1
|
Harisinghani A, Torres A, Oreskovic NM. Brief report: Physical activity assessment and counseling in adults with Down syndrome. AMERICAN JOURNAL OF MEDICAL GENETICS. PART C, SEMINARS IN MEDICAL GENETICS 2024; 196:e32066. [PMID: 37795765 DOI: 10.1002/ajmg.c.32066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/06/2023]
Abstract
Adults with Down syndrome are at an increased risk for developing certain medical conditions, which can be further exacerbated by lower levels of physical activity. Physician counseling can provide a supportive environment to encourage modes of physical activity accessible to patients and caregivers. While some adults with Down syndrome have access to a Down syndrome specialty clinic, most are followed only by a primary care physician. This report includes adult patients with Down syndrome followed at a Down syndrome specialty clinic in Boston and compares physical activity assessment and counseling rates by Down syndrome specialists and primary care physicians. Patients were more likely to have physical activity assessment and counseling performed by a Down syndrome specialist than by a primary care physician. A better understanding of the barriers primary care physicians caring for adults with Down syndrome experience related to physical activity counseling could help improve important health habit counseling in this high-risk population.
Collapse
Affiliation(s)
- Ayesha Harisinghani
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Amy Torres
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Nicolas M Oreskovic
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
- Departments of Internal Medicine and Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
2
|
Ferrero-Hernández P, Farías-Valenzuela C, Ferrari G, Álvarez-Arangua S, Villalobos-Flores H, Valdivia-Moral P. Primary Validation of the Submandibular Skinfold as an Anthropometric Measurement of Cardiometabolic Risk in People with Intellectual Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1658. [PMID: 36767026 PMCID: PMC9913969 DOI: 10.3390/ijerph20031658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
The accumulation of body fat is an important cardiometabolic risk factor; however, there is no consensus about which measure is more reliable for the assessment of cardiometabolic risk in people with intellectual disabilities. The aim of the present study was to primarily validate the submandibular skinfold as an anthropometric measurement of cardiometabolic risk in children, adolescents, and adults with intellectual disabilities, using a cross-sectional study made up of 131 people (67.2% men) with mild and moderate intellectual disability. The cardiometabolic risk indicators used were: body mass index (kg/m2), neck circumference (cm), waist circumference (cm), calf circumference (cm) and waist-to-height ratio. Moderate correlations were demonstrated between the submandibular skinfold measure and the anthropometric measurements analyzed in the three age categories, showing the highest correlation (r = 0.70) between the submandibular skinfold and BMI in the adolescent group and waist-to-height ratio in adults. The implementation of the submandibular skinfold measurement is suggested as an easy, fast, and minimally invasive anthropometric measurement as part of the physical and nutritional evaluation for the assessment of cardiometabolic risk in people with intellectual disabilities.
Collapse
Affiliation(s)
| | | | - Gerson Ferrari
- Facultad de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 9170022, Chile
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago 7500912, Chile
| | - Sebastián Álvarez-Arangua
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Science, Universidad Andres Bello, Santiago 7591538, Chile
| | | | - Pedro Valdivia-Moral
- Department of Didactics of Musical, Plastic and Body Expression, Faculty of Education, University of Granada, 18071 Granada, Spain
| |
Collapse
|
3
|
Fleming V, Helsel BC, Ptomey LT, Rosas HD, Handen B, Laymon C, Christian BT, Head E, Mapstone M, Lai F, Krinsky-McHale S, Zaman S, Ances BM, Lee JH, Hartley SL. Weight Loss and Alzheimer's Disease in Down Syndrome. J Alzheimers Dis 2023; 91:1215-1227. [PMID: 36565120 PMCID: PMC9940268 DOI: 10.3233/jad-220865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Virtually all adults with Down syndrome (DS) develop Alzheimer's disease (AD) pathology, but research gaps remain in understanding early signs of AD in DS. OBJECTIVE The goal of the present study was to determine if unintentional weight loss is part of AD in DS. The specific aims were to: 1) examine relation between chronological age, weight, AD pathology, and AD-related cognitive decline were assessed in a large cohort of adults with DS, and 2) determine if baseline PET amyloid-β (Aβ) and tau PET status (-versus+) and/or decline in memory and mental status were associated with weight loss prior to AD progression. METHODS Analyses included 261 adults with DS. PET data were acquired using [11C] PiB for Aβ and [18F] AV-1451 for tau. Body mass index (BMI) was calculated from weight and height. Direct measures assessed dementia and memory. Clinical AD status was determined using a case consensus process. Percent weight decline across 16-20 months was assessed in a subset of participants (n = 77). RESULTS Polynomial regressions indicated an 0.23 kg/m2 decrease in BMI per year beginning at age 36.5 years, which occurs alongside the period during which Aβ and tau increase and memory and mental status decline. At a within-person level, elevated Aβ, decline in memory and mental status were associated with higher percent weight loss across 16-20 months. CONCLUSION Unintentional weight loss occurs alongside Aβ deposition and prior to onset of AD dementia, and thus may be a useful sign of AD in DS.
