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Luchsinger JA, Pang D, Krinsky-McHale SJ, Schupf N, Lee JH, Silverman W, Zigman WB. Obesity, diabetes and their metabolic correlates in middle-aged adults with Down syndrome. J Intellect Disabil Res 2024; 68:212-222. [PMID: 37899501 PMCID: PMC10872834 DOI: 10.1111/jir.13103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 09/29/2023] [Accepted: 10/11/2023] [Indexed: 10/31/2023]
Abstract
BACKGROUND Obesity in adults without Down syndrome is associated with an adverse metabolic profile including high prevalence of pre-diabetes and diabetes, high levels of insulin, non-high-density lipoprotein (HDL) cholesterol, leptin and high-sensitivity C-reactive protein (hsCRP) and low levels of HDL and adiponectin. We examined whether obesity in middle-aged adults with Down syndrome is also related to an adverse metabolic profile. METHODS This cross-sectional study included 143 adults with Down syndrome, with a mean age of 55.7 ± 5.7 years and 52.5% women. Body mass index (BMI) was classified as underweight (BMI < 18.5 kg/m2 ), normal (BMI 18.5-24.9 kg/m2 ), overweight (BMI 25-29.9 kg/m2 ) and obese (BMI ≥ 30 kg/m2 ). Diabetes was ascertained by history or by haemoglobin A1c (HbA1c) as normal glucose tolerance (HbA1c < 5.7%), pre-diabetes (HbA1c 5.7-6.4%) and diabetes (HbA1c ≥ 6.5%). We measured non-fasting lipids, hsCRP, insulin, adiponectin and leptin. RESULTS The majority of the sample had an overweight (46.9%) or obesity (27.3%) status. However, there was a relatively low prevalence of pre-diabetes (9.8%) and diabetes (6.9%). Overweight and obesity status were not associated with lower HDL and adiponectin and higher insulin, non-HDL cholesterol and hsCRP as expected in adults without Down syndrome. However, overweight and obesity were strongly associated with higher leptin (P < 0.001). CONCLUSIONS The only metabolic correlate of obesity in middle-aged adults with Down syndrome was high leptin levels. Our findings are limited by non-fasting laboratory tests but suggest that middle-aged adults with Down syndrome do not have the adverse metabolic profile related to obesity found in adults without Down syndrome.
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Affiliation(s)
- José A. Luchsinger
- Department of Medicine, Columbia University Medical Center, New York, NY, USA
- Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
| | - Deborah Pang
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Sharon J. Krinsky-McHale
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Nicole Schupf
- Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA
- Taub Institute, Columbia University Medical Center, New York, NY, USA
| | - Joseph H. Lee
- Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA
- Taub Institute, Columbia University Medical Center, New York, NY, USA
| | | | - Warren B. Zigman
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
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Listwan TA, Krinsky‐McHale SJ, Kovacs CM, Lee JH, Pang DI, Schupf N, Tycko B, Zigman WB, Silverman W. Prodromal Alzheimer's disease can affect activities of daily living for adults with Down syndrome. Alzheimers Dement (Amst) 2024; 16:e12562. [PMID: 38476636 PMCID: PMC10927922 DOI: 10.1002/dad2.12562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 03/14/2024]
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.
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Affiliation(s)
- Tracy A. Listwan
- Department of PsychologyNew York State Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Sharon J. Krinsky‐McHale
- Department of PsychologyNew York State Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Cynthia M. Kovacs
- Department of PsychologyNew York State Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Joseph H. Lee
- Taub Institute for Research on Alzheimer's Disease and the Aging BrainG. H. Sergievsky CenterDepartments of Epidemiology and NeurologyCollege of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Deborah I. Pang
- Department of PsychologyNew York State Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Nicole Schupf
- Taub Institute for Research on Alzheimer's Disease and the Aging BrainG. H. Sergievsky CenterDepartments of Epidemiology and NeurologyCollege of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Benjamin Tycko
- Hackensack Meridian HealthCenter for Discovery and InnovationNutleyNew JerseyUSA
| | - Warren B. Zigman
- Department of PsychologyNew York State Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Wayne Silverman
- Department of PediatricsUniversity of CaliforniaIrvineCaliforniaUSA
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Silverman W, Krinsky‐McHale SJ, Kovacs C, Lee JH, Listwan T, Pang DI, Zigman WB, Schupf N. Individualized estimated years from onset of Alzheimer's disease- related decline for adults with Down syndrome. Alzheimers Dement (Amst) 2023; 15:e12444. [PMID: 37389223 PMCID: PMC10300244 DOI: 10.1002/dad2.12444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/29/2023] [Accepted: 04/26/2023] [Indexed: 07/01/2023]
Abstract
Introduction Adults with Down syndrome (DS) are at increased risk for Alzheimer's disease (AD) and vary in their age of transition from AD preclinical to prodromal or more advanced clinical stages. An empirically based method is needed to determine individual "estimated years from symptom onset (EYO)," the same construct used in studies of autosomal dominant AD . Methods Archived data from a previous study of > 600 adults with DS were examined using survival analysis methods. Age-specific prevalence of prodromal AD or dementia, cumulative risk, and EYOs were determined. Results Individualized EYOs for adults with DS ranging in age from 30 to 70+ were determined, dependent upon chronological age and clinical status. Discussion EYOs can be a useful tool for studies focused on biomarker changes during AD progression in this and other populations at risk, studies that should contribute to improved methods for diagnosis, prediction of risk, and identification of promising treatment targets. HIGHLIGHTS Years from Alzheimer's disease (AD) onset (EYO) was estimated for adults with Down syndrome (DS).EYOs were informed by AD clinical status and age, ranging from 30 to > 70 years.Influences of biological sex and apolipoprotein E genotype on EYOs were examined.EYOs have advantages for predicting risk of AD-related dementia compared to age.EYOs can be extremely informative in studies of preclinical AD progression.
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Affiliation(s)
- Wayne Silverman
- Department of PediatricsUniversity of California, IrvineIrvineCaliforniaUSA
| | - Sharon J. Krinsky‐McHale
- Department of PsychologyNew York State Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Cynthia Kovacs
- Department of PsychologyNew York State Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Joseph H. Lee
- Sergievsky Center, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Departments of Neurology and Epidemiology, Vagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Tracy Listwan
- Department of PsychologyNew York State Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Deborah I. Pang
- Department of PsychologyNew York State Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Warren B. Zigman
- Department of PsychologyNew York State Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Nicole Schupf
- Department of Neurology, College of Physicians and Surgeons and Department of Epidemiology, School of Public HealthColumbia UniversityNew YorkNew YorkUSA
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Silverman W, Krinsky-McHale SJ, Zigman WB, Schupf N. Adults with Down syndrome in randomized clinical trials targeting prevention of Alzheimer's disease. Alzheimers Dement 2022; 18:1736-1743. [PMID: 34873819 PMCID: PMC10302784 DOI: 10.1002/alz.12520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 08/11/2021] [Accepted: 10/11/2021] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Adults with Down syndrome, the largest population genetically predisposed to high risk for Alzheimer's disease (AD), are ideally suited participants for clinical trials targeting prevention. Critically important considerations for the design of such trials include appropriate selection of participants, outcome measures, and duration of follow-up. METHODS Archived data for 12 measures of performance over a 3-year period were analyzed for 185 adults with Down syndrome 36 years of age and older with presumptive preclinical AD. RESULTS Declines over 3 years were not observed prior to 46 years of age. However, declines were observed at older ages, increasing monotonically for groups aged 46-49, 50-55, and >55, as did incidence of prodromal AD and dementia. DISCUSSION Significant decline over a 2- to 3-year period for a prospective placebo group of adults with Down syndrome enrolled in clinical prevention trials can only be expected when inclusion is limited to adults older than 45 years of age.
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Affiliation(s)
- Wayne Silverman
- Department of Pediatrics, University of California, Irvine, Orange, California, USA
| | - Sharon J Krinsky-McHale
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Warren B Zigman
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, USA
| | - Nicole Schupf
- Department of Epidemiology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain and in Psychiatry, the Columbia University Medical Center, New York, New York, USA
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Dang LT, Krinsky‐McHale SJ, O'Bryant S, Pang D, Zigman WB, Silverman W, Schupf N, Lee JH. Sex differences in levels of plasma neurofilament light and total tau in adults with Down syndrome. Alzheimers Dement 2021. [DOI: 10.1002/alz.055785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Lam‐Ha T Dang
- Columbia University Irving Medical Center New York NY USA
| | - Sharon J Krinsky‐McHale
- New York State Institute for Basic Research in Developmental Disabilities Staten Island NY USA
| | - Sid O'Bryant
- University of North Texas Health Science Center Fort Worth TX USA
| | - Deborah Pang
- New York State Institute for Basic Research in Developmental Disabilities Staten Island NY USA
| | - Warren B. Zigman
- New York State Institute for Basic Research in Developmental Disabilities Staten Island NY USA
| | | | - Nicole Schupf
- Columbia University Irving Medical Center New York NY USA
| | - Joseph H. Lee
- Columbia University Irving Medical Center New York NY USA
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Dang LT, Krinsky‐McHale SJ, O'Bryant S, Pang D, Zigman WB, Silverman W, Schupf N, Lee JH. Elevated plasma neurofilament light (NfL) is associated with incident Alzheimer’s disease and accelerated cognitive decline in adults with Down syndrome. Alzheimers Dement 2020. [DOI: 10.1002/alz.045982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Lam‐Ha T. Dang
- Columbia University Irving Medical Center New York NY USA
| | | | - Sid O'Bryant
- University of North Texas Health Science Center Fort Worth TX USA
| | - Deborah Pang
- NYS Institute for Basic Research Staten Island NY USA
| | | | | | - Nicole Schupf
- Columbia University Irving Medical Center New York NY USA
| | - Joseph H. Lee
- Columbia University Irving Medical Center New York NY USA
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Krinsky‐McHale SJ, Zigman WB, Lee JH, Schupf N, Pang D, Listwan T, Kovacs C, Silverman W. Promising outcome measures of early Alzheimer's dementia in adults with Down syndrome. Alzheimers Dement (Amst) 2020; 12:e12044. [PMID: 32647741 PMCID: PMC7335903 DOI: 10.1002/dad2.12044] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Adults with Down syndrome (DS) are at high risk for developing Alzheimer's disease (AD) and its associated dementia, warranting the development of strategies to improve early detection when prevention is possible. METHODS Using a broad battery of neuropsychological assessments, informant interviews, and clinical record review, we evaluated the psychometrics of measures in a large sample of 561 adults with DS. We tracked longitudinal stability or decline in functioning in a subsample of 269 participants over a period of 3 years, all initially without indications of clinically significant aging-related decline. RESULTS Results identified an array of objective measures that demonstrated sensitivity in distinguishing individuals with incident "mild cognitive impairment" (MCI-DS) as well as subsequent declines occurring with incident dementia. DISCUSSION Several instruments showed clear promise for use as outcome measures for future clinical trials and for informing diagnosis of individuals suspected of experiencing early signs and symptoms of a progressive dementia process.
