Resumen
Objetivo: Analizar la evidencia sobre el impacto de las intervenciones no farmacológicas —entrenamiento cognitivo, juegos, actividad física, estrategias nutricionales y estimulación cerebral— en el retraso del deterioro cognitivo y funcional en enfermedades neurodegenerativas, con énfasis en la enfermedad de Alzheimer y la enfermedad de Parkinson. Revisión bibliográfica: La evidencia sugiere beneficios modestos pero clínicamente relevantes de intervenciones no farmacológicas en demencia / DCL y enfermedad de Parkinson leve a moderada. El entrenamiento cognitivo tiende a mejorar la atención, la memoria de trabajo y las funciones ejecutivas, con mejor respuesta en etapas iniciales y necesidad de estrategias de mantenimiento. Los juegos de mesa y los videojuegos activos son prometedores por combinar estimulación cognitiva e interacción social, aunque los estudios siguen siendo pequeños y heterogéneos. El ejercicio aeróbico y multicomponente muestra ganancias motoras y funcionales consistentes en Parkinson y puede apoyar la cognición, mientras que en demencia los resultados son variables. Los patrones alimentarios mediterráneo y MIND se asocian con un menor deterioro cognitivo en estudios observacionales. La neuromodulación es prometedora, pero aún no se han definido parámetros óptimos. Consideraciones finales: Las intervenciones no farmacológicas muestran potencial para complementar el tratamiento farmacológico y favorecer un envejecimiento más funcional, aunque todavía se requieren ensayos clínicos más robustos para definir la magnitud y la durabilidad de estos efectos.
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