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Inicio Revista Española de Geriatría y Gerontología Efecto del aislamiento social, el déficit de afrontamiento e pérdidas personal...
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Vol. 39. Núm. 6.
Páginas 371-380 (enero 2004)
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Vol. 39. Núm. 6.
Páginas 371-380 (enero 2004)
Acceso a texto completo
Efecto del aislamiento social, el déficit de afrontamiento e pérdidas personales, la apatía y el bloqueo de la percepción n enfermos de Alzheimer
Effect of social isolation, coping deficit after personal losses, apathy and perception blockade in patients with Alzheimer's disease
Visitas
2976
L.M. Sánchez de Machado
Autor para correspondencia
stopalzheimer@hotmail.com
sanchez@fcs.uner.edu.ar

Correspondencia: Facultad de Ciencias de la Salud. 8 de Junio 600. 3260 Concepción del Uruguay. Entre Ríos. Argentina.
Catedrático de Metodología de la Investigación. Facultad de Ciencias de la Salud. Universidad Nacional de Entre Ríos. Argentina
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Bibliografía
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Estadísticas
Objetivo

explorar el encadenamiento de perfiles personales restringidos de relación y comunicación, pérdidas personales significativas y déficit de afrontamiento, que culmina en un autobloqueo perceptivo e instala el proceso denominado Alzheimer.

Material y métodos

se estudió en 33 mujeres y 23 varones, actualmente con enfermedad de Alzheimer, el desarrollo de 7 áreas de relación-comunicación, las eventuales pérdidas personales y la capacidad de afrontamiento de éstas, y se compararon separadamente con otras tantas mujeres y varones con envejecimiento normal, emparejados por edad, perfil laboral, escolaridad, ingreso del grupo familiar, etnia y otros factores (seudogemelos). Los datos e informaciones se obtuvieron mediante entrevistas en profundidad, bajo protocolos previamente validados, efectuadas al familiar cuidador central o al familiar más cercano, mejor instruido y dispuesto, y en forma directa a los voluntarios con envejecimiento normal.

Resultados

todos los participantes actualmente con Alzheimer pasaron por una fase de desmotivación o depresión sui generis de leve a extrema y posterior deterioro perceptivo manifiesto. El perfil de relación y comunicación resultó significativamente menos plural y más bajo que en los seudogemelos con envejecimiento normal, y la capacidad de afrontamiento fue notablemente menor. Sin embargo, las pérdidas personales significativas fueron, en general, similares en ambos grupos.

Conclusiones

se deduce entonces que una historia de vida con introversión social importante, sumada a la incapacidad de afrontamiento de las pérdidas personales, es la ecuación de crisis en que se produce una plural desmotivación de vida y que se continúa con un autobloqueo perceptivo.

Discusión

se presume que la desmotivación con bloqueo perceptivo desencadenará a su vez la anulación o aversión del reforzamiento natural de las redes neuronales, con la consiguiente desintegración progresiva de las funciones cerebrales. Ésta sería entonces la base para una teoría que conjuga factores psicosociales con otros propiamente neurobiológicos en la instalación del proceso de alzheimerización.

Palabras clave:
Alzheimer
Perfil relacional
Pérdidas personales
Afrontamiento Bloqueo perceptivo
Aversión
Reforzamiento
Desintegración funciones cerebrales
Objective

to explore the links among restricted social relationships and communication profiles, significant personal losses and inadequate coping culminating in perception blockade and the process known as Alzheimer's disease.

Material and methods

seven areas of social relationships and communication, personal losses and the ability to cope with these were studied in 33 women and 23 men with Alzheimer's disease and were separately compared in the same number of women and men with normal ageing, matched by age, occupational profile, schooling, family income, ethnic group and other factors (pseudo-twins). Data and information were obtained through in-depth interviews with the main family caregiver or closest relative, or the best informed and most collaborative relative, using previously validated protocols. Volunteers with normal ageing were directly interviewed.