Collapse
Affiliation(s)
- Victoria Fleming
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- School of Human Ecology, University of Wisconsin-Madison, WI, USA
| | - Brian C. Helsel
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Lauren T. Ptomey
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - H. Diana Rosas
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Benjamin Handen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Charles Laymon
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Elizabeth Head
- Department of Pathology and Laboratory Medicine, University of California Irvine, Irvine, CA, USA
| | - Mark Mapstone
- Department of Neurology, University of California Irvine, Irvine, CA, USA
| | - Florence Lai
- Department of Pathology and Laboratory Medicine, University of California Irvine, Irvine, CA, USA
- Department of Pediatrics, University of California Irvine, Irvine, CA, USA
| | - Sharon Krinsky-McHale
- Department of Psychology, New York Institute for Basic Research in Developmental Disabilities, Staten Island, NY, USA
| | - Shahid Zaman
- Department of Psychiatry, Clinical School, University of Cambridge, Cambridge, UK & Cambridgeshire and Peterborough Foundation NHS Trust, Cambridge, UK
| | - Beau M. Ances
- Department of Neurology, Washington University Saint Louis, St. Louis, MO, USA
| | - Joseph H. Lee
- Departments of Neurology and Epidemiology, Sergievsky Center, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Sigan L. Hartley
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- School of Human Ecology, University of Wisconsin-Madison, WI, USA
| | | |
Collapse
|
4
|
Melo GLR, Neto IVDS, da Fonseca EF, Stone W, Nascimento DDC. Resistance training and Down Syndrome: A narrative review on considerations for exercise prescription and safety. Front Physiol 2022; 13:948439. [PMID: 36237528 PMCID: PMC9553130 DOI: 10.3389/fphys.2022.948439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
The current manuscript reviews the literature on the health effects of resistance training (RT) for individuals with Down syndrome (DS), focusing on this training modality’s methodology, application, and safety. The literature has mentioned that early aging in this population is associated with loss of muscle strength, lower lean and bone mass, and increased obesity. It is necessary to propose non-pharmacological measures for prevention and health promotion. Thus, this review suggests a current research-based RT guide for individuals with DS. This review is divided into three sections: Section 2 briefly reviews DS and the effects on structural and functional decline and how exercise and physical activity can influence health aspects in this population; Section 3 summarizes the evidence for RT prescription; Section 4 briefly reviews the health and potential benefits of RT in individuals with DS. The findings from this review suggest that most individuals with DS should engage in moderate-intensity RT at least 2 days a week and perform RT on the major muscle groups and include balance training. The RT program should be modified and adapted according to individuals’ characteristics and limitations. RT promotes positive, health-related benefits such as increasing strength, improving body composition, improving functional capacity and balance, reducing inflammatory status and oxidative stress, and improving the immune system. The RT protocols summarized in this current review provide guidance, critical conclusions, and novel research settings, which could be useful to coaches, clinicians, and researchers to effectively design RT program for individuals with DS.
Collapse
Affiliation(s)
- Geiziane Leite Rodrigues Melo
- Department of Physical Education, Catholic University of Brasília, Brasília, Brazil
- *Correspondence: Geiziane Leite Rodrigues Melo,
| | - Ivo Vieira de Sousa Neto
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | | | - Whitley Stone
- Department of School of Kinesiology Recreation and Sport, Western Kentucky University, Bowling Green, FL, United States
| | | |
Collapse
|
5
|
Mendonca GV, Santos I, Fernhall B, Baynard T. Predictive equations to estimate peak aerobic capacity and peak heart rate in persons with Down syndrome. J Appl Physiol (1985) 2021; 132:423-433. [PMID: 34941444 DOI: 10.1152/japplphysiol.00421.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Estimations based on the available equations for predicting oxygen uptake (VO2) from treadmill speed of locomotion are not appropriate for individuals with Down syndrome (DS). We aimed at developing prediction models for peak absolute oxygen uptake (VO2peak) and peak heart rate (HRpeak) based on retrospective data from a healthy population with and without Down syndrome (DS). A cross-sectional analysis of VO2peak and HRpeak was conducted in 196 and 187 persons with and without DS, respectively, aged from 16-45 years. Non-exercise data alone versus combined with HRpeak were used to develop equations predictive of absolute VO2peak. Prediction equations for HRpeak were also developed. Two additional samples of participants (30 with, 29 without DS) enabled model cross-validation. Relative VO2peak and HRpeak were lowest for persons with DS across all ages (~ 40% and 20 bpm, respectively). For persons with DS, VO2peak predictions provided no differences compared with actual values. Predicted HRpeak was similar to actual values in both groups of participants. Large limits of agreement were obtained for VO2peak (DS: 735, non-DS: 558.2 mL.min-1) and HRpeak (DS: 24.8, non-DS: 16.6 bpm). Persons with DS exhibit low levels of VO2peak and HRpeak in all age groups included in this study. It is possible to estimate absolute VO2peak in persons with DS using non-exercise variables. HRpeak can be accurately estimated in groups of people with and without DS. Yet, because of large limits of agreement, caution is advised if using these equations for individual estimations of VO2peak or HRpeak in either population.
Collapse
Affiliation(s)
- Goncalo V Mendonca
- Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada, Dafundo, Portugal.,CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada, Dafundo, Portugal
| | - Inês Santos
- CIDEFES, Universidade Lusófona, Lisboa, Portugal.,Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Bo Fernhall
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Tracy Baynard
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| |
Collapse
|