1
|
Schworer EK, Zammit MD, Wang J, Handen BL, Betthauser T, Laymon CM, Tudorascu DL, Cohen AD, Zaman SH, Ances BM, Mapstone M, Head E, Klunk WE, Christian BT, Hartley SL. Amyloid age and tau PET timeline to symptomatic Alzheimer's disease in Down syndrome. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.08.08.24311702. [PMID: 39211859 PMCID: PMC11361254 DOI: 10.1101/2024.08.08.24311702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Background Adults with Down syndrome (DS) are at risk for Alzheimer's disease (AD). Recent natural history cohort studies have characterized AD biomarkers, with a focus on PET amyloid-beta (Aβ) and PET tau. Leveraging these well-characterized biomarkers, the present study examined the timeline to symptomatic AD based on estimated years since reaching Aβ+, referred to as "amyloid age", and in relation to tau in a large cohort of individuals with DS. Methods In this multicenter cohort study, 25 - 57-year-old adults with DS (n = 167) were assessed twice from 2017 to 2022, with approximately 32 months between visits as part of the Alzheimer Biomarker Consortium - Down Syndrome. Adults with DS completed amyloid and tau PET scans, and were administered the modified Cued Recall Test and the Down Syndrome Mental Status Examination. Study partners completed the National Task Group-Early Detection Screen for Dementia. Findings Mixed linear regressions showed significant quadratic associations between amyloid age and cognitive performance and cubic associations between amyloid age and tau, both at baseline and across 32 months. Using broken stick regression models, differences in mCRT scores were detected beginning 2.7 years following Aβ+ in cross-sectional models, with an estimated decline of 1.3 points per year. Increases in tau began, on average, 2.7 - 6.1 years following Aβ+. On average, participants with mild cognitive impairment were 7.4 years post Aβ+ and those with dementia were 12.7 years post Aβ+. Interpretation There is a short timeline to initial cognitive decline and dementia from Aβ+ (Centiloid = 18) and tau deposition in DS relative to late onset AD. The established timeline based on amyloid age (or equivalent Centiloid values) is important for clinical practice and informing AD clinical trials, and avoids limitations of timelines based on chronological age. Funding. National Institute on Aging and the National Institute for Child Health and Human Development. Research in Context Evidence before this study: We searched PubMed for articles published involving the progression of Aβ and tau deposition in adults with Down syndrome from database inception to March 1, 2024. Terms included "amyloid", "Down syndrome", "tau", "Alzheimer's disease", "cognitive decline", and "amyloid chronicity," with no language restrictions. One previous study outlined the progression of tau in adults with Down syndrome without consideration of cognitive decline or clinical status. Other studies reported cognitive decline associated with Aβ burden and estimated years to AD symptom onset in Down syndrome. Amyloid age estimates have also been created for older neurotypical adults and compared to cognitive performance, but this has not been investigated in Down syndrome.Added value of this study: The timeline to symptomatic Alzheimer's disease in relation to amyloid, expressed as duration of Aβ+, and tau has yet to be described in adults with Down syndrome. Our longitudinal study is the first to provide a timeline of cognitive decline and transition to mild cognitive impairment and dementia in relation to Aβ+.Implications of all the available evidence: In a cohort study of 167 adults with Down syndrome, cognitive decline began 2.7 - 5.4 years and tau deposition began 2.7 - 6.1 years following Aβ+ (Centiloid = 18). Adults with Down syndrome converted to MCI after ~7 years and dementia after ~12-13 years of Aβ+. This shortened timeline to AD symptomology from Aβ+ and tau deposition in DS based on amyloid age (or corresponding Centiloid values) can inform clinical AD intervention trials and is of use in clinical settings.
