The life expectancy of people with Down syndrome it has increased notably from the average age of 25 30 years ago, to 60 today. As explained to Infosalus by the professor of Pharmacology and president of the Ibero-American Foundation Down21, Jesús Flórez, this situation is due to several factors: “The main one has been the availability of very good treatments that correct or prevent serious complications typical of Down syndrome (congenital heart disease, pneumonia and other recurrent infections, leukemia, hypothyroidism…)”.
Along with this, there have been substantial improvements in nutrition, an active life well integrated in the community, quality of life in general, or prevention of mental complications. Of course, he points out that people with Down syndrome, in general, have a early aging due to a series of causes related to the genes of chromosome 21 that is tripled, which is precisely what characterizes Down syndrome (for this reason it is also called ‘trisomy 21’). Furthermore, some people, regardless of this early aging, develop Alzheimer’s disease, in which the characteristic dementia is present.
In general, the population with Down syndrome shows an increased chance of developing Alzheimer’s disease than the rest of the population and the incidence increases with increasing age. The specialist specifies that the fundamental cause lies in the increased presence of ‘beta-amyloid’ protein in the brain, which is neurotoxic. And this is because the gene responsible for the production of this protein is located on chromosome 21 and, therefore, acts more, according to Flórez.
“We still do not know the reasons why some people develop Alzheimer’s and others do not. Undoubtedly, many factors related to the environment, education, active life, correct diet, physical exercise play a role. It is not clear if there is a difference in reason of sex. There is very active research on this subject and I hope that the day will come when it can be prevent the development of this disease in time“, says the expert.
Prevalence of Alzheimer’s in Down syndrome
In fact, it stands out that most studies indicate that all people with down syndrome over 35 years of age present cerebral neuropathological signs typical of Alzheimer’s disease, although he warns that prevalence studies indicate that not all of them develop the clinical symptoms that accompany or define dementia.
“The average prevalence rate of Alzheimer’s in Down syndrome appears to be around 15%., and increases with age. It depends on which diagnostic instruments are chosen and the criteria used. There seems to be a consensus that, while the prevalence rate as a whole may be similar to or slightly higher than that seen in the general population, the mean age at onset in the DS population Down is considerably lower: about 20 years earlier than in the general population,” adds Flórez.
To diagnose it, the professor of Pharmacology explains that many tests require verbal ability, attention, and other skills that some people with Down syndrome may lack. Thus, for example, it points to depression, which can be present frequently, but in Down syndrome it can show somewhat different manifestations, since they do not know how to verbalize it and have to resort to other signs (crying, withdrawal, insomnia, depressed appearance). , For example.
Likewise, it warns that in Down syndrome symptoms of physical alterations may appear, such as sensory loss of vision or hearing, hypothyroidism, sleep apnea, pain or discomfort due to organic causes, which hinder the general functioning of a person and even cause behavioral reactions, and all this can make one suspect “falsely” that the appearance of Alzheimer’s disease begins.
“Hence the need, never sufficiently recommended, to carry out a complete physical examination before issuing a diagnosis,” warns the president of the Down21 Ibero-American Foundation.
In this context, it details that Early symptoms of Alzheimer’s dementia in the Down syndrome population may differ from those seen in the rest of the population.
“In the general population, it is common for it to start with episodic memory and orientation problems. In Down syndrome, so-called symptoms of the prefrontal cortex: indifference, lack of cooperation, apathy, depression, deficient social communication and alterations in the various manifestations of adaptive functioning; and only later can memory loss manifest itself,” she says.
Finally, Flórez points out that the quality of aging for a person in general, and for a person with intellectual disabilities in particular, depends largely on the quality that they have had throughout their lives, on the degree to which their life has had a project and it has been consistently followed up.
“The more it has been possessed, the more it will retain or the longer it will take to lose it. And this serves to get them to continue carrying out some activities, grooming themselves, maintaining communication, etc. Properly caring for a patient with Alzheimer’s disease is quite a challenge; doing it to someone who also has Down syndrome is not necessarily more difficult, but it may the decline is faster and the caregiver is alarmed”, concludes the expert.