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Affiliation(s)
- Sharon J Krinsky‐McHale
- New YorkState Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Warren B. Zigman
- New YorkState Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Joseph H. Lee
- Department of NeurologyCollege of Physicians and SurgeonsColumbia UniversitySergievsky Center/Taub InstituteNew YorkNew YorkUSA
- Department of EpidemiologySchool of Public HealthColumbia UniversityNew YorkNew YorkUSA
| | - Nicole Schupf
- Department of NeurologyCollege of Physicians and SurgeonsColumbia UniversitySergievsky Center/Taub InstituteNew YorkNew YorkUSA
- Department of EpidemiologySchool of Public HealthColumbia UniversityNew YorkNew YorkUSA
| | - Deborah Pang
- New YorkState Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Tracy Listwan
- New YorkState Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Cynthia Kovacs
- New YorkState Institute for Basic Research in Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Wayne Silverman
- Department of EpidemiologySchool of Public HealthColumbia UniversityNew YorkNew YorkUSA
- University of CaliforniaIrvineCaliforniaUSA
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Schupf N, Lee JH, Pang D, Zigman WB, Tycko B, Krinsky-McHale S, Silverman W. Epidemiology of estrogen and dementia in women with Down syndrome. Free Radic Biol Med 2018; 114:62-68. [PMID: 28843780 PMCID: PMC5748249 DOI: 10.1016/j.freeradbiomed.2017.08.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 08/21/2017] [Accepted: 08/22/2017] [Indexed: 10/19/2022]
Abstract
Several lines of investigation have shown a protective role for estrogen in Alzheimer's disease through a number of biological actions. This review examines studies of the role of estrogen-related factors in age at onset and risk for Alzheimer's disease in women with Down syndrome, a population at high risk for early onset of dementia. The studies are consistent in showing that early age at menopause and that low levels of endogenous bioavailable estradiol in postmenopausal women with Down syndrome are associated with earlier age at onset and overall risk for dementia. Polymorphisms in genes associated with estrogen receptor activity and in genes for estrogen biosynthesis affecting endogenous estrogen are related to age at onset and cumulative incidence of dementia, and may serve as biomarkers of risk. To date, no clinical trials of estrogen or hormone replacement therapy (ERT/HRT) have been published for women with Down syndrome. While findings from clinical trials of ERT or HRT for dementia have generally been negative among women in the neurotypical population, the short interval between menopause and onset of cognitive decline, together with a more positive balance between potential benefits and risks, suggests an opportunity to evaluate the efficacy of ERT/HRT for delaying or preventing dementia in this high risk population, although questions concerning the optimal formulation and timing of the hormone therapy are not yet resolved.
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Affiliation(s)
- Nicole Schupf
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; G.H. Sergievsky Center, Columbia University, New York, NY, United States; Departments of Neurology and Psychiatry, Columbia University Medical Center, New York, NY, United States; Department of Epidemiology, Mailman School of Public Health Columbia University, New York, NY, United States.
| | - Joseph H Lee
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; G.H. Sergievsky Center, Columbia University, New York, NY, United States; Department of Epidemiology, Mailman School of Public Health Columbia University, New York, NY, United States
| | - Deborah Pang
- Department of Psychology, NYS Institute for Basic Research in Developmental Disabilities, Staten Island, New York, NY, United States
| | - Warren B Zigman
- Department of Psychology, NYS Institute for Basic Research in Developmental Disabilities, Staten Island, New York, NY, United States
| | - Benjamin Tycko
- Department of Pathology & Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Sharon Krinsky-McHale
- Department of Psychology, NYS Institute for Basic Research in Developmental Disabilities, Staten Island, New York, NY, United States
| | - Wayne Silverman
- Kennedy Krieger Institute and Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Jenkins EC, Marchi EJ, Velinov MT, Ye L, Krinsky-McHale SJ, Zigman WB, Schupf N, Silverman WP. Cover Image, Volume 174B, Number 8, December 2017. Am J Med Genet 2017. [DOI: 10.1002/ajmg.b.32609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Edmund C. Jenkins
- New York State Institute for Basic Research in Developmental Disabilities; Staten Island New York
| | - Elaine J. Marchi
- New York State Institute for Basic Research in Developmental Disabilities; Staten Island New York
| | - Milen T. Velinov
- New York State Institute for Basic Research in Developmental Disabilities; Staten Island New York
| | - Lingling Ye
- New York State Institute for Basic Research in Developmental Disabilities; Staten Island New York
| | - Sharon J. Krinsky-McHale
- New York State Institute for Basic Research in Developmental Disabilities; Staten Island New York
- Taub Institute for Research on Alzheimer's disease and the Aging Brain; Columbia University; New York New York
| | - Warren B. Zigman
- New York State Institute for Basic Research in Developmental Disabilities; Staten Island New York
| | - Nicole Schupf
- New York State Institute for Basic Research in Developmental Disabilities; Staten Island New York
- Taub Institute for Research on Alzheimer's disease and the Aging Brain; Columbia University; New York New York
| | - Wayne P. Silverman
- The Kennedy Krieger Institute and Johns Hopkins University School of Medicine; Baltimore Maryland
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Jenkins EC, Marchi EJ, Velinov MT, Ye L, Krinsky-McHale SJ, Zigman WB, Schupf N, Silverman WP. Longitudinal telomere shortening and early Alzheimer's disease progression in adults with down syndrome. Am J Med Genet B Neuropsychiatr Genet 2017; 174:772-778. [PMID: 28856789 DOI: 10.1002/ajmg.b.32575] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 07/05/2017] [Indexed: 11/10/2022]
Abstract
Telomere shortening was shown to parallel Alzheimer's disease (AD) associated dementia. By using a dual PNA Probe system we have developed a practical method for comparing telomere length in T-lymphocyte interphases from individuals with Down syndrome (DS) with and without "mild cognitive impairment" (MCI-DS) and demonstrated that telomere length can serve as a valid biomarker for the onset of MCI-DS in this high-risk population. To verify progressive cognitive decline we have now examined sequential changes in telomere length in 10 adults with DS (N = 4 Female, N = 6 Male) developing MCI-DS. Cases were selected blind to telomere length from a sample of adults with DS previously enrolled in a prospective longitudinal study at 18-month intervals with clinical and telomere assessments: (1) MCI-DS group data were collected approximately three years prior to development of MCI-DS; (2) 18 months later; (3) when MCI-DS was first observed. These telomere measures were compared to those from another 10 adults with DS matched by sex and approximate age but without indications of MCI-DS (Controls). PNA (peptide nucleic acid) probes for telomeres together with a chromosome two centromere probe were used. Findings indicated telomere shortening over time for both Cases and Controls. Group differences emerged by 18-months prior to recognition of MCI-DS onset and completely non-overlapping distributions of telomere measures were observed by the time of MCI-DS onset. This study adds to accumulating evidence of the value of telomere length, as an early biomarker of AD progression in adults with Down syndrome.
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Affiliation(s)
- Edmund C Jenkins
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York
| | - Elaine J Marchi
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York
| | - Milen T Velinov
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York
| | - Lingling Ye
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York
| | - Sharon J Krinsky-McHale
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York.,Taub Institute for Research on Alzheimer's disease and the Aging Brain, Columbia University, New York, New York
| | - Warren B Zigman
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York
| | - Nicole Schupf
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York.,Taub Institute for Research on Alzheimer's disease and the Aging Brain, Columbia University, New York, New York
| | - Wayne P Silverman
- The Kennedy Krieger Institute and Johns Hopkins University School of Medicine, Baltimore, Maryland
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Krinsky‐McHale SJ, Jenkins EC, Lee JH, Schupf N, Zigman WB, Silverman W. [P3–434]: INDIVIDUAL DIFFERENCES IN LIFELONG ABILITIES MUST BE CONSIDERED FOR STAGING OF EARLY AD. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Edmund C. Jenkins
- New York State Institute for Basic Research in Developmental DisabilitiesStaten IslandNYUSA
| | | | | | | | - Wayne Silverman
- Kennedy Krieger Institute and Johns Hopkins UniversityBaltimoreMDUSA
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12
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Lee JH, Lee AJ, Dang LH, Pang D, Kisselev S, Krinsky-McHale SJ, Zigman WB, Luchsinger JA, Silverman W, Tycko B, Clark LN, Schupf N. Candidate gene analysis for Alzheimer's disease in adults with Down syndrome. Neurobiol Aging 2017; 56:150-158. [PMID: 28554490 DOI: 10.1016/j.neurobiolaging.2017.04.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 03/17/2017] [Accepted: 04/21/2017] [Indexed: 11/16/2022]
Abstract
Individuals with Down syndrome (DS) overexpress many genes on chromosome 21 due to trisomy and have high risk of dementia due to the Alzheimer's disease (AD) neuropathology. However, there is a wide range of phenotypic differences (e.g., age at onset of AD, amyloid β levels) among adults with DS, suggesting the importance of factors that modify risk within this particularly vulnerable population, including genotypic variability. Previous genetic studies in the general population have identified multiple genes that are associated with AD. This study examined the contribution of polymorphisms in these genes to the risk of AD in adults with DS ranging from 30 to 78 years of age at study entry (N = 320). We used multiple logistic regressions to estimate the likelihood of AD using single-nucleotide polymorphisms (SNPs) in candidate genes, adjusting for age, sex, race/ethnicity, level of intellectual disability and APOE genotype. This study identified multiple SNPs in APP and CST3 that were associated with AD at a gene-wise level empirical p-value of 0.05, with odds ratios in the range of 1.5-2. SNPs in MARK4 were marginally associated with AD. CST3 and MARK4 may contribute to our understanding of potential mechanisms where CST3 may contribute to the amyloid pathway by inhibiting plaque formation, and MARK4 may contribute to the regulation of the transition between stable and dynamic microtubules.
