medidas top para frenar o esquivar cualquier enfermedad, especialmente las patologías cardiacas. Y algunas líneas de investigación establecen también una relación entre el deterioro cardiovascular y el cognitivo.
Divulgación y atención primaria Queda mucho por hacer en el terreno de la divulgación y de la atención primaria. A diferencia de otras enfermedades, en las que es posible hacer campañas de prevención o protocolos de intervención entre pacientes y cuidadores, en el alzheimer hay mucho camino por recorrer. “Hoy por hoy el alzheimer no se puede frenar . Todos los tratamientos con personas con demencia han fracasado, por eso no tendría sentido que se hiciera ninguna intervención en atención primaria. En el campo de la investigación, sí”, explica Oriol Grau.
Sin embargo, diagnosticar la enfermedad es esencial para mejorar la calidad de vida del paciente y ayudar a que familia y cuidadores aprendan a vivir con esta enfermedad. “La demencia aún forma parte de un tabú social , aunque su incidencia es muy grande entre las personas mayores. Pero conocer el diagnóstico es muy útil para, por ejemplo, poder tomar decisiones ”, afirma este especialista. Cualquier cambio de comportamiento, cualquier signo de deterioro cognitivo y cambios en la manera de hablar o de la propia personalidad deben ser motivo de consulta médica. Y si, además, nos atacan los ‘malos sueños’, la visita al centro de salud ya es obligada.
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