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. 2024 Mar 11;16(1):e12562.
doi: 10.1002/dad2.12562. eCollection 2024 Jan-Mar.

Prodromal Alzheimer's disease can affect activities of daily living for adults with Down syndrome

Tracy A Listwan  1 , Sharon J Krinsky-McHale  1 , Cynthia M Kovacs  1 , Joseph H Lee  2 , Deborah I Pang  1 , Nicole Schupf  2 , Benjamin Tycko  3 , Warren B Zigman  1 , Wayne Silverman  4
Affiliations

Prodromal Alzheimer's disease can affect activities of daily living for adults with Down syndrome

Tracy A Listwan et al. Alzheimers Dement (Amst). .

Abstract

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.

Keywords: Alzheimer's disease; Down syndrome; activities of daily living; mild cognitive impairment; prodromal Alzheimer's disease.

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Conflict of interest statement

The authors declare no conflicts of interest. Author disclosures are available in the supporting information.

Figures

FIGURE 1
FIGURE 1
Scatterplots relating changes in activities of daily living (ADLs) as assessed with the Adaptive Behavior Scale (ABSI) to changes in the expanded Down Syndrome Mental Status Examination (DSMSE), a broadly based assessment of cognition (A), or to changes in the modified Selective Reminding Test (MSRT), a specific test of episodic memory (B), for adults with Down syndrome transitioning from preclinical to prodromal Alzheimer's disease (mild cognitive impairment [MCI]‐DS).
See this image and copyright information in PMC

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