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Affiliation(s)
- Joseph H Lee
- Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Taub Institute, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, School of Public Health, Columbia University, New York, NY, USA.
| | - Annie J Lee
- Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Lam-Ha Dang
- Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, School of Public Health, Columbia University, New York, NY, USA
| | - Deborah Pang
- Department of Psychology, NYS Institute for Basic Research in Developmental Disabilities, Staten Island, NY, USA
| | - Sergey Kisselev
- Department of Pathology & Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Sharon J Krinsky-McHale
- Department of Psychology, NYS Institute for Basic Research in Developmental Disabilities, Staten Island, NY, USA
| | - Warren B Zigman
- Department of Psychology, NYS Institute for Basic Research in Developmental Disabilities, Staten Island, NY, USA
| | - José A Luchsinger
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Wayne Silverman
- Kennedy Krieger Institute and Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Benjamin Tycko
- Department of Pathology & Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Lorraine N Clark
- Taub Institute, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Pathology & Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Nicole Schupf
- Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Taub Institute, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, School of Public Health, Columbia University, New York, NY, USA
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13
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Jenkins EC, Ye L, Krinsky-McHale SJ, Zigman WB, Schupf N, Silverman WP. Telomere longitudinal shortening as a biomarker for dementia status of adults with Down syndrome. Am J Med Genet B Neuropsychiatr Genet 2016; 171B:169-74. [PMID: 26593971 DOI: 10.1002/ajmg.b.32389] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 09/28/2015] [Indexed: 01/22/2023]
Abstract
Previous studies have suggested that Alzheimer's disease (AD) causes an accelerated shortening of telomeres, the ends of chromosomes consisting of highly conserved TTAGGG repeats that, because of unidirectional 5'-3' DNA synthesis, lose end point material with each cell division. Our own previous work suggested that telomere length of T-lymphocytes might be a remarkably accurate biomarker for "mild cognitive impairment" in adults with Down syndrome (MCI-DS), a population at dramatically high risk for AD. To verify that the progression of cognitive and functional losses due to AD produced this observed telomere shortening, we have now examined sequential changes in telomere length in five individuals with Down syndrome (3F, 2M) as they transitioned from preclinical AD to MCI-DS (N = 4) or dementia (N = 1). As in our previous studies, we used PNA (peptide nucleic acid) probes for telomeres and the chromosome 2 centromere (as an "internal standard" expected to be unaffected by aging or dementia status), with samples from the same individuals now collected prior to and following development of MCI-DS or dementia. Consistent shortening of telomere length was observed over time. Further comparisons with our previous cross-sectional findings indicated that telomere lengths prior to clinical decline were similar to those of other adults with Down syndrome (DS) who have not experienced clinical decline while telomere lengths following transition to MCI-DS or dementia in the current study were comparable to those of other adults with DS who have developed MCI-DS or dementia. Taken together, findings indicate that telomere length has significant promise as a biomarker of clinical progression of AD for adults with DS, and further longitudinal studies of a larger sample of individuals with DS are clearly warranted to validate these findings and determine if and how factors affecting AD risk also influence these measures of telomere length.
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Affiliation(s)
- Edmund C Jenkins
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York
| | - Lingling Ye
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York
| | - Sharon J Krinsky-McHale
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York
| | - Warren B Zigman
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York
| | - Nicole Schupf
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York
| | - Wayne P Silverman
- The Kennedy Krieger Institute and The Johns Hopkins University School of Medicine, Baltimore, Maryland
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Schupf N, Dang LH, Lee A, Pang D, Zigman WB, Luchsinger JA, Krinsky-McHale S, Silverman W, Tycko B, Kisselev S, Clark L, Lee JH. P1‐268: Variants in candidate genes for Alzheimer's disease are associated with declining plasma abeta peptides in adults with down syndrome. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Lam-Ha Dang
- Columbia Univeristy Medical CenterNew YorkNYUSA
| | - Annie Lee
- Columbia University Medical CenterNew YorkNYUSA
| | - Deborah Pang
- NYS Institute for Basic ReseachStaten IslandNYUSA
| | | | | | | | - Wayne Silverman
- Kennedy Krieger Institute and Johns Hopkins UniversityBaltimoreMDUSA
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15
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Schupf N, Lee A, Park N, Dang LH, Pang D, Yale A, Oh DKT, Krinsky-McHale SJ, Jenkins EC, Luchsinger JA, Zigman WB, Silverman W, Tycko B, Kisselev S, Clark L, Lee JH. Candidate genes for Alzheimer's disease are associated with individual differences in plasma levels of beta amyloid peptides in adults with Down syndrome. Neurobiol Aging 2015; 36:2907.e1-10. [PMID: 26166206 DOI: 10.1016/j.neurobiolaging.2015.06.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 06/08/2015] [Accepted: 06/14/2015] [Indexed: 01/08/2023]
Abstract
We examined the contribution of candidates genes for Alzheimer's disease (AD) to individual differences in levels of beta amyloid peptides in adults with Down syndrom, a population at high risk for AD. Participants were 254 non-demented adults with Down syndrome, 30-78 years of age. Genomic deoxyribonucleic acid was genotyped using an Illumina GoldenGate custom array. We used linear regression to examine differences in levels of Aβ peptides associated with the number of risk alleles, adjusting for age, sex, level of intellectual disability, race and/or ethnicity, and the presence of the APOE ε4 allele. For Aβ42 levels, the strongest gene-wise association was found for a single nucleotide polymorphism (SNP) on CAHLM1; for Aβ40 levels, the strongest gene-wise associations were found for SNPs in IDE and SOD1, while the strongest gene-wise associations with levels of the Aβ42/Aβ40 ratio were found for SNPs in SORCS1. Broadly classified, variants in these genes may influence amyloid precursor protein processing (CALHM1, IDE), vesicular trafficking (SORCS1), and response to oxidative stress (SOD1).
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Affiliation(s)
- Nicole Schupf
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA; G.H. Sergievsky Center, New York, NY, USA; Department of Epidemiology, Columbia University Medical Center, New York, NY, USA; Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.
| | - Annie Lee
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Naeun Park
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Lam-Ha Dang
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Deborah Pang
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY, USA
| | - Alexander Yale
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - David Kyung-Taek Oh
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Sharon J Krinsky-McHale
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY, USA
| | - Edmund C Jenkins
- Department of Human Genetics, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY, USA
| | - José A Luchsinger
- Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Warren B Zigman
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY, USA
| | - Wayne Silverman
- Kennedy Krieger Institute and Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Benjamin Tycko
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Sergey Kisselev
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Lorraine Clark
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Joseph H Lee
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA; G.H. Sergievsky Center, New York, NY, USA; Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
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16
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Silverman WP, Zigman WB, Krinsky-McHale SJ, Ryan R, Schupf N. Intellectual Disability, Mild Cognitive Impairment, and Risk for Dementia. J Policy Pract Intellect Disabil 2013; 10. [PMID: 24273589 DOI: 10.1111/jppi.12042] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
People with intellectual disability (ID) are living longer than ever before, raising concerns about old-age associated disorders. Dementia is among the most serious of these disorders, and theories relating cognitive reserve to risk predict that older adults with ID should be particularly vulnerable. Previous estimates of relative risk for dementia associated with ID have been inconsistent, and the present analyses examined the possible influence of variation in diagnostic criteria on findings. As expected, relaxation in the stringency of case definition for adults with ID increased relative risk, underscoring the importance of developing valid criteria for defining mild cognitive impairment, early dementia, and distinguishing between the two in adults with ID. Once available, these standards will contribute to more effective evidence-based planning.
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Affiliation(s)
- Wayne P Silverman
- Kennedy Krieger Institute and Johns Hopkins University School of Medicine, Baltimore, Maryland USA
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Affiliation(s)
- Warren B. Zigman
- Department of Psychology, Laboratory of Community Psychology, NYS Institute for Basic Research in Developmental Disabilities; Staten Island; New York
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18
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Jenkins EC, Ye L, Velinov M, Krinsky-McHale SJ, Zigman WB, Schupf N, Silverman WP. Mild cognitive impairment identified in older individuals with Down syndrome by reduced telomere signal numbers and shorter telomeres measured in microns. Am J Med Genet B Neuropsychiatr Genet 2012; 159B:598-604. [PMID: 22592955 PMCID: PMC3415710 DOI: 10.1002/ajmg.b.32066] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 04/25/2012] [Indexed: 11/10/2022]
Abstract
Previously, we established that short-term T lymphocyte cultures from people with Down syndrome (DS) and dementia (Alzheimer's disease) had shorter telomeres than did those from age- and sex-matched people with DS only, quantified as significantly reduced numbers of signals of peptide nucleic acid (PNA) telomere probes in whole metaphases [Jenkins et al. (2008); Neurosci Lett 440:340-343] as well as reduced telomere probe light intensity values in interphases [Jenkins et al. (2010); Neurobiol Aging 31:765-771]. We now describe shorter telomere length in adults with DS and mild cognitive impairment (MCI) compared to age- and sex-matched individuals with DS without MCI. Telomere length is quantified by reduced telomere signal numbers and shorter chromosome 1 telomeres measured in micrometers (microns). These findings were in agreement with quantitative light intensity measurements of chromosome 1 and chromosome 21 PNA telomere probes with and without the use of a "normalizing ratio" involving the fluorescence exhibited by a PNA probe for centromere 2, and with the use of light intensity measurements of interphase preparations. Most importantly, the distributions of chromosome 1 telomere lengths (in microns) were completely non-overlapping for adults with and without MCI, indicating that this measure has great promise as a biomarker for MCI as well as dementia in this population.
