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. 2025 Jul;38(4):e70109.
doi: 10.1111/jar.70109.

Lifestyle Composite and Resilience to Alzheimer's Disease Pathology in Down Syndrome

Emily K Schworer  1 , Matthew D Zammit  1 , Benjamin L Handen  2 , Brianna Piro-Gambetti  1 , Melissa R Jenkins  1 , Courtney Brothers  1 , Ozioma C Okonkwo  3 , Christy L Hom  4 , Beau M Ances  5 , Bradley T Christian  1   3 , Sigan L Hartley  1
Affiliations

Lifestyle Composite and Resilience to Alzheimer's Disease Pathology in Down Syndrome

Emily K Schworer et al. J Appl Res Intellect Disabil. 2025 Jul.

Abstract

Background: People with Down syndrome (DS) have a high risk for Alzheimer's disease (AD). Identifying resiliency factors for AD is of critical importance to the DS community.

Method: Participants were 63 adults with DS. Measures included amyloid-beta PET scans (amyloid age), National Task Group-Early Detection Screen for Dementia (NTG-EDSD), and Down Syndrome Mental Status Examination (DSMSE). Lifestyle composites were created by assessing time spent in leisure, employment, and physical activity across 7 days through informant reports and accelerometry.

Results: There was a significant moderation effect of the lifestyle composite on the association between amyloid age and the NTG-EDSD and DSMSE. Participants with a higher lifestyle composite (higher leisure, employment engagement, and physical activity) had fewer dementia symptoms than those with a lower lifestyle composite score of a similar amyloid age.

Conclusions: Modifiable lifestyle factors may allow adults with DS to maintain cognitive functioning for longer in the face of AD pathology.

Keywords: amyloid‐beta; cognition; employment; leisure; physical activity.

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Conflict of interest statement

B.L.H. receives royalties from two co‐authored books, is paid consulting fees from Patient‐Centered Outcomes Research Institute (PCORI) grant, received honoraria from the University of North Carolina and University of California Davis, and served on a data monitoring board for a Department of Defense funded grant. B.T.C. is on scientific advisory board for Alnylam Inc and has received equipment and materials from Avid Radiopharmaceuticals and Lantheus Inc. S.L.H. is a consultant for Ionis Pharmaceuticals and Alnylam Pharmaceuticals. The remaining authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Cognitive and social leisure activities completed by adults with DS at least once a month.
FIGURE 2
FIGURE 2
Number of adults with DS participating in each cognitively stimulating employment activity.
FIGURE 3
FIGURE 3
Number of adults with DS in each average step count category.
FIGURE 4
FIGURE 4
Moderation effect of lifestyle composite on the association between amyloid age and National Task Group‐Early Detection Screen for Dementia (NTG‐EDSD). Plot shows simple slopes at low (16th%), average (50th%), and high levels (84th%) of the moderator (lifestyle composite).
FIGURE 5
FIGURE 5
Moderation effect of lifestyle composite on the association between amyloid age and Down Syndrome Mental Status Examination (DSMSE). Plot shows simple slopes at low (16th%), average (50th%), and high levels (84th%) of the moderator (lifestyle composite).
See this image and copyright information in PMC

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