Results

all the participants with Alzheimer's disease passed through a phase of demotivation or mild to severe sui generis depression and subsequently manifested perceptive dysfunction. Social relationships and communication profiles were significantly less plural and lower than in pseudo-twins with normal ageing, and the ability to cope was markedly lower. However, significant personal losses were generally similar in both groups.

Conclusions

a life history with marked social introversion added to inadequate coping with personal losses is the critical equation that produces demotivation to continue living followed by perception blockade.

Discussion

it is presumed that demotivation with perception blockade will in turn trigger cancellation or aversion of natural reinforcement of the neuronal networks, with a consequent progressive disintegration of brain functions. This could then form the basis for a theory that would combine psychosocial and neurobiological factors in the initiation of the process of Alzheimerisation.

Key words:
Alzheimer
Social relationships
Personal losses
Coping
Perception blockade
Aversion
Reinforcement
Brain function disintegration
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Bibliografía
[1.]
B. Richarz.
Considerations to the psychosomatics of Alzheimer's disease.
Dynamische Psychiatrie, 166/167 (1997), pp. 340-355
[2.]
J. Bauer.
Benefits of psychotherapeutic treatment in Alzheimer patients in the early stage of the disease.
Nervenarzt, 68 (1997), pp. 421-424
[3.]
B. Richarz.
Psychodynamische un gruppendynamische. Aspekte einer Alzheimer Demenz.
Dyn Psychiat, 29 (1996), pp. 101-115
[4.]
W.D. Oswald.
Non-drug therapy and prevention of Alzheimer disease.
Z Gerontol Geriatrie, 34 (2001), pp. 116-121
[5.]
K. Kondo, I. Yamashita.
A case-control study of Alzheimer's disease in Japan: association with inactive psychosocial behaviors.
Psychogeriatrics biomedical and social advances, pp. 49-53
[6.]
L.M. Sanchez, J.D. Garcia.
La patología de la sociabilidad y la comunicación como fase previa a la instalación de la enfermedad de Alzheimer.
II Congreso del Comité Regional Latinoamericano-International Association of Gerontology. Buenos Aires:, 11 (1995), pp. 26-30
[7.]
R.T. Linn, P.A. Wolf, D.L. Bachman, J.E. Knoefel, J.L. Cobb, A.J. Belanger, et al.
The “preclinical phase” of probable Alzheimer's disease. A 13-year prospective study of the Framingham cohort.
Arch Neurol, 52 (1995), pp. 485-490
[8.]
U. Kropiunigg, K. Sebek, A. Leonhardsberger, M. Schemper, P. Dal'Bianco.
Psychosocial risk factors for Alzheimer's disease.
Psychoter Psychosom Med Psychol, 49 (1999), pp. 153-159
[9.]
J.L. Conde Sala.
Personalidad premórbida y factores de riesgo en la enfermedad de Alzheimer.
Rev Esp Geriatr Gerontol, 34 (1999), pp. 157-161
[10.]
M. Malinchoc, W.A. Rocca, R.C. Coligan, K.F. Offord, E. Kokmen.
Premorbid psychosocial proceses in patients with Alzheimer's disease: an exploratory case-control study.
Behav Neurol, 10 (1997), pp. 117-120
[11.]
L.M. Sanchez.
Dinámica relacional y comunicacional y perfiles de pérdidas personales en la fase preclínica de casos de Alzheimer no genético de instalación temprana.
Geriatrianet.com, 5 (2003), pp. 1-14
[12.]
J. Bauer, G. Stadtmüller, J. Qualmann, H. Bauer.
Prämorbide psychologische Prozesse bei Alzheimer-Patienten un bei Patienten mi vaskulären Demenzerkrankungen.