Collapse
|
2
|
Aldecoa I, Barroeta I, Carroll SL, Fortea J, Gilmore A, Ginsberg SD, Guzman SJ, Hamlett ED, Head E, Perez SE, Potter H, Molina‐Porcel L, Raha‐Chowdhury R, Wisniewski T, Yong WH, Zaman S, Ghosh S, Mufson EJ, Granholm A. Down Syndrome Biobank Consortium: A perspective. Alzheimers Dement 2024; 20:2262-2272. [PMID: 38270275 PMCID: PMC10984425 DOI: 10.1002/alz.13692] [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] [Received: 11/02/2023] [Revised: 12/14/2023] [Accepted: 12/16/2023] [Indexed: 01/26/2024]
Abstract
Individuals with Down syndrome (DS) have a partial or complete trisomy of chromosome 21, resulting in an increased risk for early-onset Alzheimer's disease (AD)-type dementia by early midlife. Despite ongoing clinical trials to treat late-onset AD, individuals with DS are often excluded. Furthermore, timely diagnosis or management is often not available. Of the genetic causes of AD, people with DS represent the largest cohort. Currently, there is a knowledge gap regarding the underlying neurobiological mechanisms of DS-related AD (DS-AD), partly due to limited access to well-characterized brain tissue and biomaterials for research. To address this challenge, we created an international consortium of brain banks focused on collecting and disseminating brain tissue from persons with DS throughout their lifespan, named the Down Syndrome Biobank Consortium (DSBC) consisting of 11 biobanking sites located in Europe, India, and the USA. This perspective describes the DSBC harmonized protocols and tissue dissemination goals.
Collapse
Affiliation(s)
- Iban Aldecoa
- Pathology DepartmentHospital Clinic de Barcelona‐University of BarcelonaBarcelonaSpain
- Neurological Tissue Bank of the BiobankHospital Clinic de Barcelona‐FCRB/IDIBAPSBarcelonaSpain
| | - Isabel Barroeta
- Neurology DepartmentHospital de la Santa Creu i Sant Pau, NeurologyBarcelonaSpain
| | - Steven L. Carroll
- Department of Pathology & Laboratory MedicineMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Juan Fortea
- Neurology DepartmentHospital de la Santa Creu i Sant Pau, NeurologyBarcelonaSpain
| | - Anah Gilmore
- University of Colorado Denver Anschutz Medical Campus, NeurosurgeryAuroraColoradoUSA
| | - Stephen D. Ginsberg
- Center for Dementia Research, Nathan Kline InstituteOrangeburgNew YorkUSA
- Departments of PsychiatryNeuroscience & Physiology, and the NYU Neuroscience Institute, New York University Grossman School of MedicineNew YorkNew YorkUSA
| | - Samuel J. Guzman
- Department of PathologyUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Eric D. Hamlett
- Department of Pathology & Laboratory MedicineMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Elizabeth Head
- Department of Pathology and Laboratory MedicineUniversity of California Irvine, UCI School of Medicine D440 Medical Sciences IIrvineCaliforniaUSA
| | - Sylvia E. Perez
- Barrow Neurological InstituteTranslational Neurosciences and NeurologyPhoenixArizonaUSA
| | - Huntington Potter
- University of Colorado Denver Anschutz Medical Campus, NeurologyAuroraColoradoUSA
| | - Laura Molina‐Porcel
- Pathology DepartmentHospital Clinic de Barcelona‐University of BarcelonaBarcelonaSpain
- Alzheimer's Disease and Other Cognitive Disorders UnitNeurology Service, Hospital Clínic, IDIBAPS, University of BarcelonaBarcelonaSpain
| | - Ruma Raha‐Chowdhury
- Department of PsychiatryCambridge Intellectual & Developmental Disabilities Research GroupUniversity of CambridgeCambridgeUK
| | - Thomas Wisniewski
- Center for Cognitive Neurology, Departments of Neurology, Pathology and PsychiatryNew York University Grossman School of MedicineNew YorkNew YorkUSA
| | - William H. Yong
- Department of Pathology and Laboratory MedicineUniversity of California Irvine, UCI School of Medicine D440 Medical Sciences IIrvineCaliforniaUSA
| | - Shahid Zaman
- Department of PsychiatryCambridge Intellectual & Developmental Disabilities Research GroupUniversity of CambridgeCambridgeUK
| | - Sujay Ghosh
- Department of ZoologyCytogenetics and Genomics Research UnitKolkataIndia
| | - Elliott J. Mufson
- Barrow Neurological InstituteTranslational Neurosciences and NeurologyPhoenixArizonaUSA
| | | |
Collapse
|
3
|
Altuna M, Estanga A, Garrido A, Saldias J, Cañada M, Echeverria M, Larrea JÁ, Ayo P, Fiz A, Muñoz M, Santa-Inés J, García-Landarte V, García-Sebastián M. Down Syndrome-Basque Alzheimer Initiative (DS-BAI): Clinic-Biological Cohort. J Clin Med 2024; 13:1139. [PMID: 38398452 PMCID: PMC10889106 DOI: 10.3390/jcm13041139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Down syndrome (DS) is the most common genetically determined intellectual disability. In recent decades, it has experienced an exponential increase in life expectancy, leading to a rise in age-related diseases, including Alzheimer's disease (AD). Specific health plans for the comprehensive care of the DS community are an unmet need, which is crucial for the early and accurate diagnosis of main medical comorbidities. We present the protocol of a newly created clinical and research cohort and its feasibility in real life. METHODS The Down Syndrome-Basque Alzheimer Initiative (DS-BAI) is a population-based, inclusive, multidisciplinary initiative for the clinical-assistance and clinical-biological research approach to aging in DS led by the CITA-Alzheimer Foundation (Donostia, Basque Country). It aims to achieve the following: (1) provide comprehensive care for adults with DS, (2) optimize access to rigorous and quality training for socio-family and healthcare references, and (3) create a valuable multimodal clinical-biological research platform. RESULTS During the first year, 114 adults with DS joined the initiative, with 36% of them showing symptoms indicative of AD. Furthermore, adherence to training programs for healthcare professionals and families has been high, and the willingness to collaborate in basic and translational research has been encouraging. CONCLUSION Specific health plans for DS and conducting clinical and translational research on the challenges of aging, including AD, are necessary and feasible.