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Affiliation(s)
- Edmund C. Jenkins
- New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY 10314, United States,Correspondence to: Edmund C. Jenkins, Ph.D., Department of Human Genetics, New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY 10314. ;
| | - Lingling Ye
- New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY 10314, United States
| | - Milen Velinov
- New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY 10314, United States
| | - Sharon J. Krinsky-McHale
- New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY 10314, United States
| | - Warren B. Zigman
- New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY 10314, United States
| | - Nicole Schupf
- New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY 10314, United States,Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, 630 West 168 St., New York, NY 10032, United States
| | - Wayne P. Silverman
- The Kennedy Krieger Institute and The Johns Hopkins University School of Medicine, Suite 222s, 707 North Broadway, Baltimore, MD 21205, United States
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Zhao Q, Lee JH, Pang D, Temkin A, Park N, Janicki SC, Zigman WB, Silverman W, Tycko B, Schupf N. Estrogen receptor-Beta variants are associated with increased risk of Alzheimer's disease in women with down syndrome. Dement Geriatr Cogn Disord 2012; 32:241-9. [PMID: 22156442 PMCID: PMC3250648 DOI: 10.1159/000334522] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/04/2011] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND/AIMS Genetic variants that affect estrogen activity may influence the risk of Alzheimer's disease (AD). We examined the relation of polymorphisms in the gene for the estrogen receptor-beta (ESR2) to the risk of AD in women with Down syndrome. METHODS Two hundred and forty-nine women with Down syndrome, 31-70 years of age and nondemented at baseline, were followed at 14- to 18-month intervals for 4 years. Women were genotyped for 13 single-nucleotide polymorphisms (SNPs) in the ESR2 gene, and their association with AD incidence was examined. RESULTS Among postmenopausal women, we found a 2-fold increase in the risk of AD for women carrying 1 or 2 copies of the minor allele at 3 SNPs in introns seven (rs17766755) and six (rs4365213 and rs12435857) and 1 SNP in intron eight (rs4986938) of ESR2. CONCLUSION These findings support a role for estrogen and its major brain receptors in modulating susceptibility to AD in women.
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Affiliation(s)
- Qi Zhao
- Department of Epidemiology, Columbia University Medical Center, New York, N.Y
| | - Joseph H. Lee
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, N.Y.,G.H. Sergievsky Center, Columbia University Medical Center, New York, N.Y.,Department of Epidemiology, Columbia University Medical Center, New York, N.Y
| | - Deborah Pang
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, N.Y.,Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, N.Y
| | - Alexis Temkin
- Department of Pathology, Columbia University Medical Center, New York, N.Y
| | - Naeun Park
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, N.Y
| | - Sarah C. Janicki
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, N.Y.,G.H. Sergievsky Center, Columbia University Medical Center, New York, N.Y.,Department of Neurology, Columbia University Medical Center, New York, N.Y
| | - Warren B. Zigman
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, N.Y
| | - Wayne Silverman
- Kennedy Krieger Institute and Johns Hopkins University School of Medicine, Baltimore, Md., USA
| | - Benjamin Tycko
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, N.Y.,Department of Pathology, Columbia University Medical Center, New York, N.Y
| | - Nicole Schupf
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, N.Y.,Department of Epidemiology, Columbia University Medical Center, New York, N.Y.,Department of Psychiatry, Columbia University Medical Center, New York, N.Y.,*Nicole Schupf, PhD, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, PO Box 16, 630 West 168th Street, New York, NY 10032 (USA), Tel. +1 212 305 2381, E-Mail
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20
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Schupf N, Zigman WB, Tang MX, Pang D, Mayeux R, Mehta P, Silverman W. Change in plasma Aß peptides and onset of dementia in adults with Down syndrome. Neurology 2010; 75:1639-44. [PMID: 21041786 DOI: 10.1212/wnl.0b013e3181fb448b] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine changes in levels of plasma amyloid-β (Aβ) peptides, Aβ42 and Aβ40, in relation to onset of Alzheimer disease (AD) in adults with Down syndrome (DS). METHODS Plasma Aβ42 and Aβ40 were measured at initial examination and at follow-up in a community-based cohort of 225 adults with DS who did not have dementia at baseline and were assessed for cognitive/functional abilities and health status and followed at 14- to 20-month intervals. We used Cox proportional hazards modeling to estimate the cumulative incidence of AD by Aβ peptide change group (increasing, no change, or decreasing), adjusting for covariates. RESULTS Sixty-one (27.1%) of the participants developed AD. At follow-up, a decrease in Aβ42 levels, a decrease in the Aβ42/Aβ40 ratio, and an increase in Aβ40 levels were related to conversion to AD. Compared with the group with increasing levels of Aβ42, the likelihood of developing AD was 5 times higher for those whose plasma Aβ42 levels decreased over follow-up (hazard ratio [HR] = 4.9, 95% confidence interval [CI] 2.1-11.4). Decreasing Aβ42/Aβ40 was also strongly related to AD risk (HR = 4.9, 95% CI 1.8-13.2), while decreasing Aβ40 was associated with lower risk (HR = 0.4, 95% CI 0.2-0.9). CONCLUSIONS Among adults with DS, decreasing levels of plasma Aβ42, a decline in the Aβ42/Aβ40 ratio, or increasing levels of Aβ40 may be sensitive indicators of conversion to AD, possibly reflecting compartmentalization of Aβ peptides in the brain.
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Affiliation(s)
- N Schupf
- Taub Institute for Research on AD and the Aging Brain, Columbia University Medical Center, 630 West 168th Street, New York, NY 10032, USA.
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Kerkel K, Schupf N, Hatta K, Pang D, Salas M, Kratz A, Minden M, Murty V, Zigman WB, Mayeux RP, Jenkins EC, Torkamani A, Schork NJ, Silverman W, Croy BA, Tycko B. Altered DNA methylation in leukocytes with trisomy 21. PLoS Genet 2010; 6:e1001212. [PMID: 21124956 PMCID: PMC2987931 DOI: 10.1371/journal.pgen.1001212] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Accepted: 10/19/2010] [Indexed: 11/24/2022] Open
Abstract
The primary abnormality in Down syndrome (DS), trisomy 21, is well known; but how this chromosomal gain produces the complex DS phenotype, including immune system defects, is not well understood. We profiled DNA methylation in total peripheral blood leukocytes (PBL) and T-lymphocytes from adults with DS and normal controls and found gene-specific abnormalities of CpG methylation in DS, with many of the differentially methylated genes having known or predicted roles in lymphocyte development and function. Validation of the microarray data by bisulfite sequencing and methylation-sensitive Pyrosequencing (MS-Pyroseq) confirmed strong differences in methylation (p<0.0001) for each of 8 genes tested: TMEM131, TCF7, CD3Z/CD247, SH3BP2, EIF4E, PLD6, SUMO3, and CPT1B, in DS versus control PBL. In addition, we validated differential methylation of NOD2/CARD15 by bisulfite sequencing in DS versus control T-cells. The differentially methylated genes were found on various autosomes, with no enrichment on chromosome 21. Differences in methylation were generally stable in a given individual, remained significant after adjusting for age, and were not due to altered cell counts. Some but not all of the differentially methylated genes showed different mean mRNA expression in DS versus control PBL; and the altered expression of 5 of these genes, TMEM131, TCF7, CD3Z, NOD2, and NPDC1, was recapitulated by exposing normal lymphocytes to the demethylating drug 5-aza-2′deoxycytidine (5aza-dC) plus mitogens. We conclude that altered gene-specific DNA methylation is a recurrent and functionally relevant downstream response to trisomy 21 in human cells. Down syndrome (DS; trisomy 21) is caused by the gain of a single extra chromosome 21. However, the mechanisms by which this extra chromosome produces the medical abnormalities seen in DS, including not only mental retardation but also susceptibility to autoimmune diseases and recurrent infections, are still not understood. DNA methylation is a mechanism that might contribute to these abnormalities. To test this possibility, we profiled DNA methylation in white blood cells from adults with DS and normal controls and found recurrent abnormalities of gene methylation in DS, with several of the differentially methylated genes having roles in blood cells. Among the genes with hypo- or hyper-methylation in white blood cells or purified T-lymphocytes from adults with DS, compared to these same types of cells from normal adults, were TMEM131, TCF7, CD3Z, SH3BP2, EIF4E, SUMO3, CPT1B, NOD2/CARD15, NPDC1, and PLD6. Several of these genes showed not only different methylation but also different expression in DS versus control blood cells, which was recapitulated by exposing normal white blood cells to a demethylating drug. These findings show that altered DNA methylation of a specific group of genes is a fundamental cellular response to the gain of an extra chromosome 21 in humans. The abnormally methylated genes identified here may contribute to immune system abnormalities in people with DS.
