1
|
Tishad A, Vadakal S, Talati J, Louis M, Jacob R. Comprehensive Care for Adults with Down Syndrome in Primary Care Settings. South Med J 2024; 117:296-301. [PMID: 38830582 DOI: 10.14423/smj.0000000000001693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
This review article aims to bridge the knowledge gap in providing comprehensive care to adults with Down syndrome (DS) in primary care settings. Despite the increasing prevalence of adults with DS, there is a significant lack of familiarity and comprehensive guidelines for their health care among primary care physicians. This often results in subpar health promotion, preventive screenings, and individualized care. This article attempts to provide guidance for healthcare providers on previsit preparation, clinic visit characteristics, testing and screening considerations, and decision making/guardianship for adults with DS. By emphasizing a patient-centered approach, this review aims to enhance the quality of care, reduce associated morbidity and mortality, and ultimately improve the health outcomes of adults with DS.
Collapse
Affiliation(s)
| | | | - Jay Talati
- From the University of Florida, Jacksonville
| | - Mariam Louis
- University of Florida College of Medicine - Jacksonville, Jacksonville
| | - Rafik Jacob
- Division of General Internal Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville
| |
Collapse
|
2
|
Frank L, Helsel B, Dodd D, Bodde AE, Danon JC, Sherman JR, Forsha DE, Szabo-Reed A, Washburn RA, Donnelly JE, Ptomey LT. The association between cardiovascular health and cognition in adults with Down syndrome. J Neurodev Disord 2023; 15:43. [PMID: 38057709 PMCID: PMC10699046 DOI: 10.1186/s11689-023-09510-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/07/2023] [Indexed: 12/08/2023] Open
Abstract
INTRODUCTION Evidence in the general population suggests that predictors of cardiovascular health such as moderate to vigorous physical activity (MVPA), cardiorespiratory fitness, and systolic blood pressure are associated with cognitive function. Studies supporting these associations in adults with Down syndrome (DS) are limited. The purpose of this study was to examine the associations between systolic blood pressure, cardiorespiratory fitness, and MVPA on cognition in adults with DS. METHODS This is a cross-sectional analysis using baseline data from a trial in adults with DS. Participants attended a laboratory visit where resting blood pressure, cardiorespiratory fitness (VO2 Peak), and cognitive function (CANTAB® DS Battery) were obtained. The cognitive battery included tests measuring multitasking, episodic memory, and reaction time. Physical activity (accelerometer) was collected over the week following the laboratory visit. Pearson correlations and linear regressions were used to measure the impact of systolic blood pressure, cardiorespiratory fitness, and MVPA on cognitive outcomes. RESULTS Complete data was available for 72 adults with DS (26.8 ± 9.3 years of age, 57% female). At baseline, VO2 Peak (21.1 ± 4.2 ml/kg/min) and MVPA were low (14.4 ± 14.4 min/day), and systolic blood pressure was 118.3 ± 13.3 mmHg. VO2 Peak was correlated with simple movement time (rho = - 0.28, p = 0.03) but was not significant using a linear regression controlling for age and sex. Systolic blood pressure was significantly associated with episodic memory (first attempt memory score: β = - 0.11, p = 0.002; total errors: β = 0.58, p = 0.001) and reaction time (five-choice movement time: β = 4.11, p = 0.03; simple movement time: β = 6.14, p = 0.005) using age- and sex-adjusted linear regressions. No associations were observed between MVPA and multitasking, episodic memory, or reaction time. CONCLUSION Predictors of cardiovascular health, including cardiorespiratory fitness and systolic blood pressure, were associated with some aspects of cognition in adults with DS. While future research should examine the role of improved cardiovascular health on delaying decreases in cognitive function and dementia in adults with DS, we recommend that health care providers convey the importance of exercise and cardiovascular health to their patients with DS. TRIAL REGISTRATION NCT04048759, registered on August 7, 2019.