Collapse
Affiliation(s)
- Miren Altuna
- Fundación CITA-Alzheimer Fundazioa, 20009 Donostia, Spain
- Debabarrena Integrated Health Organization, Osakidetza Basque Health Service, 20690 Gipuzkoa, Spain
- Department of Medicine, Faculty of Health Sciences, University of Deusto, 48007 Bilbo, Spain
| | - Ainara Estanga
- Fundación CITA-Alzheimer Fundazioa, 20009 Donostia, Spain
| | - Adolfo Garrido
- Donostialdea Integrated Health Organisation, Clinical Biochemistry Department, Osakidetza Basque Health Service, 20014 Donostia, Spain
| | - Jon Saldias
- Fundación CITA-Alzheimer Fundazioa, 20009 Donostia, Spain
| | - Marta Cañada
- Fundación CITA-Alzheimer Fundazioa, 20009 Donostia, Spain
| | - Maitane Echeverria
- Donostialdea Integrated Health Organisation, Clinical Biochemistry Department, Osakidetza Basque Health Service, 20014 Donostia, Spain
| | - José Ángel Larrea
- Department of Medicine, Faculty of Health Sciences, University of Deusto, 48007 Bilbo, Spain
- Donostialdea Integrated Health Organisation, Radiology Department, Osakidetza Basque Health Service, 20014 Donostia, Spain
| | | | | | - María Muñoz
- Fundación Goyeneche de San Sebastián, 20018 Donostia, Spain
| | | | | | | |
Collapse
|
4
|
DiProspero N, Sathishkumar M, Janecek J, Smith A, McMillan L, Petersen M, Tustison N, Keator DB, Doran E, Hom CL, Nguyen D, Andrews H, Krinsky‐McHale S, Brickman AM, Rosas HD, Lai F, Head E, Mapstone M, Silverman W, Lott IT, O'Bryant S, Yassa MA. Neurofilament light chain concentration mediates the association between regional medial temporal lobe structure and memory in adults with Down syndrome. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12542. [PMID: 38348178 PMCID: PMC10859879 DOI: 10.1002/dad2.12542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 08/03/2023] [Accepted: 09/26/2023] [Indexed: 02/15/2024]
Abstract
INTRODUCTION Virtually all people with Down syndrome (DS) develop neuropathology associated with Alzheimer's disease (AD). Atrophy of the hippocampus and entorhinal cortex (EC), as well as elevated plasma concentrations of neurofilament light chain (NfL) protein, are markers of neurodegeneration associated with late-onset AD. We hypothesized that hippocampus and EC gray matter loss and increased plasma NfL concentrations are associated with memory in adults with DS. METHODS T1-weighted structural magnetic resonance imaging (MRI) data were collected from 101 participants with DS. Hippocampus and EC volume, as well as EC subregional cortical thickness, were derived. In a subset of participants, plasma NfL concentrations and modified Cued Recall Test scores were obtained. Partial correlation and mediation were used to test relationships between medial temporal lobe (MTL) atrophy, plasma NfL, and episodic memory. RESULTS Hippocampus volume, left anterolateral EC (alEC) thickness, and plasma NfL were correlated with each other and were associated with memory. Plasma NfL mediated the relationship between left alEC thickness and memory as well as hippocampus volume and memory. DISCUSSION The relationship between MTL gray matter and memory is mediated by plasma NfL levels, suggesting a link between neurodegenerative processes underlying axonal injury and frank gray matter loss in key structures supporting episodic memory in people with DS.