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Affiliation(s)
- Kristi Kerkel
- Institute for Cancer Genetics, Columbia University Medical Center, New York, New York, United States of America
| | - Nicole Schupf
- Taub Institute for Research on Alzheimer's disease and the Aging Brain, Columbia University Medical Center, New York, New York, United States of America
- Departments of Human Genetics, Epidemiology, and Psychiatry, Institute for Basic Research on Developmental Disabilities, New York, New York, United States of America
| | - Kota Hatta
- Departments of Anatomy and Cell Biology and Microbiology and Immunology, Queen's University, Kingston, Canada
| | - Deborah Pang
- Taub Institute for Research on Alzheimer's disease and the Aging Brain, Columbia University Medical Center, New York, New York, United States of America
| | - Martha Salas
- Institute for Cancer Genetics, Columbia University Medical Center, New York, New York, United States of America
| | - Alexander Kratz
- Department of Pathology, Columbia University Medical Center, New York, New York, United States of America
| | - Mark Minden
- Department of Medical Oncology and Hematology and Department of Medical Biophysics, University of Toronto and Princess Margaret Hospital, Toronto, Canada
| | - Vundavalli Murty
- Institute for Cancer Genetics, Columbia University Medical Center, New York, New York, United States of America
- Department of Pathology, Columbia University Medical Center, New York, New York, United States of America
| | - Warren B. Zigman
- Departments of Human Genetics, Epidemiology, and Psychiatry, Institute for Basic Research on Developmental Disabilities, New York, New York, United States of America
| | - Richard P. Mayeux
- Taub Institute for Research on Alzheimer's disease and the Aging Brain, Columbia University Medical Center, New York, New York, United States of America
- Department of Neurology, Columbia University Medical Center, New York, New York, United States of America
| | - Edmund C. Jenkins
- Departments of Human Genetics, Epidemiology, and Psychiatry, Institute for Basic Research on Developmental Disabilities, New York, New York, United States of America
| | - Ali Torkamani
- Scripps Translational Science Institute, La Jolla, California, United States of America
| | - Nicholas J. Schork
- Scripps Translational Science Institute, La Jolla, California, United States of America
| | - Wayne Silverman
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, Maryland, United States of America
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - B. Anne Croy
- Departments of Anatomy and Cell Biology and Microbiology and Immunology, Queen's University, Kingston, Canada
| | - Benjamin Tycko
- Institute for Cancer Genetics, Columbia University Medical Center, New York, New York, United States of America
- Taub Institute for Research on Alzheimer's disease and the Aging Brain, Columbia University Medical Center, New York, New York, United States of America
- Department of Pathology, Columbia University Medical Center, New York, New York, United States of America
- * E-mail:
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Abstract
Changes in psychiatric symptoms related to specific stages of dementia were investigated in 224 adults 45 years of age or older with Down syndrome. Findings indicate that psychiatric symptoms are a prevalent feature of dementia in the population with Down syndrome and that clinical presentation is qualitatively similar to that seen in Alzheimer's disease within the general population. Psychiatric symptoms related to Alzheimer's disease vary by the type of behavior and stage of dementia, but do not seem to be influenced by sex or level of premorbid intellectual impairment. Some psychiatric symptoms may be early indicators of Alzheimer's disease and may appear prior to substantial changes in daily functioning. Improvements in understanding the progression of dementia in individuals with Down syndrome may lead to improved diagnosis and treatment.
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Affiliation(s)
- Tiina K Urv
- National Institute of Child Health and Human Development, Bethesda, MD 20892, USA.
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Abstract
OBJECTIVES To investigate the relation of plasma levels of Abeta peptides (Abeta1-40 and Abeta1-42) and apolipoprotein E (APOE) genotype to dementia status, and the duration of Alzheimer's disease (AD) in adults with Down syndrome (DS). METHODS Adults with DS were recruited from community settings and followed up for a mean period of 6.7 years. Plasma levels Abeta1-40 and Abeta1-42 and APOE genotype were determined at the last visit. RESULTS There were 83 nondemented participants and 44 participants with prevalent AD. Overall, plasma levels of Abeta1-42, Abeta1-40 and the ratio Abeta1-42/Abeta1-40 did not differ significantly between the adults with DS. Among demented participants, the mean level of Abeta1-40 was significantly lower (157.0 vs. 195.3) and the ratio of Abeta1-42/Abeta1-40 was significantly higher (0.28 vs. 0.16) in those with more than 4 years duration of dementia than in those with 4 or fewer years' duration of dementia. This pattern was generally similar in those with and without an APOE epsilon4 allele. CONCLUSIONS There is an association between plasma Abeta peptide levels and the duration of AD in older persons with DS. The predictive and diagnostic roles of Abeta1-42 and Abeta1-40 measurements for AD, however, remain controversial. Change in Abeta peptide levels with onset of AD and with the duration of dementia may account for a lack of difference between prevalent cases and nondemented individuals and for variation in the predictive power of Abeta peptide levels.
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Affiliation(s)
- V P Prasher
- Monyhull Hospital, Liverpool John Moore University, c/o The Greenfields, Monyhull, Birmingham, UK.
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Affiliation(s)
- Warren B. Zigman
- New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, New York, 10314, USA
| | - Nicole Schupf
- New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, New York, 10314, USA
| | - Wayne P. Silverman
- New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, New York, 10314, USA
| | - Robert C. Sterling
- New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, New York, 10314, USA
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25
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Prasher VP, Schupf N, Sajith SG, Zigman WB, Rees S, Patel A, Tewari S. Significant effect of APOE epsilon 4 genotype on the risk of dementia in Alzheimer's disease and mortality in persons with Down syndrome. Int J Geriatr Psychiatry 2008; 23:1134-40. [PMID: 18464295 PMCID: PMC2714805 DOI: 10.1002/gps.2039] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Virtually all adults with Down syndrome (DS) have neuropathological manifestations of Dementia in Alzheimer's disease (DAD) but not all develop clinical psychopathology. The effect of allelic variants of Apolipoprotein (APOE) gene in development and progression of DAD and mortality in persons with DS is examined. METHODS Recruited participants with DS underwent two to 14 sequential assessments over a follow up period of 6 years on average and their APOE genotype determined. Dementia status was confirmed as recommended by the Working Group for the Establishment of Criteria for the Diagnosis of Dementia in Individuals with Intellectual Disability. RESULTS APOE genotype results were available for 252 individuals. Participants with APOE epsilon 4 allele had significantly higher risk of developing DAD (HR = 1.8, 95% CI: 1.12-2.79), had an earlier onset of DAD (55.0 vs 57.0 years; p = 0.0027) and a more rapid progression to death compared with participants with epsilon 3 allele (4.2 years vs. 5.4 years, respectively, p = 0.048). In non-demented persons with DS, epsilon 4 allele was associated with earlier death by 17 years (mean survival age, 55.7 vs. 72.7 years; HR = 5.9, 95% CI: 1.7-21.3). CONCLUSIONS This study highlights the relationship of APOE genotype to morbidity and mortality in persons with DS which has important clinical implications. We recommend screening for APOE genotype in persons with DS to identify those at risk of DAD and premature death. Further research is required to investigate the underlying reasons for the early mortality in non-demented DS persons with an epsilon 4 allele.
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Affiliation(s)
- V P Prasher
- The Greenfields, Monyhull Hospital, Birmingham, UK.
| | - Nicole Schupf
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York
| | - S G. Sajith
- The Greenfields, Monyhull Hospital, Birmingham UK
| | - Warren B. Zigman
- Department of Psychology, NYS Institute for Basic Research in Developmental Disabilities, New York
| | - Simon Rees
- University of Birmingham, Birmingham, UK
| | | | - S Tewari
- Lea Castle Centre, Kidderminster, UK
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Jenkins EC, Ye L, Gu H, Ni SA, Velinov M, Pang D, Krinsky-McHale SJ, Zigman WB, Schupf N, Silverman WP. Shorter telomeres may indicate dementia status in older individuals with Down syndrome. Neurobiol Aging 2008; 31:765-71. [PMID: 18635289 DOI: 10.1016/j.neurobiolaging.2008.06.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2008] [Revised: 05/13/2008] [Accepted: 06/07/2008] [Indexed: 12/23/2022]
Abstract
We have recently reported reduced telomere length in T lymphocytes of individuals with Down syndrome (DS) and dementia due to Alzheimer's disease (AD). We have now replicated and extended that study by finding that people with DS and mild cognitive impairment (MCI-DS) also have shorter telomeres than people with DS without MCI-DS. Additional new findings demonstrated that light intensity measurements from chromosome 21 alone, or in concert with chromosomes 1, 2, and 16, exhibited shorter telomeres in adults with DS and with either dementia or MCI-DS compared to aging per se. Chromosome 21 measurements appeared to be especially promising for use as a biomarker because there was no overlap in the distribution of light intensity measurement scores between demented or MCI-DS and non-demented participants. Given that early clinical symptoms of AD can be very difficult to recognize in this population of adults due to their pre-existing cognitive impairments, a valid biomarker would be of great value. Early detection is especially important because it would allow treatments to begin before significant damage to the central nervous system has occurred. Our findings suggest that it may be feasible to use telomere shortening as a biomarker for accurately inferring dementia status.
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Affiliation(s)
- Edmund C Jenkins
- New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY 10314, USA.
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Jenkins EC, Ye L, Gu H, Ni SA, Duncan CJ, Velinov M, Pang D, Krinsky-McHale SJ, Zigman WB, Schupf N, Silverman WP. Increased "absence" of telomeres may indicate Alzheimer's disease/dementia status in older individuals with Down syndrome. Neurosci Lett 2008; 440:340-3. [PMID: 18571319 DOI: 10.1016/j.neulet.2008.05.098] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Revised: 05/19/2008] [Accepted: 05/21/2008] [Indexed: 12/30/2022]
Abstract
We have reported previously that telomeres (ends of chromosomes consisting of highly conserved TTAGGG repeats) were shorter in metaphase and interphase preparations in T lymphocytes from short-term whole blood cultures of women with Down syndrome (DS) and dementia compared to age-matched women with DS but without dementia [E.C. Jenkins, M.T. Velinov, L. Ye, H. Gu, S. Li, E.C. Jenkins Jr., S.S. Brooks, D. Pang, D.A. Devenny, W.B. Zigman, N. Schupf, W.P. Silverman, Telomere shortening in T lymphocytes of older individuals with Down syndrome and dementia, Neurobiol. Aging 27 (2006) 41-45]. Our previous study was carried out by measuring changes in fluorescence intensity [using an FITC-labeled peptide nucleic acid (PNA) probe (Applied Biosystems; DAKO) and Applied Imaging software], and we now report on a substantially simpler metric, counts of signals at the ends of chromosomes. Nine adults with DS and dementia plus four who are exhibiting declines in cognition analogous to mild cognitive impairment in the general population (MCI-DS) were compared to their pair-matched peers with DS but without dementia or MCI-DS. Results indicated that the number of chromosome ends that failed to exhibit fluorescent signal from the PNA telomere probe was higher for people with dementia or mild cognitive impairment (MCI-DS). Thus, a simple count of chromosome ends for the "presence/absence" of fluorescence may provide a valid biomarker of dementia status. If this is the case, then after additional research for validation to assure high specificity and sensitivity, the test may be used to identify and ultimately guide treatment for people at increased risk for developing mild cognitive impairment and/or dementia.
