Individualized estimated years from onset of Alzheimer's disease– related decline for adults with Down syndrome

Abstract

Abstract Introduction Adults with Down syndrome (DS) are at increased risk for Alzheimer's disease (AD) and vary in their age of transition from AD preclinical to prodromal or more advanced clinical stages. An empirically based method is needed to determine individual “estimated years from symptom onset (EYO),” the same construct used in studies of autosomal dominant AD . Methods Archived data from a previous study of > 600 adults with DS were examined using survival analysis methods. Age‐specific prevalence of prodromal AD or dementia, cumulative risk, and EYOs were determined. Results Individualized EYOs for adults with DS ranging in age from 30 to 70+ were determined, dependent upon chronological age and clinical status. Discussion EYOs can be a useful tool for studies focused on biomarker changes during AD progression in this and other populations at risk, studies that should contribute to improved methods for diagnosis, prediction of risk, and identification of promising treatment targets. HIGHLIGHTS Years from Alzheimer's disease (AD) onset (EYO) was estimated for adults with Down syndrome (DS). EYOs were informed by AD clinical status and age, ranging from 30 to > 70 years. Influences of biological sex and apolipoprotein E genotype on EYOs were examined. EYOs have advantages for predicting risk of AD‐related dementia compared to age. EYOs can be extremely informative in studies of preclinical AD progression.

Keywords

• Alzheimer's disease
• Down syndrome
• estimated years from symptom onset
• mild cognitive impairment
• prodromal Alzheimer's disease