1. ALZHEIMER’S AND DOWN’S SYNDROME
What is the correlation between the two diagnosis?

2. What is Down’s Syndrome?
Down Syndrome, also known as “trisomy 21” is a condition in which as person is born with extra genetic material from chromosome 21.
Most people with Down Syndrome have a full extra copy of chromosome 21 meaning they have 3 copies instead of the usual 2.

3. Effects of Down Syndrome
Down Syndrome almost always affects learning, language, and memory. The effects can vary greatly from individual to individual.
Other common issues include but are not limited to: heart defects that are present at birth, bone and muscle conditions, and problems with vision and hearing.

4. Atypical Aging Associated with Down Syndrome
Premature changes in skin and hair greying
Early menopause
Increased frequency of senile cataracts
Increased frequency of hearing loss
Age-related increase in hypothyroidism
Age-related increase in seizures

5. What is Alzheimer’s Disease?
It is the most prevalent cause of dementia in old age.
Cause remains unknown
Risk increases substantially after age There are some rare cases with genetic predisposition
Has a distinctive profile

6. What is the connection between Down Syndrome and Alzheimer’s Disease?
As those with Down Syndrome age they are at increased risk of developing a type of dementia that is either the same or very similar to Alzheimer’s disease.
Autopsy studies have shown that by the age of 40, the brain of almost ALL individuals with Down Syndrome have significant levels of plaque and tangles which are abnormal protein deposits considered Alzheimer’s hallmarks.

7. What is the prevalence of Alzheimer’s disease in those with Down Syndrome?
More than 75% of those with Down Syndrome aged 65 and older have Alzheimer’s disease.
Because people with Down Syndrome generally live to be 55 to 60 years old, they are more likely to develop younger-onset Alzheimer’s (occurring before age 65).

8. What causes those with Down Syndrome to be at higher risk for Alzheimer’s disease?
First, here is the hypothesis on what causes Alzheimer’s disease. B-amyloid deposits trigger a pathological cascade that leads to the neuropathological changes seen with Alzheimer’s disease. B-amyloid is formed from a large protein needed for normal cell function, call amyloid precursor protein or APP.

9. This is significant because the coding for APP occurs on chromosome 21.
Individuals with Down Syndrome have 3 copies of this gene and produce excess APP.
Over the years, the excess APP leads to B-amyloid plaque formation and eventually Alzheimer's disease.

10. What are the symptoms of Alzheimer’s disease in those with Down Syndrome?
Symptoms include but are not limited to:
~ Reduced interest in being sociable, conversing or expressing thoughts
~Decreased enthusiasm for usual activities
~Decline in ability to pay attention
~Sadness, fearfulness or anxiety
~Irritability, uncooperativeness or agitation
~Restlessness or sleep disturbance
~Seizures that begin in adulthood
~Changes in coordination and walking
~Increased noisiness or excitability

11. How is Alzheimer’s disease diagnosed?
Diagnosis is often difficult to establish in individuals with Down Syndrome in part because of the challenges involved in assessing thinking-skill changes in those with intellectual disabilities.
It is important to document baseline adult function by age 35.
Watch for changes in day-to-day function.
Consider professional assessment by a dementia expert. There are some tests that have been tailored for those with Down Syndrome.
Rule out other causes of the individuals symptoms. Some common issues to rule out are thyroid problems, depression, chronic ear and sinus infections and sleep apnea.

12. What is the treatment for Alzheimer’s disease?
There currently is no drug that has been approved specifically to treat dementia associated with Down Syndrome.
Many of the current drugs on the market to treat Alzheimer’s disease have shown little to no efficacy in treating individuals with Down Syndrome.