Down Syndrome and Alzheimer’s Disease / Dementia.
Please note: I’ve kept this page here as a snapshot in history circa year 2000. It’s still an interesting read. HOWEVER, the role of Alzheimer’s Disease in Down Syndrome has been extenisively updated and reviewed, and can be found on Alzheimer’s Disease in Down Syndrome.
Contents: Prevalence of Alzheimer’s disease and dementia amongst those with Down Syndrome — The diagnosis of dementia or Alzheimer’s disease in the those with Down Syndrome may be wrong — Another aspect to this is WHO made the diagnosis? — Causes and Treatment for Alzheimer’s disease and dementia in those with Down Syndrome — Down Syndrome Alzheimer’s disease and Dementia in conlusion.
Prevalence of Alzheimer’s disease and dementia amongst those with Down Syndrome
Deirdre A. Hill, et al, year 2003, found Down Syndrome adults had a much higher risk of Dementia and Alzheimer disease.
Age is a big cause factor in Alzheimer’s Disease – About 10% with Down Syndrome will show the Alzheimer’s disease symptoms before age 30 years. About “…25% before they are 50, and about 75% before they are 70 years old.
Women generally, get it earlier and more severely, but less prevalently. Men get it later in life and less severely, but more men have it…”. Source: Down Syndrome Guild of Dallas
People with Down Syndrome appear more predisposed to Alzheimer’s disease – one cause of Alzheimer’s disease appears to be genes – but it is unclear at present whether Down Syndrome causes a higher incidence or not. Some people place it as inevitable and that all adults with Down’s Syndrome will eventually come down with it. Others put it around 50%.
A promising study that our Down Syndrome Worker gave us a copy of, suggests that Down Syndrome adults have no greater chance of getting Alzheimer’s disease than the general population.
Regrettably though, the onset of dementia may occur 20 years earlier.
The diagnosis of dementia or Alzheimer’s disease in the those with Down Syndrome may be wrong
In the general population, the diagnosis of Alzheimer’s disease / vascular dementia may be wrong!
The cause of the Alzheimer’s disease / dementia SYMPTOMS, can be depression, vitamin deficiency, urinary tract infection and so on.
People are being incorrectly diagnosed with dementia or alzheimer’s disease when, in fact, they have a reversible condition.
In one study our Down Syndrome worker gave us, the doctors involved found that dementia was too readily diagnosed and that, in most cases of decline, the decline was reversible and notdementia or alzheimer’s disease related.
(For example, if the decline in behaviour was due to depression, when the depression was treated the behaviour returned to normal).
What all this tells us, is that you cannot make a firm and accurate diagnosis of dementia in people with Down Syndrome, unless all these other possibilities are investigated and ruled out as well.
Another aspect to this is WHO made the Diagnosis of Dementia or Alzheimers Disease?
Believe it or not, lots of people like to gesture this possibility, without realising the devastating consequences such statements have on family and friends, or on the person so diagnosed.
Always remember that only a doctor can really diagnose this, and only after having completed many tests, including MRI, to exclude other possiblities.
Further, evidence of brain atrohpy, does not mean that the person will have their abilities affected. Something, most people don’t realise, but something I learnt from working in a Home and Hospital for the Aged.
Causes and Treatment for Alzheimer’s disease and dementia in those with Down Syndrome
The genetics of Alzheimer’s disease in those with Down Syndrome
Amyloid precursor protein, or APP plays a central role in the pathogenesis of Alzheimer’s disease.
Individuals with Down syndrome develop beta-amyloid deposition characteristics of early onset Alzheimer’s disease in mid-life, presumably due to an extra copy of the chromosome 21-located APPgene.
By the age of 60, between 50 and 70% of people with Down syndrome develop dementia.
Indeed, triplication of a short segment of APP in people without Down syndrome has been associated with early-onset Alzheimer’s disease.
However, genes other than APP may also contribute to the early onset of Alzheimer’s disease in Down syndrome.
DYRK1A is one such other gene closely associated with the early onset of Alzheimer disease in Down syndrome.
The role of iron in intellectual disability, and in dementia and Alzheimer’s disease in those with Down Syndrome
Iron has received a lot of attack in at least one Down Syndrome newsgroup, as some believe iron quickens or is responsible for the damaging oxidation of the brain, which is then basically assumed (not proven) to cause Alzheimer’s Disease.
The problem was, the link between iron and Alzheimer’s disease at that time, was more theory.
Also, the bad iron is said to be the supplemental iron taken from mines that is added to food, while normal iron rich foods or iron supplements derived from plants and animals are perfectly acceptable. There is evidence that plant derived drugs have less damaging side effects than ones made from mined ingredients.
My position is that we wont lower Jacob’s iron intake from any source, unless his blood tests suggests it to be too high.
Iron is needed for oxygen transport to occur in the blood, which is vitally important for good health and well being.
Too low an iron level in the blood is called anaemia and too low an iron level can cause significantmental retardation, the last thing we want in addition to their already lowered intelligence.
However, if your kid with Down Syndrome wont be hurt by lowering the supplemental mine iron, it may help to do so.
