The association of dementia risk symptoms and functional activity in adults with Down syndrome

IF 4.9 Q1 CLINICAL NEUROLOGY Alzheimer''s and Dementia: Translational Research and Clinical Interventions Pub Date : 2024-10-10 DOI:10.1002/trc2.70007

Selena E. Washington, Amy E. Bodde, Brian C. Helsel, Rebecca M. Bollinger, Nora Smith, Lauren T. Ptomey, Beau Ances, Susan L. Stark

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Abstract

INTRODUCTION

Adults with Down syndrome (DS) have an increased risk of Alzheimer's disease (AD) dementia, often showing neuropathological indicators by age 40. Physical function and activities of daily living (ADLs) are understudied areas of function that may inform dementia risk. We investigated associations among age, physical function (gait/balance, grip strength, and lower extremity strength), ADLs, and dementia risk symptoms in adults with DS. We hypothesized that compromised physical function and lower independence with ADLs would be associated with an informant/caregiver-reported measure of dementia risk symptoms.

METHODS

A secondary analysis for this cross-sectional study was completed using data from two academic research centers with 43 adults with DS (age 30 ± 12 years). We examined the association of dementia risk symptoms, captured through the Dementia Screening Questionnaire for Individuals with Intellectual Disabilities (DSQIID), with physical function (timed up and go [TUG], sit-to-stand [STS], grip strength) and ADLs (Waisman Activities of Daily Living Scale). A linear regression model for the continuous dementia risk measure in the DSQIID used a log transformation of (1 + log(Y + 1)) to account for a high zero count. Wilcoxon rank-sum tests were used to assess differences in the physical function measures, DSQIID questionnaire, and Waisman ADL by dividing mean age categories.

RESULTS

Higher DSQIID scores were associated with lower independence with ADLs (β = −0.103, p = 0.008), slower gait times (TUG; β = 0.112, p = 0.034), and impaired lower extremity strength (STS; β = 0.112, p = 0.017) and grip strength (β = −0.039, p = 0.034). DSQIID scores differed significantly between the ≥30 and <30 age groups. Participants ≥30 years of age scored 5 points higher on the DSQIID than participants <30, suggesting that age was associated with greater dementia risk.

DISCUSSION

Greater dementia risk symptoms were associated with age, lower physical function scores, and independence with ADLs, suggesting that declines in physical function and ADLs may be early indicators of subsequent dementia risk in adults with DS.

Highlights

We explored the association of physical function and activities of daily living (ADLs) in aging adults with DS and their relationship with informant/caregiver report of dementia risk symptoms.
Our findings demonstrated a significant relationship between a higher number of dementia risk symptoms observed and lower independence with ADLs, and impaired gait/balance, grip strength, and lower extremity strength.
Further research with larger longitudinal studies is necessary to investigate any causative relationships among physical function, ADL function, and dementia risk symptoms.

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唐氏综合征成人痴呆症风险症状与功能活动的关系

引言患有唐氏综合症（DS）的成年人罹患阿尔茨海默病（AD）痴呆症的风险会增加，通常在 40 岁之前就会出现神经病理学指标。身体功能和日常生活活动（ADLs）是未被充分研究的功能领域，可能会为痴呆症风险提供信息。我们研究了 DS 患者的年龄、身体功能（步态/平衡、握力和下肢力量）、ADLs 和痴呆症风险症状之间的关系。我们假设，身体功能受损和ADL独立性降低将与信息提供者/护理者报告的痴呆风险症状相关。方法我们利用两个学术研究中心的数据对这项横断面研究进行了二次分析，研究对象为 43 名成年 DS 患者（年龄为 30 ± 12 岁）。我们研究了痴呆症风险症状（通过智障人士痴呆症筛查问卷（DSQIID）获得）与身体功能（定时起立[TUG]、坐立[STS]、握力）和日常活动能力（Waisman 日常活动量表）之间的关联。DSQIID 中连续性痴呆风险测量的线性回归模型采用了 (1 + log(Y + 1)) 的对数变换，以考虑零计数较高的情况。采用 Wilcoxon 秩和检验评估身体功能测量、DSQIID 问卷和 Waisman ADL 通过划分平均年龄类别的差异。结果 DSQIID得分越高，ADL独立性越低（β = -0.103，p = 0.008），步态时间（TUG；β = 0.112，p = 0.034）越慢，下肢力量（STS；β = 0.112，p = 0.017）和握力（β = -0.039，p = 0.034）越差。DSQIID 评分在≥30 岁组和 <30 岁组之间存在显著差异。≥30岁参与者的DSQIID得分比<30岁参与者高5分，这表明年龄与痴呆症风险的增加有关。讨论更高的痴呆症风险症状与年龄、较低的身体功能评分和ADL独立性有关，这表明身体功能和ADL的下降可能是DS成人痴呆症后续风险的早期指标。亮点我们探讨了老年 DS 患者的身体功能和日常生活活动（ADLs）与痴呆风险症状信息提供者/护理者报告之间的关系。我们的研究结果表明，观察到的痴呆症风险症状数量越多，日常生活活动独立性越低，步态/平衡、握力和下肢力量受损之间的关系就越明显。有必要通过更大规模的纵向研究来进一步探讨身体功能、ADL功能和痴呆症风险症状之间的因果关系。

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来源期刊

Alzheimer''s and Dementia: Translational Research and Clinical Interventions Medicine-Psychiatry and Mental Health

CiteScore

10.10

自引率

2.10%

发文量

134

审稿时长

10 weeks

期刊介绍： Alzheimer''s & Dementia: Translational Research & Clinical Interventions (TRCI) is a peer-reviewed, open access,journal from the Alzheimer''s Association®. The journal seeks to bridge the full scope of explorations between basic research on drug discovery and clinical studies, validating putative therapies for aging-related chronic brain conditions that affect cognition, motor functions, and other behavioral or clinical symptoms associated with all forms dementia and Alzheimer''s disease. The journal will publish findings from diverse domains of research and disciplines to accelerate the conversion of abstract facts into practical knowledge: specifically, to translate what is learned at the bench into bedside applications. The journal seeks to publish articles that go beyond a singular emphasis on either basic drug discovery research or clinical research. Rather, an important theme of articles will be the linkages between and among the various discrete steps in the complex continuum of therapy development. For rapid communication among a multidisciplinary research audience involving the range of therapeutic interventions, TRCI will consider only original contributions that include feature length research articles, systematic reviews, meta-analyses, brief reports, narrative reviews, commentaries, letters, perspectives, and research news that would advance wide range of interventions to ameliorate symptoms or alter the progression of chronic neurocognitive disorders such as dementia and Alzheimer''s disease. The journal will publish on topics related to medicine, geriatrics, neuroscience, neurophysiology, neurology, psychiatry, clinical psychology, bioinformatics, pharmaco-genetics, regulatory issues, health economics, pharmacoeconomics, and public health policy as these apply to preclinical and clinical research on therapeutics.