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Affiliation(s)
- Edmund C Jenkins
- Department of Human Genetics, New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road Staten Island, NY 10314, United States.
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Krinsky-McHale SJ, Devenny DA, Gu H, Jenkins EC, Kittler P, Murty VV, Schupf N, Scotto L, Tycko B, Urv TK, Ye L, Zigman WB, Silverman W. Successful aging in a 70-year-old man with down syndrome: a case study. Intellect Dev Disabil 2008; 46:215-228. [PMID: 18578579 DOI: 10.1352/2008.46:215-228] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The authors present a case study of a 70-year-old man with Down syndrome ("Mr. C.") who they followed for 16 years and who does not exhibit declines in cognitive or functional capacities indicative of dementia, despite having well-documented, complete trisomy 21. The authors describe the age-associated changes that occurred over 16 years as well as provide detailed information regarding Mr. C.'s health and genetic status. To further emphasize Mr. C.'s successful aging, the authors compared his longitudinal performance profile with that of 2 peers of comparable level of intellectual functioning: 1 similar-aged man with clinical Alzheimer's disease and a younger man who was healthy. The authors present potential explanations for the phenotypic variability observed in individuals with Down syndrome.
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Affiliation(s)
- Sharon J Krinsky-McHale
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY 10314, USA.
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Abstract
Down syndrome (DS) is characterized by increased mortality rates, both during early and later stages of life, and age-specific mortality risk remains higher in adults with DS compared with the overall population of people with mental retardation and with typically developing populations. Causes of increased mortality rates early in life are primarily due to the increased incidence of congenital heart disease and leukemia, while causes of higher mortality rates later in life may be due to a number of factors, two of which are an increased risk for Alzheimer's disease (AD) and an apparent tendency toward premature aging. In this article, we describe the increase in lifespan for people with DS that has occurred over the past 100 years, as well as advances in the understanding of the occurrence of AD in adults with DS. Aspects of the neurobiology of AD, including the role of amyloid, oxidative stress, Cu/ZN dismutase (SOD-1), as well as advances in neuroimaging are presented. The function of risk factors in the observed heterogeneity in the expression of AD dementia in adults with DS, as well as the need for sensitive and specific biomarkers of the clinical and pathological progressing of AD in adults with DS is considered.
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Affiliation(s)
- Warren B Zigman
- Department of Psychology, NYS Institute for Basic Research in Developmental Disabilities, Staten Island, New York 10314, USA.
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Zigman WB, Devenny DA, Krinsky-McHale SJ, Jenkins EC, Urv TK, Wegiel J, Schupf N, Silverman W. Alzheimer's Disease in Adults with Down Syndrome. Int Rev Res Ment Retard 2008; 36:103-145. [PMID: 19633729 PMCID: PMC2714652 DOI: 10.1016/s0074-7750(08)00004-9] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Warren B. Zigman
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY 10314
| | - Darlynne A. Devenny
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY 10314
| | - Sharon J. Krinsky-McHale
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY 10314
| | - Edmund C. Jenkins
- Department of Human Genetics, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY 10314
| | - Tiina K. Urv
- Mental Retardation & Developmental Disabilities Branch, National Institute of Child Health and Human Development, Bethesda, MD 20892
| | - Jerzy Wegiel
- Department of Developmental Neurobiology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY 10314
| | - Nicole Schupf
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY 10314
- The Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University College of Physicians and Surgeons, New York, N.Y. 10032
- Departments of Epidemiology and Psychiatry, Columbia University Medical Center, New York, NY 10032
| | - Wayne Silverman
- Department of Behavioral Psychology, Kennedy Krieger Institute, Baltimore, MD 21205
- Department of Psychiatry and Behavioral Medicine, Johns Hopkins University Medical School, Baltimore, MD 21205
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Schupf N, Lee JH, Wei M, Pang D, Chace C, Rong C, Zigman WB, Tycko B, Silverman W. Estrogen receptor-alpha variants increase risk of Alzheimer's disease in women with Down syndrome. Dement Geriatr Cogn Disord 2008; 25:476-82. [PMID: 18408366 PMCID: PMC2430887 DOI: 10.1159/000126495] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2008] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Genetic variants that affect estrogen activity may influence the risk of Alzheimer's disease (AD). Two tightly linked polymorphisms (PvuII and XbaI) in the first intron of estrogen receptor 1 (ESR1), the gene for ER-alpha, have been reported to influence estrogen receptor expression and may influence the risk of AD. METHODS We examined the relation of polymorphisms in ESR1 to the risk of AD in women with Down syndrome. The subjects (181 women with DS, 41-78 years of age) were followed at 14- to 18-month intervals. Information from cognitive assessments, caregiver interviews, medical record reviews and neurological examinations was used to classify dementia. Genomic DNA was genotyped for 5 single-nucleotide polymorphisms in the upstream region and the first exon/intron of the ESR1 gene. Their association with dementia risk was evaluated, adjusting for covariates. RESULTS Women with at least 1 copy of the C allele at rs2234693 (PvuII) and those homozygous for the C allele at rs2077647 had an almost 3-fold increase in the risk of AD, compared with women without the C allele. The increased risks were independent of the apolipoprotein E genotype. CONCLUSION These findings support a role for estrogen receptor activity in the development of AD in women with Down syndrome.
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Affiliation(s)
- Nicole Schupf
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, G.H. Sergievsky Center, New York, NY, USA.
| | - Joseph. H. Lee
- The Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, N.Y., G.H. Sergievsky Center, Columbia University Medical Center, New York, N.Y., Department of Epidemiology, Columbia University Medical Center, New York, N.Y
| | - Michelle Wei
- Department of Pathology, Columbia University Medical Center, New York, N.Y
| | - Deborah Pang
- The Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, N.Y., Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, N.Y
| | - Constance Chace
- The Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, N.Y., Department of Epidemiology, Columbia University Medical Center, New York, N.Y
| | - Cheng Rong
- The Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, N.Y
| | - Warren B. Zigman
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, N.Y
| | - Benjamin Tycko
- Department of Pathology, Columbia University Medical Center, New York, N.Y
| | - Wayne Silverman
- Kennedy Krieger Institute and Johns Hopkins University School of Medicine, Baltimore, MD
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Schupf N, Patel B, Pang D, Zigman WB, Silverman W, Mehta PD, Mayeux R. Elevated plasma beta-amyloid peptide Abeta(42) levels, incident dementia, and mortality in Down syndrome. ACTA ACUST UNITED AC 2007; 64:1007-13. [PMID: 17620492 PMCID: PMC2587094 DOI: 10.1001/archneur.64.7.1007] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Deposition of the beta-amyloid peptide Abeta(42) is thought to be an important initial step in the pathogenesis of Alzheimer disease (AD). Individuals with Down syndrome have increased levels of beta-amyloid peptides and an increased risk for AD. OBJECTIVE To examine the relation of plasma levels of Abeta(42) and Abeta(40) to the risk of dementia in nondemented participants and all-cause mortality in adults with Down syndrome. DESIGN Prospective, community-based longitudinal cohort study. SETTING State and voluntary service providers in New York State. PARTICIPANTS Adults with Down syndrome (N = 204). MAIN OUTCOME MEASURE Plasma Abeta(42) and Abeta(40) levels were measured at initial examination. Participants were assessed for cognitive and functional abilities, behavioral/psychiatric conditions, and health and vital status at 14- to 18-month intervals for 4 cycles of data collection. RESULTS Among participants who were nondemented at baseline, those in the middle and highest tertiles of plasma Abeta(42) levels were more than 2 times as likely to develop AD as those in the lowest tertile. Compared with participants without AD, participants with prevalent AD had higher levels of plasma Abeta(42) but not Abeta(40). Among all participants, those in the highest tertile of plasma Abeta(42) level at baseline were more than twice as likely to die during the study period as those in the lowest tertile, whereas there was no difference in risk of death between those in the middle and lowest tertiles of plasma Abeta(42) level. CONCLUSION Elevations in plasma Abeta(42) peptide levels are associated with earlier onset of AD and increased risk of death.
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Affiliation(s)
- Nicole Schupf
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, PO Box 16, 630 W 168th St, New York, NY 10032, USA.
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Lee JH, Chulikavit M, Pang D, Zigman WB, Silverman W, Schupf N. Association between genetic variants in sortilin-related receptor 1 (SORL1) and Alzheimer's disease in adults with Down syndrome. Neurosci Lett 2007; 425:105-9. [PMID: 17826910 PMCID: PMC2131721 DOI: 10.1016/j.neulet.2007.08.042] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Revised: 07/26/2007] [Accepted: 08/22/2007] [Indexed: 11/19/2022]
Abstract
Recent reports have suggested that variants in the sortilin-related receptor gene (SORL1) increase the risk of late onset Alzheimer's disease (AD) in Northern European, Hispanic, African-American and Isreali-Arab populations. SORL1 directs trafficking of amyloid precursor protein (APP) and under-expression of SORL1 may lead to over-expression of beta amyloid peptides. Adults with Down syndrome (DS) over-express APP and have early onset and high risk for AD. We investigated the relation of seven variants in the gene for SORL1 to age at onset and risk for AD among 208 adults with DS, 45-70 years of age at baseline. Participants were ascertained through the New York State developmental disability service system and followed at 18-month intervals. Information from cognitive assessments, caregiver interviews, medical record review and neurological examination was used to establish the diagnosis of dementia. Homozygosity for the minor T allele in rs556349 and for the minor C allele in rs536360 was associated with later age at onset and reduced risk of AD (HR=0.26, 95% CI: 0.08-0.86; and HR=0.40, 95% CI: 0.16-0.98, respectively). Mean age at onset was approximately four years later in individuals who were homozygous for those alleles compared with those who had at least one major allele. These findings indicate a modest association of variants in SORL1 with AD. In addition, we did not observe the same alleles to be associated with AD compared with earlier studies, suggesting that these SNPs are in linkage disequilibrium (LD) with the putative functional variants or that expression of the SORL1 gene and hence its interaction with APP might be modified by the extremely high levels of APP characteristic of Down syndrome. Thus, further studies are needed to identify functional variants that influence risk for AD in this uniquely vulnerable population.