Collapse
Affiliation(s)
- Lauren Frank
- School of Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
- Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 1073, Kansas City, KS, 66160, USA
| | - Brian Helsel
- Department of Neurology, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
| | - Danica Dodd
- School of Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
- Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 1073, Kansas City, KS, 66160, USA
| | - Amy E Bodde
- Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 1073, Kansas City, KS, 66160, USA
| | - Jessica C Danon
- Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 1073, Kansas City, KS, 66160, USA
| | - Joseph R Sherman
- Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 1073, Kansas City, KS, 66160, USA
| | - Daniel E Forsha
- Ward Family Heart Center, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Amanda Szabo-Reed
- Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 1073, Kansas City, KS, 66160, USA
| | - Richard A Washburn
- Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 1073, Kansas City, KS, 66160, USA
| | - Joseph E Donnelly
- Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 1073, Kansas City, KS, 66160, USA
| | - Lauren T Ptomey
- Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 1073, Kansas City, KS, 66160, USA.
| |
Collapse
|
3
|
Washington SE, Cler E, Lowery C, Stark SL. Down syndrome and Alzheimer's disease: A scoping review of functional performance and fall risk. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2023; 9:e12393. [PMID: 37228575 PMCID: PMC10203538 DOI: 10.1002/trc2.12393] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/12/2023] [Accepted: 04/24/2023] [Indexed: 05/27/2023]
Abstract
Introduction Alzheimer's disease (AD) occurs in aging adults with Down syndrome (DS) at a higher prevalence and an earlier age than in typical aging adults. As with the general aging adult population, there is an urgent need to understand the preclinical and early phases of AD progression in the adult population with DS. The aim of this scoping review was to synthesize the current state of the evidence and identify gaps in the literature regarding functional activity performance and falls and their significance to disease staging (i.e., mild, moderate, and severe defined staging criteria) in relation to Alzheimer's disease and related dementias (ADRD) in adults with DS. Methods This scoping review included six electronic databases (e.g., PsycInfo, Academic Search Complete, CINAHL, COCHRANE Library, MEDLINE, and PubMed). Eligible studies included participants with DS ≥25 years of age, studies with functional measures and/or outcomes (e.g., activities of daily living, balance, gait, motor control, speech, behavior, and cognition; falls; and fall risks), and studies that investigated AD pathology and implications. Results Fourteen eligible studies were included and categorized through a thematic analysis into the following themes: (1) physical activity and motor coordination (PAMC), (2) cognition, (3) behavior, and (4) sleep. The studies indicated how functional activity performance and engagement may contribute to early identification of those at risk of cognitive decline and AD development and/or progression. Discussion There is a need to expand the research regarding ADRD pathology relative to functional outcomes in adults with DS. Functional measures related to disease staging and cognitive impairment are essential to understanding how AD progression is characterized within real-world settings. This scoping review identified the need for additional mixed-methods research to examine the use of assessment and intervention related to function and its detection of cognitive decline and AD progression.
Collapse
Affiliation(s)
- Selena E. Washington
- Department of Occupational Science and Occupational TherapySaint Louis UniversitySt. LouisUSA
| | - Emily Cler
- Department of Occupational Science and Occupational TherapySaint Louis UniversitySt. LouisUSA
| | - Cameron Lowery
- Department of BiologyHarris Stowe State UniversitySt. LouisUSA
| | - Susan L. Stark
- Washington University School of Medicine in St. LouisProgram in Occupational TherapySt. LouisUSA
| |
Collapse
|
4
|
Shields N, Mizzi N, Buhlert‐Smith K, Strydom A, Prendergast L, Hocking DR. A 12-week exercise programme has a positive effect on everyday executive function in young people with Down syndrome: a pilot non-randomised controlled trial. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:924-938. [PMID: 36101998 PMCID: PMC9825892 DOI: 10.1111/jir.12979] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 07/24/2022] [Accepted: 08/17/2022] [Indexed: 05/15/2023]
Abstract
BACKGROUND Exercise has the potential to reduce cognitive decline in people with Down syndrome by maximising their cognitive function. The aim of the study was to determine the effect of regular exercise on cognitive functioning in young people with Down syndrome. METHOD People with Down syndrome were eligible if aged between 13 and 35 years and enrolled to participate in an exercise programme (called FitSkills). The intervention was a 12-week community-based exercise programme completed with a student mentor. Outcomes were assessed before (week 0) and immediately after (week 13) the intervention. Executive functioning (planning, response inhibition, attention shifting) was assessed using Tower of London, Sustained Attention to Response Task, CANTAB Intra-extra Dimensional Set Shift Test, Cognitive Scale for Down Syndrome, and Behaviour Rating Inventory of Executive Function (BRIEF). Working memory was assessed using the CANTAB Paired Associates Learning task, and information processing speed was assessed using the Motor Screening Task. Outcomes were analysed using ANCOVA with the baseline measure as the covariate. RESULTS Twenty participants (9 women; mean age 23.6 ± 6.6 years) enrolled. Between-group differences, in favour of the experimental group, were found for the global executive composite score of the BRIEF (mean difference -4.77 units, 95% CI -9.30 to -0.25). There were no between group differences for any other outcome measured. CONCLUSION Participation in a 12-week exercise programme was effective in improving everyday executive functions in young people with Down syndrome. These preliminary findings need to be confirmed in future randomised controlled trials of community-based exercise with larger sample sizes.
