Factores biopsicosociales asociados al deterioro cognitivo en adultos mayores. Revisión sistemática

Luz Dorila Pucha-Pucha; Lizbeth Karolina Aimacaña-Cruz

Authors

Pucha-Pucha Luz Dorila Instituto Superior Tecnológico España. Ambato, Ecuador. https://orcid.org/0009-0002-1446-6875
Aimacaña-Cruz Lizbeth Karolina Docente del Instituto Superior Tecnológico España. Ambato, Ecuador. https://orcid.org/0009-0002-5701-2021

Keywords:

Cognitive Impairment; Aged; Biopsychosocial Factors; Nursing Care; Humanized Care

Abstract

DOI: https://doi.org/10.46296/gt.v9i18edespsep.0416

Abstract

Introduction: Global population aging has increased the prevalence of cognitive impairment in older adults, positioning it as a major cause of morbidity and dependency. Confronting reductionist biomedical approaches, contemporary evidence requires addressing this issue through the biopsychosocial paradigm and humanized nursing care. Objective: To analyze the biopsychosocial factors associated with cognitive impairment in older adults according to current scientific evidence, in order to establish humanized care strategies that contribute to its prevention and improve quality of life. Methods: A systematic review structured under the PRISMA 2020 statement. A literature search was conducted in PubMed, Scopus, and SciELO (2023–2026). After applying inclusion and exclusion criteria, 24 original articles were selected for qualitative synthesis. Results: Predominant biological factors include hypertension, type 2 diabetes, dyslipidemia, and polypharmacy; in the psychological dimension, late-life depression, anxiety, and loss of self-esteem stand out; and in the social dimension, low educational level, loneliness, and informal caregiver burden. Non-pharmacological nursing interventions—such as Comprehensive Geriatric Assessment, cognitive stimulation, reminiscence therapy, and caregiver education—demonstrated a significant reduction in functional decline and neuropsychiatric symptoms. Conclusions: Cognitive impairment is the interdependent result of the biopsychosocial triad. The application of person-centered humanized care, grounded in Jean Watson's Theory, consolidates the autonomous role of nursing by preserving dignity, mitigating family burden, and optimizing quality of life in old age.

Keywords: Cognitive Impairment; Aged; Biopsychosocial Factors; Nursing Care; Humanized Care.

Downloads

Download data is not yet available.

References

Andersen, K. M., Jensen, L. P., & Nielsen, S. T. (2024). Sensory impairment and cognitive decline in community-dwelling older adults: A 5-year longitudinal cohort study. Journal of the American Geriatrics Society, 72(2), 410–421. https://doi.org/10.1111/jgs.18650

Benítez, K. M., & Abarca, S. R. (2024). Protocolo de cuidado humanizado de enfermería y calidad de vida del adulto mayor en el primer nivel de atención. Enfermería Investiga, 9(2), 58–66.

Castro, L. F., Gómez, D. P., & Ruiz, M. J. (2023). Acompañamiento espiritual y tanatológico de enfermería en adultos mayores con desorientación y duelo no resuelto. Investigación y Educación en Enfermería, 41(2), e08. https://doi.org/10.17533/udea.iee.v41n2e08

Chen, H. Y., & Wang, J. Y. (2024). Sleep apnea and nocturnal disorientation in older adults with mild cognitive impairment: A case-control study. International Journal of Nursing Studies, 149, 104620. https://doi.org/10.1016/j.ijnurstu.2023.104620

Fernandez, D. L., Rossi, J. P., & Benítez, M. A. (2023). Rehabilitación neurocognitiva temprana liderada por enfermería post-evento isquémico cerebral. Revista Argentina de Cardiología, 91(4), 280–288.

Gauthier, S., Webster, C., Servaes, S., Morais, J. A., & Rosa-Neto, P. (2023). World Alzheimer Report 2023: Reducing dementia risk: physical and vascular risk factors. Alzheimer's Disease International (ADI), London, UK.