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Affiliation(s)
- Joseph. H. Lee
- The Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, N.Y
- G.H. Sergievsky Center, Columbia University Medical Center, New York, N.Y
- Department of Epidemiology, Columbia University Medical Center, New York, N.Y
| | - Maruit Chulikavit
- Department of Epidemiology, Columbia University Medical Center, New York, N.Y
| | - Deborah Pang
- The Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, N.Y
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, N.Y
| | - Warren B. Zigman
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, N.Y
| | - Wayne Silverman
- Kennedy Krieger Institute and Johns Hopkins School of Medicine, Baltimore, MD
| | - Nicole Schupf
- The Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, N.Y
- Department of Epidemiology, Columbia University Medical Center, New York, N.Y
- Department of Psychiatry, Columbia University Medical Center, New York, N.Y
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, N.Y
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Zigman WB, Schupf N, Jenkins EC, Urv TK, Tycko B, Silverman W. O2–04–01: Risk for Alzheimer's disease in down syndrome is related to cholesterol level and statin use. Alzheimers Dement 2007. [DOI: 10.1016/j.jalz.2007.04.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Warren B. Zigman
- NYS Institute for Basic Research in Developmental DisabilitiesStaten IslandNYUSA
| | - Nicole Schupf
- NYS Institute for Basic Research in Developmental DisabilitiesStaten IslandNYUSA
- The Taub Institute for Research on Alzheimer's Disease and the Aging BrainColumbia UniversityNew YorkNYUSA
| | - Edmund C. Jenkins
- NYS Institute for Basic Research in Developmental DisabilitiesStaten IslandNYUSA
| | - Tiina K. Urv
- National Institute of Child Health and Human DevelopmentBethesdaMDUSA
| | - Benjamin Tycko
- The Taub Institute for Research on Alzheimer's Disease and the Aging BrainColumbia UniversityNew YorkNYUSA
| | - Wayne Silverman
- Kennedy Krieger Institute and Johns Hopkins University School of MedicineBaltimoreMDUSA
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Jenkins EC, Ye L, Gu H, Ni SA, Velinov M, Pang D, Devenny DA, Zigman WB, Schupf N, Silverman WP. P‐039: Telomere shortening and/or “absence” may indicate dementia/AD status in older individuals with down syndrome. Alzheimers Dement 2007. [DOI: 10.1016/j.jalz.2007.04.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Edmund C. Jenkins
- New York State Institute for Basic Research in Developmental Disabilities (NYS IBRDD) Staten IslandNYUSA
| | - Lingling Ye
- New York State Institute for Basic Research in Developmental Disabilities (NYS IBRDD) Staten IslandNYUSA
| | - Hong Gu
- New York State Institute for Basic Research in Developmental Disabilities (NYS IBRDD) Staten IslandNYUSA
| | - Samantha A. Ni
- New York State Institute for Basic Research in Developmental Disabilities (NYS IBRDD) Staten IslandNYUSA
| | - Milen Velinov
- New York State Institute for Basic Research in Developmental Disabilities (NYS IBRDD) Staten IslandNYUSA
| | - Deborah Pang
- New York State Institute for Basic Research in Developmental Disabilities (NYS IBRDD) Staten IslandNYUSA
| | - Darlynne A. Devenny
- New York State Institute for Basic Research in Developmental Disabilities (NYS IBRDD) Staten IslandNYUSA
| | - Warren B. Zigman
- New York State Institute for Basic Research in Developmental Disabilities (NYS IBRDD) Staten IslandNYUSA
| | - Nicole Schupf
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain Columbia University New YorkNYUSA
| | - Wayne P. Silverman
- The Kennedy Krieger Institute and Johns Hopkins University School of Medicine BaltimoreMDUSA
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Zigman WB, Schupf N, Jenkins EC, Urv TK, Tycko B, Silverman W. Cholesterol level, statin use and Alzheimer's disease in adults with Down syndrome. Neurosci Lett 2007; 416:279-84. [PMID: 17353095 PMCID: PMC1892238 DOI: 10.1016/j.neulet.2007.02.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2006] [Revised: 01/26/2007] [Accepted: 02/06/2007] [Indexed: 11/29/2022]
Abstract
Adults with Down syndrome (DS) are at significantly higher risk of Alzheimer's disease (AD) than the general population, but there is considerable variability in age at onset. This study tested the hypothesis that total cholesterol (TC) levels are related to vulnerability, and that the use of statins may decrease risk. The relation of TC level and statin use to risk of AD was investigated in 123 Caucasian adults with DS. Evaluations included serial assessments of cognitive, adaptive and maladaptive behavior, medical records, and neurological examinations. Mean length of follow-up was 5.5 years [1.2-7.1] for the entire sample, 5.1 years [1.2-7.1] for subjects who developed dementia, and 5.6 years [1.5-7.1] for those who did not develop dementia. Controlling for covariates, participants with TC>or=200mg/dL were more than two times as likely to develop AD than subjects with lower TC [hazard rate (HR)=2.59, p=.029, 95% CI: 1.1, 6.1]. In contrast, participants with higher TC levels who used statins during the study, had less than half the risk of developing AD than participants with higher TC levels who did not use statins (HR=.402, p=.095, 95% CI: .138, 1.173). If the protective effects of statins can be further validated, these findings suggest that their use may delay or prevent AD onset in vulnerable populations.
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Affiliation(s)
- Warren B Zigman
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY 10314, United States.
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Schupf N, Winsten S, Patel B, Pang D, Ferin M, Zigman WB, Silverman W, Mayeux R. Bioavailable estradiol and age at onset of Alzheimer's disease in postmenopausal women with Down syndrome. Neurosci Lett 2006; 406:298-302. [PMID: 16926067 DOI: 10.1016/j.neulet.2006.07.062] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2006] [Revised: 07/10/2006] [Accepted: 07/28/2006] [Indexed: 11/20/2022]
Abstract
Several lines of evidence suggest that loss of estrogen after menopause may play a role in the cognitive declines associated with Alzheimer's disease (AD). Women with Down syndrome (DS) experience early onset of both menopause and AD. This timing provides a model to examine the influence of endogenous estrogen deficiency on risk of AD. We hypothesized that low serum levels of bioavailable estradiol (E2) would be associated with increased risk of AD. One hundred and nineteen postmenopausal women with DS, 42-59 years of age, were ascertained through the New York State developmental disability service system and followed at 18-month intervals. Information from cognitive assessments, caregiver interviews, medical record review and neurological examination was used to establish the diagnosis of dementia. Women with DS who developed AD had lower levels of bioavailable E2, lower levels of total estradiol, higher levels of sex-hormone binding globulin, and lower levels of dehydroepiandrosterone sulfate at baseline than women who remained dementia free over the course of follow-up. Women who had low levels of bioavailable E2 at baseline were four times as likely to develop AD (HR=4.1, 95% CI: 1.2-13.9) and developed AD, on average, 3 years earlier, than those with high levels of bioavailable E2, after adjustment for age, level of mental retardation, ethnicity, body mass index, history of hypothyroidism or depression and the presence of the apolipoprotein varepsilon4 allele. Our findings support the hypothesis that reductions in estrogen following menopause can contribute to the cascade of pathological processes leading to AD.
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Affiliation(s)
- Nicole Schupf
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY 10032, USA.
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Schupf N, Patel BP, Pang D, Zigman WB, Silverman W, Mehta PD, Mayeux RP. O2–06–01: Elevated plasma amyloid β–peptide Aβ42, incident dementia and mortality in down syndrome. Alzheimers Dement 2006. [DOI: 10.1016/j.jalz.2006.05.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | | | | | - Warren B. Zigman
- NYS Institute for Research on Developmental DisabilitiesStaten IslandNew YorkUSA
| | - Wayne Silverman
- Kennedy Krieger Institute, Johns Hopkins School of MedicineBaltimoreMDUSA
| | - Pankaj D. Mehta
- NYS Institute for Research on Developmental DisabilitiesStaten IslandNew YorkUSA
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Li CM, Guo M, Salas M, Schupf N, Silverman W, Zigman WB, Husain S, Warburton D, Thaker H, Tycko B. Cell type-specific over-expression of chromosome 21 genes in fibroblasts and fetal hearts with trisomy 21. BMC Med Genet 2006; 7:24. [PMID: 16539728 PMCID: PMC1435874 DOI: 10.1186/1471-2350-7-24] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2005] [Accepted: 03/15/2006] [Indexed: 11/18/2022]
Abstract
Background Down syndrome (DS) is caused by trisomy 21 (+21), but the aberrations in gene expression resulting from this chromosomal aneuploidy are not yet completely understood. Methods We used oligonucleotide microarrays to survey mRNA expression in early- and late-passage control and +21 fibroblasts and mid-gestation fetal hearts. We supplemented this analysis with northern blotting, western blotting, real-time RT-PCR, and immunohistochemistry. Results We found chromosome 21 genes consistently over-represented among the genes over-expressed in the +21 samples. However, these sets of over-expressed genes differed across the three cell/tissue types. The chromosome 21 gene MX1 was strongly over-expressed (mean 16-fold) in senescent +21 fibroblasts, a result verified by northern and western blotting. MX1 is an interferon target gene, and its mRNA was induced by interferons present in +21 fibroblast conditioned medium, suggesting an autocrine loop for its over-expression. By immunohistochemistry the p78MX1 protein was induced in lesional tissue of alopecia areata, an autoimmune disorder associated with DS. We found strong over-expression of the purine biosynthesis gene GART (mean 3-fold) in fetal hearts with +21 and verified this result by northern blotting and real-time RT-PCR. Conclusion Different subsets of chromosome 21 genes are over-expressed in different cell types with +21, and for some genes this over-expression is non-linear (>1.5X). Hyperactive interferon signaling is a candidate pathway for cell senescence and autoimmune disorders in DS, and abnormal purine metabolism should be investigated for a potential role in cardiac defects.
