Loneliness, social isolation, resilience and purpose in life are some variables that influence a person to develop dementia or cognitive impairment. It is one of the conclusions of the Study of the factors that influence healthy aging and its relationship with cognitive deterioration in rural populationl, promoted by community pharmacists from Tiriez (Albacete): a project on cognitive impairment for more than 10 years.
They have piloted it in more than 200 patients over 50 years of age: about 30% belong to the municipality of Tiriez, but there are also patients from neighboring towns, of different sizes, and they are beginning to do so in Albacete, to compare the rural and urban environment. : “Now we have published the tool that we are using, because we have seen that it is useful and there is not much done focusing cognitive deterioration on the psychosocial variable”, points out Martínez López.
They have already drawn some conclusions: there are around 26% of people at risk of dementia, and approximately 15% of those already surveyed age healthily: “It is a low result. This is more or less what happens in Spain in general”.
These results have already been disclosed in different national congresses and in the International magazine Journal of Environmental Research and Public Health (article Approaching psychosocial factors in the development of cognitive impairment from a holistic perspective: design of the methodology and pilot study).
The results show that those people with a greater capacity to face difficult situations (resilience), satisfactory social relationships, purposes in life and without a diagnosis of hypercholesterolemia, diabetes or hypertension have a lower risk of developing cognitive impairment and, consequently, of leading to a dementia.
“The objective is to understand how the problem develops in order to propose an intervention that provides a solution. But that will be when we have the most refined results, since we are in the second year of the thesis, ”he qualifies.
On these factors, Martínez López details that there are aspects that are already described in this sense, such as those related to cardiovascular risk -hypertension, cholesterol, diabetes-, “but there are other more novel ones, of which less is known and are less described . And in the end they have as much influence as health problems. I mean loneliness, social relationships, resilience… As for this last factor, the ability to cope with complex situations, those who are more resilient are less likely to develop dementia”, he comments.
Through these provincial grants for Juan Carlos Izpisúa Belmonte Scientific Research, they have been able to discover the differential characteristics of a patient who ages healthily compared to another who does not, and design interventions (group or individualized) to prevent cognitive deterioration. It has been shown that their global analysis is relevant in rural environments at risk of depopulation, where many of the municipalities of the province of Albacete are located.
Methodology used
For its development, the authors designed a methodology that allows assessing factors related to medication, health problems, nutrition, physical activity, sleep, and stress, among others. All this, through a face-to-face interview structured in six blocks.
“This interview lasts around an hour and a half, because we analyze more than 30 variables. For this we need the pharmacy to have adequate facilities”, explains Martínez López.
The inclusion criteria to participate in this study? Being over 50 years old: “Dementia usually appears between the ages of 70 and 80, but it begins to develop much earlier,” says the pharmacist. Exclusion criteria? “Logically, that person who has already been diagnosed with dementia.”
Then, based on the results with these more than 200 patients, a statistical analysis is carried out, with the anonymized data: “I see a percentage, but I don’t see more. I cannot know to whom each data belongs”.
Specifically, three rapid neuropsychological tests previously agreed upon with neurologists are used to screen for cognitive impairment (Memory Impairment Screen; Pfeiffer Test and Verbal Fluency Test), controls that are complemented with an analysis of genetic markers in saliva.
“These neurological tests last around 15 minutes. But, apart from that, we analyze about 30 variables: what you eat, height, weight, waist circumference, hip circumference, how you sleep, medication, sociodemographic values…”. Regarding the analyses, he specifies that they have not yet begun to carry them out, “but we are working on it. They require the signing of an additional informed consent -apart from the one already signed for the interview- by the patient. If the patient wants it, a saliva sample is taken in a container for that purpose, and it is sent to a laboratory, which analyzes it.“. carmen torrent