Iron deficiency occurs in a small but significant number of people with Down Syndrome and should never be assumed not to exist. Iron deficiency also occurs in some people in the general population as well.
Jacob started out with the typical Down Syndrome high iron pattern, but developed low iron levels before 10 or 11 months of age.
I’m told by the experts that people living in certain countries, such as Great Britain, are more prone to developing low iron levels.
Irrespective of your country, I would suggest to you that very regular comprehensiveblood tests are your most important tool in keeping the effects of Down Syndrome minimised.
The role of cholesterol in dementia and Alzheimer’s disease in those with Down Syndrome
Lowering cholesterol is possibly many more times more relevant than iron in causing Alzheimer’s Disease and multi-infarct vascular dementia in Down Syndrome adults – the research suggests that what is bad or good for the heart is bad or good for the brain as well – high cholesterol has been linked to Alzheimer’s.
Fish oil capsules/liquid/margarines which are high in Omega 3’s – DHA etc – do not help in reducing cholesterol, but plant sterols can.
My other web site on cholesterol covers the treatment of high cholesterol and it’s causes very well.
The role of obesity in dementia and Alzheimer’s disease in those with Down Syndrome
Preventing pre-diabetes from turning into diabetes also reduces the risk of Alzheimer’s disease. The primary way to do this is through diet and losing weight.
Well, you probably heard about the study that linked dementia with mid life obesity / overweight.
If you were overweight, you were about 35% more likely to get alzheimers. If you were obese, it jumped to about 74%. However, it was also found that if you were a middle aged woman and obese your risk was doubled. So, at this point, it appears that women are mainly at greater risk of developing alzheimer’s disease because of obesity, where as overweight / obese males are generally not at much greater risk of developing alzheimer’s disease.
However, another study of nearly 9,000 individuals which were monitored for 30 years, revealed that males and females who were overweight or obese in their 40s, were more prone to suffering from Alzheimer’s disease later in life.
The most obese were almost three times more likely to get Alzheimer’s disease. “… These findings are important because obesity and overweight are treatable and modifiable risk factors …” Rachel A. Whitmer, PhD, of the Kaiser Permanente Foundation Research Institute in Oakland, CA, year 2006.
This finding is also quite relevant to those with Down Syndrome, as people with Down Syndrome, being generally less physically active, tend to consume an excess of three hundred calories per day, which creates overweight or obesity for most of them.
See my section on rapid weight loss and yummy yummy low calorie, low fat, low cholestrol, low sugar recipes for possible help on this point.
Remember though, that obesity and overweight are often signs of a neglected body.
Long term overweight or obesity often affects blood cholesterol levels badly, brings on diabetes ( 2 out of 3 diabetics die of stroke or heart attack ), brings on metabolic syndrome, increases blood pressure.
What the study really showed, I believe, was the connection between lack of fitness and the onslaught of dementia, with the lack of fitness causing the dementia.
Antioxidants and, dementia and Alzheimer’s disease in those with Down Syndrome
Dr. Ira Lott et al.; year 2001, had this to say about the anti-oxidant approach as a treatment preventative for Alzheimer’s Disease:
Oxidation is the initial reaction of the body to the newly formed beta-amyloid and plaques that occasionally occur in the brain. It is thought that this oxidation reaction to the placques etc, may be the preventable precursor to dementia seen in Alzheimer’s disease.
As the oxidation continues, it may lead to inflammation in the brain, which in turn worsens the dementia in all clients – not just those with Down Syndrome.
Providing the correct anti-oxidants at the right time, may enable one to prevent Alzheimer’s disease in people with Down syndrome, as well as prevent it in the general population.
The antioxidants may need to be given to the person when still a kid – in otherwords, before they grow up. Particularly so, if the person has Down Syndrome. The oxidation stage can start when a person is very young.
This in turn suggests, that the use of appropriate antioxidants [ which would be a form of TNI – targeted nutrient intervention ] during kidhood may be a worthwhile preventative measure.
Please note the folowing precaution I put together: The antioxidant approach: can be very dangerous if one uses megadoses of antioxidants. Vitamin E, in megadose form, over a long period, can be poisonous. Excessive antioxidant intake also has been found to reduce the uptake of other important vitmains and so can lead to vitmain deficiency, particularly in the B vitamins.
Also, supplementing with Vitamin B12 and folate may help prevent or treat Alzheimer’s Disease.
A meaningless boring life can contribute to dementia and Alzheimer’s disease in those with Down Syndrome
Alzheimer’s disease and dementia may be caused by a meaningless life:
Another important finding, particularly for those who have Down Syndrome, is that people with Down Syndrome, when used in meaningful employment, (as opposed to sheltered workshops, monotonous work etc) tend to avert Alzheimer’s disease for a considerably longer period of time. The same has been found for the general population.
Down Syndrome Alzheimer’s disease in conlusion
Alzheimer’s disease and dementia, as you can probably see, can have many causes, whether you have Down Syndrome or not.
The important thing is that there are some things we appear to be able to do that appears to lessen the risk.
Remember though that you have to do your own searching, talk with doctors and make your own mind up on things.
I report what I find on alzheimer’s disease and dementia, but you may find something quite different.