A cura di @LaLeona (Miki) e @ulrich (modificato).

In questo recente articolo, gli autori considerano le caratteristiche che distinguono l’Alzheimer (nel seguito AD per uniformità al testo linkato) dalle altre malattie neurodegenerative solitamente connesse al processo di invecchiamento. Gli autori partono da questa considerazione.

According to the dominant biomedical position, Alzheimer’s disease
(AD) is a chronic and progressive disease that can be identified on
the basis of specific cognitive symptoms (in particular, episodic
memory deficits) and neuropathological characteristics (i. e.,
neurotic plaques and neurofibrillary tangles). Importantly, this
approach considers AD to be intrinsically different from normal ageing
and other neurodegenerative diseases and proposes that, by pursuing
extensive research on what are considered the specific
neuropathological characteristics of AD, we will eventually be able to
identify the cause of this disease and develop medical treatments that
will allow us to successfully cure it.

Gli autori giungono alla conclusione che per la AD manca un criterio diagnostico preciso sia a livello cognitivo sia a livello biologico e che i metodi attualmente impiegati nella pratica clinica non contemplano l’eterogeneità e la complessità di questa condizione.

Propongono invece quella che loro chiamano “A life-span plurifactorial view”:

Explicitly, according to this alternative and more recent perspective,
the nature and extent of the cognitive and functional difficulties that
people experience as they grow older are modulated by a myriad of
factors and mechanisms that interact throughout the lifespan. In
particular, numerous epidemiological studies have shown that the factors
that influence cognitive and cerebral ageing are biological (e.g., age,
cardiovascular risk factors, diabetes, etc.), psychological (e.g.,
depression, anxiety, stress, etc.), environmental (e.g., environmental
toxins, etc.), social (e.g., social isolation, etc.), cultural (e.g.,
living in a society that holds negative stereotypes towards ageing), and
related to one’s lifestyle (e.g., lack of regular physical activity,
etc.) in nature. Importantly, these factors are thought to operate
through a complex set of interacting mechanisms and to function either
as risk or as protective factors depending on how each person relates to
them individually.

Le conclusioni cui giungono gli autori dell’articolo sono queste:

Altogether, these findings have lead a growing number of authors to
suggest that we must free ourselves from the reductionist biomedical
conceptualisation of AD and that, instead of imprisoning people in
pathologising and stigmatising diagnostic categories, we should
reinstate the different expressions of this supposedly specific disease
in a broader framework of cerebral and cognitive ageing.

Immagine da Pixabay.