Enfermedad de Parkinson y enfermedad de Alzheimer: factores de riesgo ambientales

Resumen Introduccion Esta revision pretende actualizar y resumir la evidencia disponible sobre los factores de riesgo ambientales que se han asociado a riesgo de enfermedad de Parkinson (EP) o de Alzheimer (EA) y discutir sus posibles mecanismos. Desarrollo Hay evidencia consistente de mayor riesgo de EP asociado a pesticidas y de mayor riesgo de EA asociado a pesticidas, hipertension y colesterol en edad media, hiperhomocisteinemia, tabaco, traumatismo craneoencefalico grave y depresion. Hay evidencia debil de mayor riesgo de EP asociado a consumo elevado de leche en hombres, ingesta alta de hierro, anemia cronica y traumatismo craneoencefalico grave, y de mayor riesgo de EA asociado a ingesta elevada de aluminio en agua potable, alta exposicion a redes electricas, DM e hiperinsulinemia, obesidad en edad media, consumo excesivo de alcohol y anemia cronica. Hay evidencia consistente de menor riesgo de EP asociado a hiperuricemia, tabaco y cafe, y de menor riesgo de EA asociado a consumo moderado de alcohol, ejercicio fisico, terapia hormonal sustitutiva perimenopausica y buena reserva cognitiva; hay evidencia debil de menor riesgo de EP asociado a mayor consumo de vitamina E, alcohol, te y AINE y a ejercicio fisico vigoroso, y de menor riesgo de EA asociado a dieta mediterranea, cafe y consumo cronico de AINE. Conclusiones Diversos factores ambientales contribuyen significativamente al riesgo de EP y EA. Algunos de ellos podrian actuar ya desde etapas tempranas de la vida o interaccionar con otros factores geneticos. Estrategias poblacionales de modificacion de estos factores podrian potencialmente evitar algunos casos de EP o de EA.

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