Introduction: Alzheimer's disease (AD) affecting adults with Down syndrome (DS-AD), like late-onset AD (LOAD) in the neurotypical population, has preclinical, prodromal, and more advanced stages. Only tasks placing high demands on cognition are expected to be affected during the prodromal stage, with activities of daily living (ADLs) typically being spared. However, cognitive demands of ADLs could be high for adults with DS and may be affected during prodromal DS-AD.
Methods: Cognitively stable cases that subsequently developed prodromal DS-AD were identified within a set of archived data from a previous longitudinal study. Measures of ADLs and multiple cognitive domains were examined over time.
Results: Clear declines in ADLs accompanied cognitive declines with prodromal DS-AD while stability in all measures was verified during preclinical DS-AD.
Discussion: Operationally defining prodromal DS-AD is essential to disease staging in this high-risk population and for informing treatment options and timing as new disease-modifying drugs become available.
Highlights: Cognitive and functional stability were demonstrated prior to the onset of prodromal DS-AD.ADL declines accompanied cognitive declines as adults with DS transitioned to prodromal AD.Declines in ADLs should be a defining feature of prodromal AD for adults with DS.Better characterization of prodromal DS-AD can improve AD diagnosis and disease staging.Improvements in DS-AD diagnosis and staging could also inform the timing of interventions.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10927922 | PMC |
| http://dx.doi.org/10.1002/dad2.12562 | DOI Listing |
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Introduction: Alzheimer's disease (AD) affecting adults with Down syndrome (DS-AD), like late-onset AD (LOAD) in the neurotypical population, has preclinical, prodromal, and more advanced stages. Only tasks placing high demands on cognition are expected to be affected during the prodromal stage, with activities of daily living (ADLs) typically being spared. However, cognitive demands of ADLs could be high for adults with DS and may be affected during prodromal DS-AD.
View Article and Find Full Text PDFSymptoms and age of prodromal Alzheimer's disease in Down syndrome: a systematic review and meta-analysis.
Neurol Sci
June 2024
Department of Neurology, Juntendo University, Tokyo, Japan.
Article Synopsis
- - This study explores the lack of standardized criteria for diagnosing Alzheimer's disease (AD) in adults with Down syndrome (DS) and examines specific symptoms along with the average age of diagnosis for dementia stages.
- - Researchers analyzed data from 14 articles, identifying early symptoms of AD in DS, which included irritability, apathy, and sleep disturbances, and noted a mean diagnosis age of approximately 53 for prodromal symptoms and 56 for AD.
- - The findings suggest that the severity of intellectual disability may influence the diagnosis of mild dementia in patients with DS, highlighting the need for age-appropriate cognitive assessments and further research using biomarkers.
Monoaminergic impairment in Down syndrome with Alzheimer's disease compared to early-onset Alzheimer's disease.
Alzheimers Dement (Amst)
November 2017
Department of Neurology and Alzheimer Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Introduction: People with Down syndrome (DS) are at high risk for Alzheimer's disease (AD). Defects in monoamine neurotransmitter systems are implicated in DS and AD but have not been comprehensively studied in DS.
Methods: Noradrenaline, adrenaline, and their metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG); dopamine and its metabolites 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid; and serotonin and its metabolite 5-hydroxyindoleacetic acid were quantified in 15 brain regions of DS without AD (DS, n = 4), DS with AD (DS+AD, n = 17), early-onset AD (EOAD, n = 11) patients, and healthy non-DS controls (n = 10) in the general population.
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