Collapse
Affiliation(s)
- Natalie DiProspero
- Department of Neurobiology and BehaviorSchool of Biological SciencesUniversity of CaliforniaIrvineCaliforniaUSA
- Center for the Neurobiology of Learning and MemoryUniversity of CaliforniaIrvineCaliforniaUSA
| | - Mithra Sathishkumar
- Department of Neurobiology and BehaviorSchool of Biological SciencesUniversity of CaliforniaIrvineCaliforniaUSA
- Center for the Neurobiology of Learning and MemoryUniversity of CaliforniaIrvineCaliforniaUSA
| | - John Janecek
- Department of Neurobiology and BehaviorSchool of Biological SciencesUniversity of CaliforniaIrvineCaliforniaUSA
- Center for the Neurobiology of Learning and MemoryUniversity of CaliforniaIrvineCaliforniaUSA
| | - Anna Smith
- Department of Neurobiology and BehaviorSchool of Biological SciencesUniversity of CaliforniaIrvineCaliforniaUSA
- Center for the Neurobiology of Learning and MemoryUniversity of CaliforniaIrvineCaliforniaUSA
| | - Liv McMillan
- Department of Neurobiology and BehaviorSchool of Biological SciencesUniversity of CaliforniaIrvineCaliforniaUSA
- Center for the Neurobiology of Learning and MemoryUniversity of CaliforniaIrvineCaliforniaUSA
| | - Melissa Petersen
- Institute for Translational ResearchUniversity of North Texas Health Science CenterFort WorthTexasUSA
| | - Nicholas Tustison
- Department of Neurobiology and BehaviorSchool of Biological SciencesUniversity of CaliforniaIrvineCaliforniaUSA
- Department of RadiologyUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - David B. Keator
- Department of Psychiatry and Behavioral SciencesSchool of MedicineUniversity of CaliforniaIrvineCaliforniaUSA
| | - Eric Doran
- Department of PediatricsSchool of MedicineUniversity of CaliforniaIrvineCaliforniaUSA
| | - Christy L. Hom
- Department of PediatricsSchool of MedicineUniversity of CaliforniaIrvineCaliforniaUSA
| | - Dana Nguyen
- Department of PediatricsSchool of MedicineUniversity of CaliforniaIrvineCaliforniaUSA
| | - Howard Andrews
- Department of PsychiatryCollege of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Sharon Krinsky‐McHale
- Department of NeurologyCollege of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Adam M. Brickman
- Department of NeurologyCollege of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
- Taub Institute for Research on Alzheimer's Disease and the Aging BrainCollege of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - H. Diana Rosas
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Florence Lai
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Elizabeth Head
- Center for the Neurobiology of Learning and MemoryUniversity of CaliforniaIrvineCaliforniaUSA
- Department of PathologySchool of MedicineUniversity of CaliforniaIrvineCaliforniaUSA
| | - Mark Mapstone
- Center for the Neurobiology of Learning and MemoryUniversity of CaliforniaIrvineCaliforniaUSA
- Department of NeurologySchool of MedicineUniversity of CaliforniaIrvineCaliforniaUSA
| | - Wayne Silverman
- Department of PediatricsSchool of MedicineUniversity of CaliforniaIrvineCaliforniaUSA
| | - Ira T. Lott
- Department of PediatricsSchool of MedicineUniversity of CaliforniaIrvineCaliforniaUSA
| | - Sid O'Bryant
- Institute for Translational ResearchUniversity of North Texas Health Science CenterFort WorthTexasUSA
| | - Michael A. Yassa
- Department of Neurobiology and BehaviorSchool of Biological SciencesUniversity of CaliforniaIrvineCaliforniaUSA
- Center for the Neurobiology of Learning and MemoryUniversity of CaliforniaIrvineCaliforniaUSA
- Department of Psychiatry and Behavioral SciencesSchool of MedicineUniversity of CaliforniaIrvineCaliforniaUSA
- Department of NeurologySchool of MedicineUniversity of CaliforniaIrvineCaliforniaUSA
| |
Collapse
|
5
|
Corniello C, Dono F, Evangelista G, Consoli S, De Angelis S, Cipollone S, Liviello D, Polito G, Melchiorre S, Russo M, Granzotto A, Anzellotti F, Onofrj M, Thomas A, Sensi SL. Diagnosis and treatment of late-onset myoclonic epilepsy in Down syndrome (LOMEDS): A systematic review with individual patients' data analysis. Seizure 2023; 109:62-67. [PMID: 37267668 DOI: 10.1016/j.seizure.2023.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/18/2023] [Accepted: 05/20/2023] [Indexed: 06/04/2023] Open
Abstract