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Affiliation(s)
- Chi-Ming Li
- Institute for Cancer Genetics, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Meirong Guo
- Institute for Cancer Genetics, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Martha Salas
- Institute for Cancer Genetics, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Nicole Schupf
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, New York, NY, USA
| | - Wayne Silverman
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, New York, NY, USA
| | - Warren B Zigman
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, New York, NY, USA
| | - Sameera Husain
- Department of Pathology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Dorothy Warburton
- Department of Pathology, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Department of Genetics and Development, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Harshwardhan Thaker
- Department of Pathology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Benjamin Tycko
- Institute for Cancer Genetics, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Department of Pathology, Columbia University College of Physicians and Surgeons, New York, NY, USA
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Zigman WB, Jenkins EC, Tycko B, Schupf N, Silverman W. Mortality is associated with apolipoprotein E ɛ4 in nondemented adults with Down syndrome. Neurosci Lett 2005; 390:93-7. [PMID: 16122874 DOI: 10.1016/j.neulet.2005.08.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2005] [Revised: 07/11/2005] [Accepted: 08/01/2005] [Indexed: 11/16/2022]
Abstract
Apolipoprotein E genotype has been related to survival in the general population, but its strong association with Alzheimer's disease (AD) makes interpretation of findings difficult. Previous studies of adults with Down syndrome (DS) have consistently found that the presence of the apolipoprotein E epsilon2 allele increases longevity and reduces the risk of dementia, while the apolipoprotein E epsilon4 allele increases risk for dementia. In contrast, reduced frequencies of the apolipoprotein E epsilon4 allele among elderly groups have been reported, suggesting that the epsilon4 allele may be associated with early mortality in this population. To disentangle effects of dementia from those of aging, per se, we compared mortality risk as a function of apolipoprotein E genotype in 146 nondemented adults with DS in a prospective study. Individuals with at least one epsilon4 allele were approximately five times more likely to die within a 5- to 7-year follow-up period than those without an epsilon4 allele, adjusting for age, sex, body mass index, level of mental retardation, and cholesterol level. These results suggest that the apolipoprotein E epsilon4 allele has an independent and strong relation to early mortality.
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Affiliation(s)
- Warren B Zigman
- New York State Institute For Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY 10314-6399, USA.
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Jenkins EC, Velinov MT, Ye L, Gu H, Li S, Jenkins EC, Brooks SS, Pang D, Devenny DA, Zigman WB, Schupf N, Silverman WP. Telomere shortening in T lymphocytes of older individuals with Down syndrome and dementia. Neurobiol Aging 2005; 27:941-5. [PMID: 16046031 DOI: 10.1016/j.neurobiolaging.2005.05.021] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2003] [Revised: 04/29/2005] [Accepted: 05/04/2005] [Indexed: 11/25/2022]
Abstract
Telomere shortening has been recently correlated with Alzheimer's disease status. Therefore, we hypothesized that a possible association might exist for adults with Down syndrome (DS). Using blind, quantitative telomere protein nucleic acid FISH analyses of metaphase and interphase preparations from 18 age-matched trisomy 21 female study participants with and without dementia, we have observed increased telomere shortening in adults with DS and dementia (p < .01). From this initial study, we conclude that telomere shortening is associated with dementia in this high-risk population and suggest that additional research may show that telomere shortening may be a biological marker of dementia status.
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Affiliation(s)
- Edmund C Jenkins
- New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY 10314, USA.
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Zigman WB, Schupf N, Devenny DA, Miezejeski C, Ryan R, Urv TK, Schubert R, Silverman W. Incidence and prevalence of dementia in elderly adults with mental retardation without down syndrome. ACTA ACUST UNITED AC 2004; 109:126-41. [PMID: 15000676 DOI: 10.1352/0895-8017(2004)109<126:iapodi>2.0.co;2] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Rates of dementia in adults with mental retardation without Down syndrome were equivalent to or lower than would be expected compared to general population rates, whereas prevalence rates of other chronic health concerns varied as a function of condition. Given that individual differences in vulnerability to Alzheimer's disease have been hypothesized to be due to variation in cognitive reserve, adults with mental retardation, who have long-standing intellectual and cognitive impairments, should be at increased risk. This suggests that factors determining intelligence may have little or no direct relationship to risk for dementia and that dementia risk for individuals with mental retardation will be comparable to that of adults without mental retardation unless predisposing risk factors for dementia are also present.
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Affiliation(s)
- Warren B Zigman
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island 10314, USA.
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Jenkins EC, Velinov M, Li S, Ye L, Jenkins EC, Gu H, Zigman WB, Schupf N, Brooks SS, Pang D, Silverman WP. P3-010 Telomere shortening and dementia in older individuals with down syndrome. Neurobiol Aging 2004. [DOI: 10.1016/s0197-4580(04)81165-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Jenkins EC, Ye L, Li S, Zigman WB, Schupf N, Sersen EA, Zhong N, Miezejeski CM, Brooks SS, Silverman WP. Mitotic index in Down's syndrome with and without dementia. Am J Med Genet A 2004; 125A:315-7. [PMID: 14994244 DOI: 10.1002/ajmg.a.20453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
Changes in patterns of maladaptive behavior related to age-associated adaptive declines were investigated in 529 adults with mental retardation. Although individuals with no significant adaptive decline displayed stable patterns of maladaptive behavior over a 3-year period, those with declines in function showed more variable patterns. Certain maladaptive behaviors were related to the onset of adaptive declines, with some becoming of increasing concern even before adaptive declines were noted (e.g., lack of boundaries). Other behaviors increased as adaptive declines developed (e.g., withdrawal). In general, findings suggest similarities in the course of age-associated dementia of adults with and without mental retardation and indicate that increases in selected areas of maladaptive behavior may be early indicators of concern for individuals at risk.
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Affiliation(s)
- Tiina K Urv
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY 10314, USA.
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Abstract
The age-associated incidence of significant decline in adaptive behavior and the temporal pattern of decline in specific functional skill domains were examined in 646 adults with mental retardation through 88 years of age. Cumulative incidence of significant decline for adults with Down syndrome increased from less than.04 at age 50 to.67 by age 72, whereas cumulative incidence of significant decline for adults with mental retardation without Down syndrome increased from less than.02 at age 50 to.52 at age 88. Among adults experiencing overall decline, four clusters of behaviors were identified based upon the sequence and magnitude of changes, suggesting a pattern of loss not unlike that noted in the population without mental retardation with dementia.
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Affiliation(s)
- Warren B Zigman
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY 10314-6399, USA.
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Schupf N, Patel B, Silverman W, Zigman WB, Zhong N, Tycko B, Mehta PD, Mayeux R. Elevated plasma amyloid beta-peptide 1-42 and onset of dementia in adults with Down syndrome. Neurosci Lett 2001; 301:199-203. [PMID: 11257432 DOI: 10.1016/s0304-3940(01)01657-3] [Citation(s) in RCA: 114] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We compared levels of plasma amyloid beta-peptides Abeta1-42 and Abeta1-40 in 108 demented and nondemented adults with Down syndrome (DS) and 64 adults from the general population. Abeta1-42 and Abeta1-40 levels were significantly higher in adults with DS than in controls (P=0.0001). Compared to nondemented adults with DS, Abeta1-42 levels in demented adults with DS were selectively increased by 26% (28.2 pg/ml vs. 22.4 pg/ml, P=0.004). In addition, mean plasma levels of Abeta1-42 were 22% higher in DS cases with the apolipoprotein varepsilon4 allele than in DS subjects without an varepsilon4 allele (25.9 pg/ml vs. 21.2 pg/ml, P=0.01), while mean plasma levels of Abeta1-40 did not vary by APOE genotype. These results support the hypothesis that Abeta1-42 plays an important role in the pathogenesis of dementia associated with DS, as it does in Alzheimer's disease, and that variations in plasma levels may be related to disease progression.
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Affiliation(s)
- N Schupf
- Department of Psychology and Laboratory of Epidemiology, New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY 10314, USA.
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Kapell D, Nightingale B, Rodriguez A, Lee JH, Zigman WB, Schupf N. Prevalence of chronic medical conditions in adults with mental retardation: comparison with the general population. Ment Retard 1998; 36:269-79. [PMID: 9713183 DOI: 10.1352/0047-6765(1998)036<0269:pocmci>2.0.co;2] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We interviewed caregivers and reviewed medical records of 278 adults with mental retardation with and without Down syndrome, 45 to 74 years of age. Standardized morbidity ratios were used to compare frequency of medical disorders in these adults to frequency in the general population. In adults with mental retardation, the frequency of common age-related disorders was comparable to that in the general population, but there was an increased frequency of thyroid disorders, nonischemic heart disorders, and sensory impairment. Surveillance of health status and increased access to health care for screening and treatment of age-related disorders that are more frequent in adults with mental retardation would be important to prevent the development or delay the impact of these conditions and to promote healthy aging.
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Affiliation(s)
- D Kapell
- New York State Institute for Basic Research in Developmental Disabilities, Staten Island 10314, USA
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Silverman W, Zigman WB, Kim H, Krinsky-McHale S, Wisniewski HM. Aging and Dementia among Adults with Mental Retardation and Down Syndrome. Topics in Geriatric Rehabilitation 1998. [DOI: 10.1097/00013614-199803000-00007] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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