Z Gerontol Geriat, 28 (1995), pp. 179-189
[13.]
L.M. Sanchez.
Psychosocial corralling profiles at the preclinical phase as a trigger for the Alzheimer's disease.
Alzheimer Disease International, 12th International Conference, (1996),
[14.]
R.P. Friedland, K.A. Smyth, D.Y. Rowland, C. Esteban-Santillan, E. Koss, R. Cole, et al.
Pre-morbid activities in patients with Alzheimer's disease as compared to age-and sex-matched controls: results of a case-control study.
Alzheimer's disease: Biology, diagnosis and therapeutics, pp. 33-37
[15.]
Y. Shen.
A case-control study of risk factors on Alzheimer's disease. Multicenter collaborative study in China.
Chung Hua Shen Ching Ching Shen Ko Tsa Chih, 25 (1992), pp. 284-287
[16.]
C. Helmer, D. Damon, L. Letenneur, C. Fabrigoule, P. Barberger-Gateau, S. Lafont, et al.
Marital status and risk of Alzheimer's disease: a French population-based cohort study.
Neurology, 53 (1999), pp. 1953-1958
[17.]
S.M. Pecyna.
Effect of psychological family crises on manifestations of Alzheimer's disease in people of working age.
Przegl Epidemiol, 47 (1993), pp. 343-348
[18.]
W.H. Coleman.
Importance of behavioral and psychological symptons of dementia in primary care.
Psychogeriatr, 12 (2000), pp. 72
[19.]
S. Cahill.
Family carers recognition of early stage dementia.
Alzheimer Disease International, 12th International Conference, (1996),
[20.]
A. La Rue, S. Watson, D. Plotkin.
First symptoms of dementia: a study of relatives'reports.
Int J Geriatr Psychiatry, 8 (1993), pp. 239-245
[21.]
H.X. Wang, A. Karp, B. Winblad, L. Fratiglioni.
Late-life engagement in social and leisure activities is associated with a decreased risk of dementia: a longitudinal study from the Kungsholmen Project.
Am J Epidemiol, 155 (2002), pp. 1081-1087
[22.]
D.D. Danner, D.A. Snowdon.
Positive emotions in early and longevity: finding from the Nun Study.
J Pers Soc Psychol, 80 (2001), pp. 804-813
[23.]
L. Fratiglioni, M. Grut, Y. Forsell, M. Viitanen, M. Grafstrum, K. Holmen, et al.
Prevalence of Alzheimer's disease and other dementias in an elderly urban population: relationship with age sex and education.
Neurology, 41 (1991), pp. 1886-1892
[24.]
R. Katzman.
Education and the prevalence of dementia and Alzheimer disease.
Neurology, 43 (1993), pp. 13
[25.]
J.A. Mortimer, A.B. Graves.
Education and other socioeconomic determinants and Alzheimer's disease.
Neurology, 43 (1993), pp. S39-S44
[26.]
J.M. Martinez Lage.
Educación, reserva cerebral y factores de riesgo de demencia y enfermedad de Alzheimer.
Med Clin (Barc), 116 (2001), pp. 418-421
[27.]
B. Schmand, J. Smit, M.L. Geerlings.
Low education is a genuine risk factor for accelerated memory decline and dementia.
J Neurol Neurosurg Psychiatry, 59 (1997), pp. 170-174
[28.]
Y. Stern, B.J. Gurland, T.K. Tatemichi, M.X. Tang, D. Wilder, R. Mayeaux.
Influence of education and occupation on the incidence of Alzheimer's disease.
J Am Med Assoc, 271 (1994), pp. 1004-1010
[29.]
G. Ravaglia, P. Forti, F. Maioli, O. Orlanducci, L. Sacchett, E. Flisi, et al.
Education, occupation and prevalence of dementia: findings from the Conselice Study.
Dement Geriatr Cogn Disord, 14 (2002), pp. 90-100
[30.]
S. Bonaiuto, W.A. Rocca, A. Lippi, E. Giannandrea, M. Mele, F. Cavarzeran, et al.
Education and occupation as risk factors for dementia: a population-based case-control study.