Collapse
Affiliation(s)
- N. Shields
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and SportLa Trobe UniversityMelbourneAustralia
| | - N. Mizzi
- Developmental Neuromotor & Cognition Lab, School of Psychology and Public HealthLa Trobe UniversityMelbourneAustralia
| | - K. Buhlert‐Smith
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and SportLa Trobe UniversityMelbourneAustralia
| | - A. Strydom
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & NeuroscienceKings College LondonLondonUK
| | - L. Prendergast
- Department of Mathematics and StatisticsLa Trobe UniversityMelbourneAustralia
| | - D. R. Hocking
- Developmental Neuromotor & Cognition Lab, School of Psychology and Public HealthLa Trobe UniversityMelbourneAustralia
- Centre for Mental HealthSwinburne University of TechnologyMelbourneAustralia
| |
Collapse
|
5
|
Melo GLR, Neto IVDS, da Fonseca EF, Stone W, Nascimento DDC. Resistance training and Down Syndrome: A narrative review on considerations for exercise prescription and safety. Front Physiol 2022; 13:948439. [PMID: 36237528 PMCID: PMC9553130 DOI: 10.3389/fphys.2022.948439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
The current manuscript reviews the literature on the health effects of resistance training (RT) for individuals with Down syndrome (DS), focusing on this training modality’s methodology, application, and safety. The literature has mentioned that early aging in this population is associated with loss of muscle strength, lower lean and bone mass, and increased obesity. It is necessary to propose non-pharmacological measures for prevention and health promotion. Thus, this review suggests a current research-based RT guide for individuals with DS. This review is divided into three sections: Section 2 briefly reviews DS and the effects on structural and functional decline and how exercise and physical activity can influence health aspects in this population; Section 3 summarizes the evidence for RT prescription; Section 4 briefly reviews the health and potential benefits of RT in individuals with DS. The findings from this review suggest that most individuals with DS should engage in moderate-intensity RT at least 2 days a week and perform RT on the major muscle groups and include balance training. The RT program should be modified and adapted according to individuals’ characteristics and limitations. RT promotes positive, health-related benefits such as increasing strength, improving body composition, improving functional capacity and balance, reducing inflammatory status and oxidative stress, and improving the immune system. The RT protocols summarized in this current review provide guidance, critical conclusions, and novel research settings, which could be useful to coaches, clinicians, and researchers to effectively design RT program for individuals with DS.
Collapse
Affiliation(s)
- Geiziane Leite Rodrigues Melo
- Department of Physical Education, Catholic University of Brasília, Brasília, Brazil
- *Correspondence: Geiziane Leite Rodrigues Melo,
| | - Ivo Vieira de Sousa Neto
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | | | - Whitley Stone
- Department of School of Kinesiology Recreation and Sport, Western Kentucky University, Bowling Green, FL, United States
| | | |
Collapse
|
6
|
Lamsal Lamichhane S, Ramesh V, Opara CO, Khan FY, Kabiraj G, Kauser H, Palakeel JJ, Ali M, Chaduvula P, Chhabra S, Mohammed L. Treatment Modalities for Dementia in Down’s Syndrome: A Literature Review. Cureus 2022; 14:e27881. [PMID: 36110433 PMCID: PMC9462651 DOI: 10.7759/cureus.27881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 08/10/2022] [Indexed: 11/24/2022] Open
Abstract
Down's syndrome (DS) is the most well-known chromosomal abnormality characterized by an extra chromosome 21 and multiple systemic issues. The higher production of amyloid precursor protein (APP), the precursor peptide of beta-amyloid, predisposes persons with DS to early Alzheimer's disease (AD). The prevalence of dementia has increased as a function of the extended life expectancy of persons with DS. Because we know little about the treatment of dementia in persons with DS, this review focuses on the pathophysiology and management strategies to improve the overall quality of life.
