Down Syndrome, Metabolic Syndrome, and Alzheimer’s Disease
Dina Dass, MD1, Lam-Ha Dang1, Laura Xicota Vila, PhD1, Sharon Krinsky-McHale, PhD1, Brad Christian, PhD2, Elizabeth Head, MA, PhD3, Mark Mapstone, PhD3, Benjamin Handen, PhD4, Karen Marder, MD, MPH1, Joseph Lee, DrPH1
1Columbia University Irving Medical Center, 2University of Wisconsin-Madison, 3University of California, Irvine, 4University of Pittsburgh Medical Center
Objective:

This study aims to determine 1) prevalence of metabolic syndrome (MetS) in adults with Down syndrome (DS), 2) whether MetS alters risk of dementia in adults with DS.

Background:

Adults with DS are at higher risk of developing AD due to having a third copy of the APP gene on chromosome 21. MetS is a risk factor for AD in the neurotypical population. MetS in adults with DS is complex in that prevalence of obesity is high, however prevalence of other cardiovascular risk factors such as hypertension is low. As such, the prevalence of MetS in adults with DS has been difficult to estimate accurately.

Design/Methods:

The Alzheimer’s Biomarker Consortium-Down Syndrome (ABC-DS) study was used (N=393) to study adults with DS, and the Health and Aging Brain Study – Health Disparities (HABS-HD) study was used (N=1244) to study the US neurotypical population. MetS was defined as having three out of the four following: body mass index (BMI) ≥30, history of hypertension, history of hyperlipidemia, and history of diabetes (at this time, fasting lab data and waist circumference data are not available, as such, a modified version of the American Heart Association’s definition of MetS was used). Mantel-Haenszel chi squared analyses were performed for stratified testing.

Results:

Obesity was higher in adults with DS, and hypertension, hyperlipidemia, and diabetes were lower. Prevalence of MetS was lower in adults with DS. There was no significant association between MetS and dementia in adults with DS.

Conclusions:

There may be fundamental differences in the pathophysiology of AD in DS compared to the neurotypical population. Further investigation will be required to understand cardiovascular risk factors in adults with DS, and any interaction they may have with risk of dementia.

10.1212/WNL.0000000000204678