INTRODUCTION The late onset myoclonic epilepsy in Down Syndrome (LOMEDS) is a peculiar epilepsy type characterized by cortical myoclonus and generalized tonic-clonic seizures (GTCS), in people suffering from cognitive decline in Down syndrome (DS). In this review, we analyzed available data on the diagnostic and therapeutic management of individuals with LOMEDS. METHODS We performed a systematic search of the literature to identify the diagnostic and therapeutic management of patients with LOMEDS. The following databases were used: PubMed, Google Scholar, EMBASE, CrossRef. The protocol was registered on PROSPERO (registration code: CRD42023390748). RESULTS Data from 46 patients were included. DS was diagnosed according to the patient's clinical and genetic characteristics. Diagnosis of Alzheimer's dementia (AD) preceded the onset of epilepsy in all cases. Both myoclonic seizures (MS) and generalized tonic-clonic seizures (GTCS) were reported, the latter preceding the onset of MS in 28 cases. EEG was performed in 45 patients, showing diffuse theta/delta slowing with superimposed generalized spike-and-wave or polyspike-and-wave. A diffuse cortical atrophy was detected in 34 patients on neuroimaging. Twenty-seven patients were treated with antiseizure medication (ASM) monotherapy, with reduced seizure frequency in 17 patients. Levetiracetam and valproic acid were the most used ASMs. Up to 41% of patients were unresponsive to first-line treatment and needed adjunctive therapy for seizure control. CONCLUSIONS AD-related pathological changes in the brain may play a role in LOMEDS onset, although the mechanism underlying this phenomenon is still unknown. EEG remains the most relevant investigation to be performed. A significant percentage of patients developed a first-line ASM refractory epilepsy. ASMs which modulate the glutamatergic system may represent a good therapeutic option.
Collapse
Affiliation(s)
- Clarissa Corniello
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Epilepsy Center, "SS Annunziata" Hospital, Chieti, Italy
| | - Fedele Dono
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Epilepsy Center, "SS Annunziata" Hospital, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST, University "G. d'Annunzio" of Chieti-Pescara, Italy.
| | - Giacomo Evangelista
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Epilepsy Center, "SS Annunziata" Hospital, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST, University "G. d'Annunzio" of Chieti-Pescara, Italy
| | - Stefano Consoli
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Epilepsy Center, "SS Annunziata" Hospital, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST, University "G. d'Annunzio" of Chieti-Pescara, Italy
| | - Sibilla De Angelis
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Epilepsy Center, "SS Annunziata" Hospital, Chieti, Italy
| | - Sara Cipollone
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Epilepsy Center, "SS Annunziata" Hospital, Chieti, Italy
| | - Davide Liviello
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Epilepsy Center, "SS Annunziata" Hospital, Chieti, Italy
| | - Gaetano Polito
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Sara Melchiorre
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Mirella Russo
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST, University "G. d'Annunzio" of Chieti-Pescara, Italy
| | - Alberto Granzotto
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST, University "G. d'Annunzio" of Chieti-Pescara, Italy
| | | | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST, University "G. d'Annunzio" of Chieti-Pescara, Italy
| | - Astrid Thomas
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST, University "G. d'Annunzio" of Chieti-Pescara, Italy
| | - Stefano L Sensi
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST, University "G. d'Annunzio" of Chieti-Pescara, Italy; Institute for Advanced Biomedical Technologies, University of Chieti-Pescara, Chieti, Italy
| |
Collapse
|
6
|
Rodríguez-Hidalgo E, García-Alba J, Novell R, Esteba-Castillo S. The Global Deterioration Scale for Down Syndrome Population (GDS-DS): A Rating Scale to Assess the Progression of Alzheimer's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5096. [PMID: 36982004 PMCID: PMC10049652 DOI: 10.3390/ijerph20065096] [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: 12/29/2022] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study is to adapt and validate the global deterioration scale (GDS) for the systematic tracking of Alzheimer's disease (AD) progression in a population with Down syndrome (DS). A retrospective dual-center cohort study was conducted with 83 participants with DS (46.65 ± 5.08 years) who formed the primary diagnosis (PD) group: cognitive stability (n = 48), mild cognitive impairment (n = 24), and Alzheimer's disease (n = 11). The proposed scale for adults with DS (GDS-DS) comprises six stages, from cognitive and/or behavioral stability to advanced AD. Two neuropsychologists placed the participants of the PD group in each stage of the GDS-DS according to cognitive, behavioral and daily living skills data. Inter-rater reliability in staging with the GDS-DS was excellent (ICC = 0.86; CI: 0.80-0.93), and the agreement with the diagnosis categories of the PD group ranged from substantial to excellent with κ values of 0.82 (95% CI: 0.73-0.92) and 0.85 (95% CI: 0.72, 0.99). Performance with regard to the CAMCOG-DS total score and orientation subtest of the Barcelona test for intellectual disability showed a slight progressive decline across all the GDS-DS stages. The GDS-DS scale is a sensitive tool for staging the progression of AD in the DS population, with special relevance in daily clinical practice.