Collapse
|
7
|
Martini AC, Gross TJ, Head E, Mapstone M. Beyond amyloid: Immune, cerebrovascular, and metabolic contributions to Alzheimer disease in people with Down syndrome. Neuron 2022; 110:2063-2079. [PMID: 35472307 PMCID: PMC9262826 DOI: 10.1016/j.neuron.2022.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/08/2022] [Accepted: 03/31/2022] [Indexed: 12/16/2022]
Abstract
People with Down syndrome (DS) have increased risk of Alzheimer disease (AD), presumably conferred through genetic predispositions arising from trisomy 21. These predispositions necessarily include triplication of the amyloid precursor protein (APP), but also other Ch21 genes that confer risk directly or through interactions with genes on other chromosomes. We discuss evidence that multiple genes on chromosome 21 are associated with metabolic dysfunction in DS. The resulting dysregulated pathways involve the immune system, leading to chronic inflammation; the cerebrovascular system, leading to disruption of the blood brain barrier (BBB); and cellular energy metabolism, promoting increased oxidative stress. In combination, these disruptions may produce a precarious biological milieu that, in the presence of accumulating amyloid, drives the pathophysiological cascade of AD in people with DS. Critically, mechanistic drivers of this dysfunction may be targetable in future clinical trials of pharmaceutical and/or lifestyle interventions.
Collapse
Affiliation(s)
- Alessandra C Martini
- Department of Pathology and Laboratory Medicine, University of California, Irvine, Irvine, CA 92697, USA
| | - Thomas J Gross
- Department of Neurology, University of California, Irvine, Irvine, CA 92697, USA
| | - Elizabeth Head
- Department of Pathology and Laboratory Medicine, University of California, Irvine, Irvine, CA 92697, USA
| | - Mark Mapstone
- Department of Neurology, University of California, Irvine, Irvine, CA 92697, USA.
| |
Collapse
|
8
|
Impact of the COVID-19 pandemic on daily life, mood, and behavior of adults with Down syndrome. Disabil Health J 2022; 15:101278. [PMID: 35256308 PMCID: PMC8849846 DOI: 10.1016/j.dhjo.2022.101278] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND The Down syndrome population has been disproportionately affected by Coronavirus 2019 (COVID-19) in terms of experiencing severe illness and death. Societal efforts to curb the spread of COVID-19 may also have taken a heavy toll on the daily lives of individuals with Down syndrome. OBJECTIVE/HYPOTHESIS The goal of the study was to understand how the COVID-19 pandemic has altered daily life (including residence, employment, and participation in adult disability day programs) and influenced the mood and behavior of adults with Down syndrome. METHODS Between September 2020 and February 2021, caregivers of 171 adults with Down syndrome (aged 22-66 years) located across the United States and in the United Kingdom enrolled in the Alzheimer's Biomarker Research Consortium on Down Syndrome (ABC-DS) completed a survey. RESULTS The residence of 17% of individuals was altered, and 89% of those who had been employed stopped working during the pandemic. One-third (33%) of individuals were reported to be more irritable or easily angered, 52% were reported to be more anxious, and 41% were reported to be more sad/depressed/unhappy relative to prepandemic. The majority of changes in mood and behavior were of modest severity. CONCLUSIONS The COVID-19 pandemic has had widespread effects on the daily life and mood and behavior of adults with Down syndrome. In the short term, caregivers and providers should be prepared to help adults with Down syndrome with changes in daily routines, residence, employment, or adult disability day programs as society shifts away from COVID-19 safety protocols.
