Age-Related Changes of Adaptive and Neuropsychological Features in Persons with Down Syndrome

Abstract

Down Syndrome (DS) is characterised by premature aging and an accelerated decline of cognitive functions in the vast majority of cases. As the life expectancy of DS persons is rapidly increasing, this decline is becoming a dramatic health problem. The aim of this study was to thoroughly evaluate a group of 67 non-demented persons with DS of different ages (11 to 66 years), from a neuropsychological, neuropsychiatric and psychomotor point of view in order to evaluate in a cross-sectional study the age-related adaptive and neuropsychological features, and to possibly identify early signs predictive of cognitive decline. The main finding of this study is that both neuropsychological functions and adaptive skills are lower in adult DS persons over 40 years old, compared to younger ones. In particular, language and short memory skills, frontal lobe functions, visuo-spatial abilities and adaptive behaviour appear to be the more affected domains. A growing deficit in verbal comprehension, along with social isolation, loss of interest and greater fatigue in daily tasks, are the main features found in older, non demented DS persons evaluated in our study. It is proposed that these signs can be alarm bells for incipient dementia, and that neuro-cognitive rehabilitation and psycho-pharmacological interventions must start as soon as the fourth decade (or even earlier) in DS persons, i.e. at an age where interventions can have the greatest efficacy.

Down Syndrome - Onset Age of Dementia

“…These long-term longitudinal observations do dispute the prevailing understanding that neuropathology [8,9] occurring concomitantly with a prodromal or asymptomatic phase precedes clinical dementia [4,10,11]. It can be speculated here whether the lack of this kind of long-term clinical data and/or the varying clinical follow-up methods utilized in different countries could explain this evident discrepancy between our results and the findings published by the others.…”

“…According to the literature AD neuropathology is observable in virtually all individuals by the age of 40 years [8,9], after which there is generally thought to be a prodromal or asymptomatic phase when AD pathology progressively accumulates so that clinical dementia is usually recognized within an age range of 48 to 56 years [10,11]. However, the results from our recent paper with 27 years follow-up of 45 adults with DS suggested that the turning point in the course of adaptive skills occurs already at the age of 35 [12].…”

HNE-modified proteins in Down syndrome: Involvement in development of Alzheimer disease neuropathology

“…The incidence of dementia among DS patients is 10% in the age range 35–50, 55% in the age range 50–60, and becomes 75% above the age of 60 years, but AD neuropathology is present in virtually all adults with DS older than 40 years [13]. However, there is a subset of aged DS persons who do not develop clinical signs of dementia at any age [14].…”

Aspectos nutricionais associados ao envelhecimento de indivíduos com síndrome de Down: uma revisão integrativa

“…Pesquisas nessa área vem aumentando, na tentativa de reduzir as complicações relacionadas à demência, incluindo a mortalidade. Ghezzo et al (2014) observaram maior declínio cognitivo e fadiga em pessoas com SD após os 40 anos. Um dos critérios de exclusão dos participantes da pesquisa foi o uso de suplementos como vitaminas, minerais, ácidos graxos ômega 3 e 6, probióticos, acetilcisteína e ácido lipóico.…”