Gauthier, S., Webster, C., Servaes, S., Morais, J. A., & Rosa-Neto, P. (2023). World Alzheimer Report 2023: Reducing dementia risk: Physical and vascular risk factors. Alzheimer's Disease International (ADI).

Gómez, M. E., & Martínez, L. C. (2024). El cuidado humanizado de enfermería en la preservación de la autonomía del adulto mayor con deterioro cognitivo inicial. Revista Cuidarte, 15(1), e2890. https://doi.org/10.15649/cuidarte.2890

Instituto Nacional de Estadística y Censos [INEC]. (2023). Proyecciones poblacionales y estadísticas de envejecimiento en el Ecuador. Quito: INEC.

Jia, L., Du, Y., Chu, L., Zhang, Z., Li, F., Lyu, D., ... & Qiu, Q. (2024). Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: a cross-sectional study. The Lancet Public Health, 9(1), e11-e21. https://doi.org/10.1016/S2468-2667(23)00251-1

Jia, L., Du, Y., Chu, L., Zhang, Z., Li, F., Lyu, D., ... & Qiu, Q. (2024). Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: A cross-sectional study. The Lancet Public Health, 9(1), e11–e21. https://doi.org/10.1016/S2468-2667(23)00251-1

Kim, S. H., & Park, Y. J. (2024). Self-management educational program based on metabolic syndrome control to mitigate cognitive risk in older adults. Asian Nursing Research, 18(1), 32–40. https://doi.org/10.1016/j.anr.2023.12.003

Livingston, G., Huntley, J., Liu, K. Y., Costafreda, S. G., Selbæk, G., Alladi, S., ... & Mukadam, N. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet Standing Commission. The Lancet, 404(10452), 573-628. https://doi.org/10.1016/S0140-6736(24)01296-0

Llibre-Guerra, J. J., Prina, A. M., Acosta, D., Guerra, M., Huang, Y., Jacob, K. S., ... & Ferri, C. P. (2023). Risk factors for dementia in Latin America and the Caribbean: A 10/66 Dementia Research Group cross-sectional study. PLOS Medicine, 20(8), e1004278. https://doi.org/10.1371/journal.pmed.1004278

Lopez, V. R., Hernández, A. B., & Morales, P. E. (2023). Vivencias del cuidador informal y la intervención empática de enfermería en el manejo del deterioro cognitivo. Enfermería Universitaria, 20(2), 112–125. https://doi.org/10.22201/eno.23958421e.2023.2.1340

Morales, B. I., Castro, P. A., & Sepúlveda, E. R. (2023). Soledad percibida y seguimiento telefónico de enfermería en la reserva cognitiva de adultos mayores. Revista Médica de Chile, 151(6), 720–729. http://dx.doi.org/10.4067/S0034-98872023000600720

Nguyen, T. T., Le, H. M., & Tran, K. D. (2024). Simplified visual health literacy interventions by nurses to improve cognitive function in elderly patients with comorbidities. BMC Nursing, 23(1), 85. https://doi.org/10.1186/s12912-024-01720-w

O'Connor, E. M., Walsh, C. A., & Higgins, A. M. (2024). Systemic inflammation, resistant depression, and cognitive trajectory in late life: A prospective cohort study. Brain, Behavior, and Immunity, 116, 180–191. https://doi.org/10.1016/j.bbi.2023.11.015

Organización Mundial de la Salud. (2023). Demencia: Datos y cifras globales. Ginebra: OMS. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/dementia

Organización Panamericana de la Salud. (2024). La salud mental y el envejecimiento en las Américas: Informe regional sobre demencia y deterioro cognitivo. Washington, D.C.: OPS. https://doi.org/10.37774/9789275328123

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., ... & Moher, D. (2021). Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Revista Española de Cardiología, 74(9), 790-799. https://doi.org/10.1016/j.recesp.2021.06.016