Collapse
|
9
|
Hamadelseed O, Elkhidir IH, Skutella T. Psychosocial Risk Factors for Alzheimer's Disease in Patients with Down Syndrome and Their Association with Brain Changes: A Narrative Review. Neurol Ther 2022; 11:931-953. [PMID: 35596914 PMCID: PMC9338203 DOI: 10.1007/s40120-022-00361-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/28/2022] [Indexed: 12/02/2022] Open
Abstract
Several recent epidemiological studies attempted to identify risk factors for Alzheimer’s disease. Age, family history, genetic factors (APOE genotype, trisomy 21), physical activity, and a low level of schooling are significant risk factors. In this review, we summarize the known psychosocial risk factors for the development of Alzheimer’s disease in patients with Down syndrome and their association with neuroanatomical changes in the brains of people with Down syndrome. We completed a comprehensive review of the literature on PubMed, Google Scholar, and Web of Science about psychosocial risk factors for Alzheimer’s disease, for Alzheimer’s disease in Down syndrome, and Alzheimer’s disease in Down syndrome and their association with neuroanatomical changes in the brains of people with Down syndrome. Alzheimer’s disease causes early pathological changes in individuals with Down syndrome, especially in the hippocampus and corpus callosum. People with Down syndrome living with dementia showed reduced volumes of brain areas affected by Alzheimer’s disease as the hippocampus and corpus callosum in association with cognitive decline. These changes occur with increasing age, and the presence or absence of psychosocial risk factors impacts the degree of cognitive function. Correlating Alzheimer’s disease biomarkers in Down syndrome and cognitive function scores while considering the effect of psychosocial risk factors helps us identify the mechanisms leading to Alzheimer’s disease at an early age. Also, this approach enables us to create more sensitive and relevant clinical, memory, and reasoning assessments for people with Down syndrome.
Collapse
Affiliation(s)
- Osama Hamadelseed
- Department of Neuroanatomy, Institute of Anatomy and Cell Biology, University of Heidelberg, Im Neuenheimer Feld 307, 69120, Heidelberg, Germany.
| | - Ibrahim H Elkhidir
- Faculty of Medicine, University of Khartoum, Alqasr St., Khartoum, Sudan
| | - Thomas Skutella
- Department of Neuroanatomy, Institute of Anatomy and Cell Biology, University of Heidelberg, Im Neuenheimer Feld 307, 69120, Heidelberg, Germany
| |
Collapse
|
10
|
Profit versus Quality: The Enigma of Scientific Wellness. J Pers Med 2022; 12:jpm12010034. [PMID: 35055349 PMCID: PMC8779909 DOI: 10.3390/jpm12010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/21/2021] [Accepted: 12/24/2021] [Indexed: 11/23/2022] Open
Abstract
The “best of both worlds” is not often the case when it comes to implementing new health models, particularly in community settings. It is often a struggle between choosing or balancing between two components: depth of research or financial profit. This has become even more apparent with the recent shift to move away from a traditionally reactive model of medicine toward a predictive/preventative one. This has given rise to many new concepts and approaches with a variety of often overlapping aims. The purpose of this perspective is to highlight the pros and cons of the numerous ventures already implementing new concepts, to varying degrees, in community settings of quite differing scales—some successful and some falling short. Scientific wellness is a complex, multifaceted concept that requires integrated experimental/analytical designs that demand both high-quality research/healthcare and significant funding. We currently see the more likely long-term success of those ventures in which any profit is largely reinvested into research efforts and health/healthspan is the primary focus.
