Washington Selena E, Bodde Amy E, Helsel Brian C, Bollinger Rebecca M, Smith Nora, Ptomey Lauren T, Ances Beau, Stark Susan L
Department of Occupational Science and Occupational Therapy Saint Louis University St. Louis Missouri USA.
Department of Internal Medicine University of Kansas Medical Center Kansas City Kansas USA.
Alzheimers Dement (N Y). 2024 Oct 10;10(4):e70007. doi: 10.1002/trc2.70007. eCollection 2024 Oct-Dec.
Adults with Down syndrome (DS) have an increased risk of Alzheimer's disease (AD) dementia, often showing neuropathological indicators by age 40. Physical function and activities of daily living (ADLs) are understudied areas of function that may inform dementia risk. We investigated associations among age, physical function (gait/balance, grip strength, and lower extremity strength), ADLs, and dementia risk symptoms in adults with DS. We hypothesized that compromised physical function and lower independence with ADLs would be associated with an informant/caregiver-reported measure of dementia risk symptoms.
A secondary analysis for this cross-sectional study was completed using data from two academic research centers with 43 adults with DS (age 30 ± 12 years). We examined the association of dementia risk symptoms, captured through the Dementia Screening Questionnaire for Individuals with Intellectual Disabilities (DSQIID), with physical function (timed up and go [TUG], sit-to-stand [STS], grip strength) and ADLs (Waisman Activities of Daily Living Scale). A linear regression model for the continuous dementia risk measure in the DSQIID used a log transformation of (1 + log(Y + 1)) to account for a high zero count. Wilcoxon rank-sum tests were used to assess differences in the physical function measures, DSQIID questionnaire, and Waisman ADL by dividing mean age categories.
Higher DSQIID scores were associated with lower independence with ADLs ( = -0.103, = 0.008), slower gait times (TUG; = 0.112, = 0.034), and impaired lower extremity strength (STS; = 0.112, = 0.017) and grip strength ( = -0.039, = 0.034). DSQIID scores differed significantly between the ≥30 and <30 age groups. Participants ≥30 years of age scored 5 points higher on the DSQIID than participants <30, suggesting that age was associated with greater dementia risk.
Greater dementia risk symptoms were associated with age, lower physical function scores, and independence with ADLs, suggesting that declines in physical function and ADLs may be early indicators of subsequent dementia risk in adults with DS.
We explored the association of physical function and activities of daily living (ADLs) in aging adults with DS and their relationship with informant/caregiver report of dementia risk symptoms.Our findings demonstrated a significant relationship between a higher number of dementia risk symptoms observed and lower independence with ADLs, and impaired gait/balance, grip strength, and lower extremity strength.Further research with larger longitudinal studies is necessary to investigate any causative relationships among physical function, ADL function, and dementia risk symptoms.
成年唐氏综合征（DS）患者患阿尔茨海默病（AD）痴呆症的风险增加，通常在40岁时就会出现神经病理学指标。身体功能和日常生活活动（ADL）是功能研究较少的领域，可能为痴呆风险提供信息。我们调查了DS成年患者的年龄、身体功能（步态/平衡、握力和下肢力量）、ADL与痴呆风险症状之间的关联。我们假设身体功能受损和ADL独立性降低与信息提供者/照顾者报告的痴呆风险症状测量值相关。
对这项横断面研究进行二次分析，使用来自两个学术研究中心的43名DS成年患者（年龄30±12岁）的数据。我们通过智力残疾个体痴呆筛查问卷（DSQIID）来研究痴呆风险症状与身体功能（计时起立行走测试[TUG]、坐立测试[STS]、握力）和ADL（韦斯曼日常生活活动量表）之间的关联。DSQIID中连续痴呆风险测量的线性回归模型使用(1 + log(Y + 1))的对数变换来处理大量零计数的情况。通过划分平均年龄类别，使用Wilcoxon秩和检验来评估身体功能测量、DSQIID问卷和韦斯曼ADL的差异。
DSQIID得分越高，与ADL独立性越低（β = -0.103，P = 0.008）、步态时间越慢（TUG；β = 0.112，P = 0.034）以及下肢力量受损（STS；β = 0.112，P = 0.017）和握力受损（β = -0.039，P = 0.034）相关。DSQIID得分在≥30岁和<30岁年龄组之间存在显著差异。年龄≥30岁的参与者在DSQIID上的得分比<30岁的参与者高5分，表明年龄与更高的痴呆风险相关。
更大的痴呆风险症状与年龄、更低的身体功能得分以及ADL独立性相关，这表明身体功能和ADL的下降可能是DS成年患者随后痴呆风险的早期指标。
我们探讨了DS老年患者的身体功能和日常生活活动（ADL）及其与信息提供者/照顾者报告的痴呆风险症状之间的关联。我们的研究结果表明，观察到的痴呆风险症状数量越多与ADL独立性越低、步态/平衡受损、握力和下肢力量受损之间存在显著关系。需要进行更大规模的纵向研究以进一步调查身体功能、ADL功能和痴呆风险症状之间的任何因果关系。