Collapse
Affiliation(s)
- Emili Rodríguez-Hidalgo
- Specialized Service in Mental Health and Intellectual Disability, Institute of Health Assistance (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain
- Neurodevelopmental Group [Girona Biomedical Research Institute]-IDIBGI, Institute of Health Assistance (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain
| | - Javier García-Alba
- Research and Psychology in Education Department, Complutense University of Madrid, 28040 Madrid, Spain
| | - Ramon Novell
- Specialized Service in Mental Health and Intellectual Disability, Institute of Health Assistance (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain
- Neurodevelopmental Group [Girona Biomedical Research Institute]-IDIBGI, Institute of Health Assistance (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain
| | - Susanna Esteba-Castillo
- Specialized Service in Mental Health and Intellectual Disability, Institute of Health Assistance (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain
- Neurodevelopmental Group [Girona Biomedical Research Institute]-IDIBGI, Institute of Health Assistance (IAS), Parc Hospitalari Martí i Julià, 17190 Girona, Spain
| |
Collapse
|
7
|
Nadeau PA, Jobin B, Boller B. Diagnostic Sensitivity and Specificity of Cognitive Tests for Mild Cognitive Impairment and Alzheimer's Disease in Patients with Down Syndrome: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2023; 95:13-51. [PMID: 37522203 DOI: 10.3233/jad-220991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
BACKGROUND Improved health care for people with Down syndrome (DS) has resulted in an increase in their life expectancy therefore increasing comorbidities associated with age-related problems in this population, the most frequent being Alzheimer's disease (AD). To date, several cognitive tests have been developed to evaluate cognitive changes related to the development of mild cognitive impairment (MCI) and AD in people with DS. OBJECTIVE Identify and evaluate available cognitive tests for the diagnosis of MCI and AD in people with DS. METHODS A systematic search of the Pubmed and PsycInfo databases was performed to identify articles published from January 1, 2000 and July 1, 2022. Keysearch terms were DS, AD or MCI, cognition, and assessment. Relevant studies assessing the diagnostic accuracy of cognitive tests for AD or MCI with standard clinical evaluation were extracted. Risk of bias was assessed using the QUADAS 2. RESULTS We identified 15 batteries, 2 intelligence scales, 14 memory tests, 11 executive, functioning tests, 11 motor and visuospatial functioning tests, 5 language tests, 3 attention tests, and 2 orientation tests. Analysis showed that the CAMCOG-DS present a fair to excellent diagnostic accuracy for detecting AD in patients with DS. However, for the diagnosis of MCI, this battery showed poor to good diagnostic accuracy. CONCLUSION The findings highlight important limitations of the current assessment available for the screening of mild cognitive impairment and AD in patients with DS and support the need for more clinical trials to ensure better screening for this highly at-risk population.
Collapse
Affiliation(s)
| | - Benoît Jobin
- Université du Québec à Trois-Rivière, Quebec, Canada
| | - Benjamin Boller
- Univerisité de Montréal, Quebec, Canada
- Université du Québec à Trois-Rivière, Quebec, Canada
| |
Collapse
|