Collapse
|
11
|
Fleming V, Piro-Gambetti B, Patrick A, Zammit M, Alexander A, Christian BT, Handen B, Cohen A, Klunk W, Laymon C, Ances BM, Plante DT, Okonkwo O, Hartley SL. Physical activity and cognitive and imaging biomarkers of Alzheimer's disease in down syndrome. Neurobiol Aging 2021; 107:118-127. [PMID: 34428720 PMCID: PMC8641014 DOI: 10.1016/j.neurobiolaging.2021.07.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 10/20/2022]
Abstract
Adults with Down syndrome (DS) are at risk for Alzheimer's disease. Despite sharing trisomy 21, however, there is variability in the age of disease onset. This variability may mean that other factors, such as lifestyle, influence cognitive aging and disease timing. The present study assessed the association between everyday life physical activity using an actigraph accelerometer and cognitive functioning and early Alzheimer's disease pathology via positron emission tomography amyloid-β and tau and diffusion tension imaging measures of white matter integrity in 61 non-demented adults with DS. Percent time in sedentary behavior and in moderate-to-vigorous activity were associated (negatively and positively, respectively) with cognitive functioning (r = -.472 to .572, p < 0.05). Neither sedentary behavior nor moderate-to-vigorous activity were associated with amyloid-β or tau, but both were associated with white matter integrity in the superior and inferior longitudinal fasciculus (Fractional Anisotropy: r = -.397 to -.419, p < 0.05; Mean Diffusivity: r = .400, p < 0.05). Longitudinal studies are needed to determine if physical activity promotes healthy aging in DS.
Collapse
Affiliation(s)
- Victoria Fleming
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA; School of Human Ecology, University of Wisconsin-Madison, Madison, WI, USA
| | - Brianna Piro-Gambetti
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA; School of Human Ecology, University of Wisconsin-Madison, Madison, WI, USA
| | - Austin Patrick
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA; Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, USA
| | - Matthew Zammit
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA; Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, USA
| | - Andrew Alexander
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA; Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, USA
| | - Bradley T Christian
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA; Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, USA
| | - Benjamin Handen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Annie Cohen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - William Klunk
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Charles Laymon
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Beau M Ances
- Department of Neurology, Washington University at St. Louis, St. Louis, MO, USA
| | - David T Plante
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Ozioma Okonkwo
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA; Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Sigan L Hartley
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA; School of Human Ecology, University of Wisconsin-Madison, Madison, WI, USA.
| |
Collapse
|
12
|
Martini AC, Alldred MJ, Granholm AC. Aging in Down Syndrome: Latest Clinical Advances and Prospects. J Clin Med 2021; 10:5037. [PMID: 34768560 PMCID: PMC8584622 DOI: 10.3390/jcm10215037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 12/30/2022] Open
Abstract
Down syndrome (DS), or trisomy 21, is the most common genetic cause of intellectual disability [...].
Collapse
Affiliation(s)
- Alessandra C. Martini
- Department of Pathology and Lab. Medicine, University of California Irvine, Irvine, CA 92697, USA;
| | - Melissa J. Alldred
- Nathan Kline Institute, NYU Grossman Medical School, 140 Old Orangeburg Rd., Orangeburg, NY 10962, USA;
| | - Ann-Charlotte Granholm
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO 80208, USA
- Department of Neurosurgery, CU Anschutz Medical Campus, 12700 E. 19th Ave., Aurora, CO 80045, USA
| |
Collapse
|
13
|
Consorti A, Di Marco I, Sansevero G. Physical Exercise Modulates Brain Physiology Through a Network of Long- and Short-Range Cellular Interactions. Front Mol Neurosci 2021; 14:710303. [PMID: 34489641 PMCID: PMC8417110 DOI: 10.3389/fnmol.2021.710303] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/23/2021] [Indexed: 12/14/2022] Open
Abstract
In the last decades, the effects of sedentary lifestyles have emerged as a critical aspect of modern society. Interestingly, recent evidence demonstrated that physical exercise plays an important role not only in maintaining peripheral health but also in the regulation of central nervous system function. Many studies have shown that physical exercise promotes the release of molecules, involved in neuronal survival, differentiation, plasticity and neurogenesis, from several peripheral organs. Thus, aerobic exercise has emerged as an intriguing tool that, on one hand, could serve as a therapeutic protocol for diseases of the nervous system, and on the other hand, could help to unravel potential molecular targets for pharmacological approaches. In the present review, we will summarize the cellular interactions that mediate the effects of physical exercise on brain health, starting from the factors released in myocytes during muscle contraction to the cellular pathways that regulate higher cognitive functions, in both health and disease.
Collapse
Affiliation(s)
- Alan Consorti
- Neuroscience Institute, National Research Council (CNR), Pisa, Italy.,NEUROFARBA, University of Florence, Florence, Italy
| | | | | |
Collapse
|