Neuroepidemiology, 14 (1995), pp. 101-109
[31.]
A. Ott, C.T.M. Van Rossum, F. Van Harskam, H. Von de Mheen, A. Hofman, M.M. Breteler.
Education and the incidence of dementia in a large population-based study: the Rotterdam Study.
Neurology, 53 (1999), pp. 663-666
[32.]
J.L. Cobb, P.A. Wolf, R. Au, R. White, R.B. D'Agostino.
The effect of education on the incidence of dementia and Alzheimer's disease in the Framingham Study.
Neurology, 45 (1995), pp. 1707-1712
[33.]
D.A. Evans, L.E. Hebert, L.A. Beckett, P.A. Scherr, M.S. Albert, M.J. Chown, et al.
Education and other measures of socioeconomic staus and risk of incident Alzheimer disease in a defined population of older persons.
Arch Neurology, 54 (1997), pp. 1399-1405
[34.]
H.C. Hendrie, B.O. Osuntokun, K.S. Hall.
Prevalence of Alzheimer's disease and dementia in two communities: nigerian africans and african Americans.
Am J Psychiatry, 152 (1995), pp. 1485-1492
[35.]
H.C. Hendrie.
Alzheimer's disease: a review of cross cultural studies.
Epidemiology of Alzheimer's disease: from gene to prevention, pp. 87-101
[36.]
H.C. Hendrie, K.S. Hall, N. Pillay, et al.
Alzheimer's disease is rare in Cree.
Int Psychogeriatr, 5 (1993), pp. 5-14
[37.]
L.J. Whaley, B.M. Thomas, G. McGonical, J.M. Starr.
Epidemiology of presenile Alzheimer's disease in Scotland (1974-88): 1. Non-random geographical variation.
Br J Psychiatry, 167 (1995), pp. 728-731
[38.]
S.R. Brenner.
Lower incidence of Alzheimer disease in an Indian community compared with an American community.
Arch Neurol, 58 (2001), pp. 517
[39.]
C. Dold.
Lifestyle and Alzheimer disease. Study strenghthens link.
Bull WHO, 79 (2001), pp. 378
[40.]
C.E. Speck, W.A. Kukull, D.E. Brenner, J.D. Bowen, W.C. McCormick, L. Teri, et al.
History of depresión as a risk factor for Alzheimer's disease.
Epidemiology, 6 (1995), pp. 366
[41.]
D. Devanand, M. Sano, M. Tang, S. Taylord, B. Gurland, D. Wilder, et al.
Depressed mood and the incidence of Alzheimer's disease in the elderly living in the community.
Arch Gen Psychiatry, 53 (1996), pp. 175-182
[42.]
S.E. Starkstein, E. Chemerinski, L. Sabe.
Prospective longitudinal study of depression and anosognosia in Alzheimer's disease.
Br J Psychiatry, 171 (1997), pp. 47-52
[43.]
H. Förstl, A. Burns, P. Luthert.
Clinical and neuropathological correlates of depression in Alzheimer's disease.
Psychological Medicine, 22 (1992), pp. 877-884
[44.]
D.J. Loreck, M.F. Folstein.
Depression in Alzheimer's disease.
Depression in neurologic disease, pp. 50-62
[45.]
B. Kaskie, M. Storandt.
Visuospatial deficit in dementia of the Alzheimer type.
Arch Neurol, 52 (1995), pp. 422-425
[46.]
G. Binetti, S.F. Cappa, E. Magni, A. Padovani, A. Bianchetti, M. Trabucchi.
Visual and spatial perception in the early phase of Alzheimer's disease.
Neuropsychology, 12 (1998), pp. 29-33
[47.]
D.C. Davies, P. Mccoubrie, B. McDonald, et al.
Myelinated axon number in the optic nerve is unaffected by the Alzheimer's disease.
Br J Ophtalmol, 79 (1995), pp. 596-600
[48.]
S.P. Tipper, B. Weaver, G. Houghton.
Behavioral goals determine inhibitory mechanisms of selective attention.
Quat J Exptl Psychol, 47A (1994), pp. 809-840
[49.]
J.P. Marmonier, A. Charles.
Démence et résolution de problemes un déclin progressif des structures de controle. 3.er trimestre.
Rev Eur Psychol Appl, 45 (1995), pp. 203-214
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