Alzheimer’s Starts Earlier and Progresses Faster in People With Down Syndrome
**What is Down syndrome?**
Down syndrome is a genetic condition caused by an extra copy of chromosome 21. This extra chromosome leads to a variety of physical and intellectual disabilities, including cognitive impairment, developmental delays, and characteristic facial features.
**How does Down syndrome affect Alzheimer’s disease?**
Nearly all adults with Down syndrome will develop evidence of Alzheimer’s disease by late middle age. A new study by researchers at Washington University School of Medicine in St. Louis shows that the disease both starts earlier and moves faster in people with Down syndrome, a finding that may have important implications for the treatment and care of this vulnerable group of patients.
**What are the key findings of the study?**
The study, published in the journal Lancet Neurology, compared how Alzheimer’s develops and progresses in two genetic forms of the disease: a familial form known as autosomal-dominant Alzheimer’s disease, and Down syndrome-linked Alzheimer’s.
The researchers found that:
* Amyloid plaques and tau tangles — protein abnormalities that precede cognitive decline in Alzheimer’s — accumulate in the same areas of the brain and in the same sequence in both groups, broadly speaking.
* However, the process happens earlier and more quickly in people with Down syndrome, and the levels of tau are greater for a given level of amyloid.
* There is a compression of the amyloid and the tau phases of the disease for people with Down syndrome-associated Alzheimer’s.
**What are the implications of these findings?**
These findings suggest that Alzheimer’s disease starts earlier and progresses faster in people with Down syndrome than in other forms of the disease. This could have important implications for the treatment and care of this vulnerable group of patients.
“Since there is a compression of the amyloid and the tau phases of the disease for people with Down syndrome-associated Alzheimer’s, we will need to target both amyloid and tau,” said co-senior author Bradley F. Boeve, MD, the Daniel J. Brennan Professor of Neurology. “We may need to come up with different approaches for this population.”
**What are the next steps in research?**
The researchers plan to continue studying the progression of Alzheimer’s disease in people with Down syndrome. They hope to identify new therapeutic targets that could slow or stop the progression of the disease.
“We are building a more detailed and nuanced understanding of Alzheimer’s pathology that could lead to better diagnostics and therapies for people with any form of the disease,” said co-senior author John C. Morris, MD, the Harvey A. Friedman Distinguished Professor and head of the Department of Neurology.
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