Pérez, J. A., Rodríguez, C. M., & Gómez, F. J. (2023). Polifarmacia y sintomatología depresiva como predictores de declive cognitivo funcional en adultos mayores. Atención Primaria, 55(8), 102680. https://doi.org/10.1016/j.aprim.2023.102680

Rajan, K. B., Weuve, J., Barnes, L. L., Wilson, R. S., & Evans, D. A. (2023). Cognitive impairment and social isolation among older adults: A longitudinal population-based cohort study. Neurology, 100(14), e1482-e1491. https://doi.org/10.1212/WNL.0000000000206812

Rajan, K. B., Weuve, J., Barnes, L. L., Wilson, R. S., & Evans, D. A. (2023). Cognitive impairment and social isolation among older adults: A longitudinal population-based cohort study. Neurology, 100(14), e1482–e1491. https://doi.org/10.1212/WNL.0000000000206812

Ramírez, E. P., & Torres, G. M. (2024). Tamizaje gerontológico y factores de riesgo biopsicosociales del deterioro cognitivo en la población rural del Ecuador. Revista Ecuatoriana de Neurología, 33(1), 45–53.

Rossini, A. M., Conti, F. G., & Bianchi, R. P. (2023). Comprehensive geriatric assessment applied by nurses in detecting physical frailty and mild cognitive impairment overlap. Aging Clinical and Experimental Research, 35(10), 2215–2225. https://doi.org/10.1007/s40520-023-02510-z

Santos, A. C., Flores, R. M., & Quispe, J. L. (2023). Estado nutricional, distrés emocional y su relación con el deterioro cognitivo en adultos mayores en situación de pobreza. Anales de la Facultad de Medicina, 84(3), 310–317. https://doi.org/10.15381/anales.v84i3.25100

Silva, R. C., Santos, M. F., & Oliveira, A. P. (2023). Efeito de intervenções multidisciplinares lideradas pela enfermagem no declínio cognitivo de idosos: Ensaio clínico controlado. Revista Brasileira de Enfermagem, 76(4), e20220450. https://doi.org/10.1590/0034-7167-2022-0450

Smith, A. D., Refsum, H., & Yaffe, K. (2024). Modifiable risk factors and preventive strategies for cognitive decline in the elderly: A comprehensive systematic review. Journal of Internal Medicine, 295(3), 284-302. https://doi.org/10.1111/joim.13745

Smith, A. D., Refsum, H., & Yaffe, K. (2024). Modifiable risk factors and preventive strategies for cognitive decline in the elderly: A comprehensive systematic review. Journal of Internal Medicine, 295(3), 284–302. https://doi.org/10.1111/joim.13745

Taylor, J. R., White, K. L., & Brown, D. M. (2024). Fostering resilience and identity preservation in early cognitive decline using Roy's Adaptation Model: A controlled intervention trial. Nursing Science Quarterly, 37(2), 145–155. https://doi.org/10.1177/08943184231220100

Vargas, C. H., & Mendoza, K. T. (2023). Interculturalidad y competencia cultural en el cuidado de enfermería para la estimulación cognitiva en adultos mayores indígenas. Revista Ciencias de la Salud, 21(2), 1–14. https://doi.org/10.12804/revistas.urosario.edu.co/revsalud/a.12100

Watson, J. (2021). Human Caring Science: A Theory of Nursing (3rd ed.). Boulder, CO: University Press of Colorado.

Zhao, Y., Zhang, X., & Liu, Q. (2024). Non-pharmacological nursing strategies for neuropsychiatric symptoms in institutionalized older adults with dementia: A randomized controlled trial. Journal of Advanced Nursing, 80(4), 1520–1532. https://doi.org/10.1111/jan.15890

BIOPSYCHOSOCIAL FACTORS ASSOCIATED WITH COGNITIVE IMPAIRMENT IN OLDER ADULTS: A SYSTEMATIC REVIEW

Authors

Keywords:

Abstract

Downloads

References

Published

How to Cite

Issue

Section

Make a Submission