Washington Selena E, Cler Emily, Lowery Cameron, Stark Susan L
Department of Occupational Science and Occupational Therapy Saint Louis University St. Louis USA.
Department of Biology Harris Stowe State University St. Louis USA.
Alzheimers Dement (N Y). 2023 May 22;9(2):e12393. doi: 10.1002/trc2.12393. eCollection 2023 Apr-Jun.
Alzheimer's disease (AD) occurs in aging adults with Down syndrome (DS) at a higher prevalence and an earlier age than in typical aging adults. As with the general aging adult population, there is an urgent need to understand the preclinical and early phases of AD progression in the adult population with DS. The aim of this scoping review was to synthesize the current state of the evidence and identify gaps in the literature regarding functional activity performance and falls and their significance to disease staging (i.e., mild, moderate, and severe defined staging criteria) in relation to Alzheimer's disease and related dementias (ADRD) in adults with DS.
This scoping review included six electronic databases (e.g., PsycInfo, Academic Search Complete, CINAHL, COCHRANE Library, MEDLINE, and PubMed). Eligible studies included participants with DS ≥25 years of age, studies with functional measures and/or outcomes (e.g., activities of daily living, balance, gait, motor control, speech, behavior, and cognition; falls; and fall risks), and studies that investigated AD pathology and implications.
Fourteen eligible studies were included and categorized through a thematic analysis into the following themes: (1) physical activity and motor coordination (PAMC), (2) cognition, (3) behavior, and (4) sleep. The studies indicated how functional activity performance and engagement may contribute to early identification of those at risk of cognitive decline and AD development and/or progression.
There is a need to expand the research regarding ADRD pathology relative to functional outcomes in adults with DS. Functional measures related to disease staging and cognitive impairment are essential to understanding how AD progression is characterized within real-world settings. This scoping review identified the need for additional mixed-methods research to examine the use of assessment and intervention related to function and its detection of cognitive decline and AD progression.
与典型的老年成年人相比，患有唐氏综合征（DS）的老年人患阿尔茨海默病（AD）的患病率更高且发病年龄更早。与一般老年人群一样，迫切需要了解患有DS的成年人群中AD进展的临床前和早期阶段。本范围综述的目的是综合现有证据状况，确定文献中关于功能活动表现和跌倒及其与DS成年患者阿尔茨海默病及相关痴呆（ADRD）疾病分期（即轻度、中度和重度定义的分期标准）的相关性方面的差距。
本范围综述纳入了六个电子数据库（如PsycInfo、学术搜索完整版、护理学与健康领域数据库、考克兰图书馆、医学索引数据库和PubMed）。符合条件的研究包括年龄≥25岁的DS参与者、具有功能测量和/或结果（如日常生活活动、平衡、步态、运动控制、言语、行为和认知；跌倒；以及跌倒风险）的研究，以及调查AD病理学及其影响的研究。
纳入了14项符合条件的研究，并通过主题分析将其分为以下主题：（1）身体活动与运动协调（PAMC），（2）认知，（3）行为，以及（4）睡眠。这些研究表明功能活动表现和参与度如何有助于早期识别有认知能力下降和AD发展及/或进展风险的人群。
有必要扩大关于DS成年患者ADRD病理学与功能结果相关性的研究。与疾病分期和认知障碍相关的功能测量对于理解AD在现实环境中的进展特征至关重要。本范围综述确定需要更多的混合方法研究来检验与功能相关的评估和干预的使用及其对认知能力下降和AD进展的检测。
