Pape Sarah E, Baksh R Asaad, Startin Carla, Hamburg Sarah, Hithersay Rosalyn, Strydom Andre
Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK.
Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London BR3 3BX, UK.
J Clin Med. 2021 Apr 27;10(9):1882. doi: 10.3390/jcm10091882.
People with Down syndrome are at ultra-high risk of developing Alzheimer'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 syndrome and changes in dementia-related domains of cognition and function. This was to consider whether physical activity may be a protective measure to delay cognitive decline and dementia in Down syndrome.
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 assessment using the Cambridge Examination for Mental Disorders of Older People with Down Syndrome and Others with Intellectual Disabilities (CAMDEX-DS) and genetic analysis. Logistic regression models were used to examine the potential associations between decline in CAMDEX-DS domains and exercise whilst controlling for key variables.
At baseline, engaging in moderate intensity 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 decline in personality and behaviour. Moderate intensity exercise at baseline was associated with a 62% reduction in risk of decline during the follow-up period in memory and orientation.
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 benefits. People with Down syndrome may engage in less physical activity than their peers, and barriers 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.
唐氏综合征患者患阿尔茨海默病性痴呆的风险极高。目前，尚无预防或治疗方法。散发性阿尔茨海默病文献的证据表明，包括体育活动在内的生活方式因素可能有助于维持认知和功能技能，并降低痴呆风险。我们的研究旨在探讨唐氏综合征参与者进行的规律运动与痴呆相关认知和功能领域变化之间的关联。这是为了考虑体育活动是否可能是延缓唐氏综合征认知衰退和痴呆的一种保护措施。
收集了214名无痴呆的成年唐氏综合征患者基线时和两年随访时的人口统计学、生活方式和健康信息，这些患者还接受了使用《剑桥唐氏综合征及其他智障老年人精神障碍检查》（CAMDEX-DS）的评估和基因分析。使用逻辑回归模型来检验在控制关键变量的同时，CAMDEX-DS领域的衰退与运动之间的潜在关联。
在基线时，进行中等强度运动与日常技能衰退风险降低47%相关，进行高强度运动与人格和行为衰退风险降低62%相关。在随访时，高水平运动与人格和行为衰退风险降低87%相关。基线时的中等强度运动与随访期间记忆和定向衰退风险降低62%相关。
根据我们的数据，规律的中等强度和高强度运动似乎可以降低唐氏综合征人群临床可检测到的衰退风险，并可能带来长期益处。唐氏综合征患者的身体活动可能比同龄人少，而且仍然存在阻碍唐氏综合征患者进行运动的障碍。我们的工作强调了支持唐氏综合征患者进行体育活动以及将运动作为健康老龄化计划一部分加以推广的重要性。在这一领域进行临床试验是合理的，以确定进行运动是否能切实改善唐氏综合征患者维持功能和延缓痴呆发病的情况，并有助于制定该领域的指导建议。
