The Association between Physical Activity and CAMDEX-DS Changes Prior to the Onset of Alzheimer’s Disease in Down Syndrome

TY - JOUR

T1 - The Association between Physical Activity and CAMDEX-DS Changes Prior to the Onset of Alzheimer’s Disease in Down Syndrome

AU - Pape, Sarah E.

AU - Baksh, R. Asaad

AU - Startin, Carla

AU - Hamburg, Sarah

AU - Hithersay, Rosalyn

AU - Strydom, Andre

PY - 2021/4/27

Y1 - 2021/4/27

N2 - Abstract: Background: People with Down syndrome are at ultra-high risk of developing Alz-heimer’s dementia. At present, there are no preventative or curative treatments. Evidence from sporadic Alzheimer’s disease literature suggests that lifestyle factors including physical activity may help maintain cognitive and functional skills and reduce dementia risk. Our study aimed to explore the association between regular exercise undertaken by participants with Down syn-drome and changes in dementia-related domains of cognition and function. This was to consider whether physical activity may be a protective measure to delay the cognitive decline and demen-tia in Down syndrome. Methods: Demographic, lifestyle, and health information was collected at baseline and at a two year follow up from 214 adults with Down syndrome without dementia, who also underwent the CAMDEX-DS assessment and genetic analysis. Logistic regression mod-els were used to examine the potential associations between decline in CAMDEX-DS domains and exercise whilst controlling for key variables. Results: At baseline, engaging in moderate in-tensity exercise was associated with a 47% reduced risk of everyday skills decline and engaging in high intensity exercise was associated with a 62% reduced risk of decline in personality and behaviour. At follow-up, high levels of exercise were associated with an 87% reduced risk of de-cline in personality and behaviour. Moderate intensity exercise at T1 was associated with a 62% reduction in risk of decline during the follow-up period in memory and orientation. Discussion: Based on our data it appears that regular moderate and high intensity exercise could reduce the risk of clinically detectable decline in a Down syndrome population with possible long-term ben-efits. People with Down syndrome may engage in less physical activity than their peers, and bar-riers remain, which can prevent people with Down syndrome engaging in exercise. Our work highlights how important it is that people with Down syndrome are supported to be physically active, and to promote exercise as part of a healthy ageing plan. Clinical trials in this area would be justified to determine if engaging in exercise can lead to realistic improvements in maintaining functioning and delaying dementia onset in Down syndrome and to help develop guidance in this area.

AB - Abstract: Background: People with Down syndrome are at ultra-high risk of developing Alz-heimer’s dementia. At present, there are no preventative or curative treatments. Evidence from sporadic Alzheimer’s disease literature suggests that lifestyle factors including physical activity may help maintain cognitive and functional skills and reduce dementia risk. Our study aimed to explore the association between regular exercise undertaken by participants with Down syn-drome and changes in dementia-related domains of cognition and function. This was to consider whether physical activity may be a protective measure to delay the cognitive decline and demen-tia in Down syndrome. Methods: Demographic, lifestyle, and health information was collected at baseline and at a two year follow up from 214 adults with Down syndrome without dementia, who also underwent the CAMDEX-DS assessment and genetic analysis. Logistic regression mod-els were used to examine the potential associations between decline in CAMDEX-DS domains and exercise whilst controlling for key variables. Results: At baseline, engaging in moderate in-tensity exercise was associated with a 47% reduced risk of everyday skills decline and engaging in high intensity exercise was associated with a 62% reduced risk of decline in personality and behaviour. At follow-up, high levels of exercise were associated with an 87% reduced risk of de-cline in personality and behaviour. Moderate intensity exercise at T1 was associated with a 62% reduction in risk of decline during the follow-up period in memory and orientation. Discussion: Based on our data it appears that regular moderate and high intensity exercise could reduce the risk of clinically detectable decline in a Down syndrome population with possible long-term ben-efits. People with Down syndrome may engage in less physical activity than their peers, and bar-riers remain, which can prevent people with Down syndrome engaging in exercise. Our work highlights how important it is that people with Down syndrome are supported to be physically active, and to promote exercise as part of a healthy ageing plan. Clinical trials in this area would be justified to determine if engaging in exercise can lead to realistic improvements in maintaining functioning and delaying dementia onset in Down syndrome and to help develop guidance in this area.

KW - dementia

KW - Down syndrome

KW - exercise

KW - modifiable risk factors

KW - cognitive decline

KW - Alzheimer&#8217

KW - s disease

KW - physical activity

U2 - 10.3390/jcm10091882

DO - 10.3390/jcm10091882

M3 - Article

SN - 2077-0383

VL - 10

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

IS - 9

ER -