Deterioro Neurocognitivo en Adultos Mayores con Diabetes Mellitus desde un enfoque de género
Palabras clave:
Diabetes Mellitus, Trastornos Neurocognitivos, Anciano, Disparidades en el Estado de Salud, Factores Sexuales, Factores de GéneroResumen
Introducción: La diabetes mellitus (DM) y el deterioro neurocognitivo (DNC) en adultos mayores representan un desafío de salud pública de magnitud creciente. La literatura científica ha destacado la necesidad de incorporar un enfoque de género para discernir las disparidades en la prevalencia, fisiopatología, expresión clínica y abordaje entre hombres y mujeres.
Objetivo: Realizar una revisión exhaustiva de la evidencia científica sobre la asociación entre DM y DNC en adultos mayores, que integra la perspectiva de género y utilizando la terminología del DSM-5.
Métodos: Se realizó una búsqueda sistemática en PubMed/MEDLINE, SciELO, Scopus, Web of Science y Cochrane Library (2015-2024) utilizando descriptores MeSH/DeCS relacionados con DM, DNC, género y envejecimiento. Se priorizaron revisiones sistemáticas, meta-análisis y estudios de cohorte.
Resultados: La DM es un factor de riesgo potente para todo el espectro de DNC. Los mecanismos fisiopatológicos incluyen enfermedad vascular cerebral, resistencia a insulina central, neuroinflamación e hipoglucemias. El análisis de género revela que las mujeres con DM tienen mayor riesgo de demencia vascular, atribuible a deprivación estrogénica posmenopáusica, mayor carga de factores de riesgo cardiometabólicos y determinantes sociales como menor reserva cognitiva. Los hombres muestran patrones diferenciales con afectación más temprana de dominios ejecutivos.
Conclusiones: La incorporación del enfoque de género es esencial y debe traducirse en cribado cognitivo obligatorio con instrumentos sensibles a dominios no mnésicos, estrategias de prevención personalizadas, optimización del control glucémico, y políticas que aborden inequidades de género.
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Derechos de autor 2025 Yuniel Abreu Hernández, Daimara Barrera León, Jorge Luis Lorente Montiel
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
