Barry Ashlyn, Peven Jamie C, Handen Benjamin L, Bolt Daniel, Krinsky-McHale Sharon J, Hom Christy L, Clare Isabel C H, Glueck Amanda, Harp Jordan, Schmitt Frederick, Zammit Matthew, Minhas Davneet, Luo Weiquan, Laymon Charles, Price Julie, Lee Joseph H, Lott Ira, Cohen Annie, Ances Beau M, Pulsifer Margaret, Rosa H Diana, Lai Florencia, Zaman Shahid H, Head Elizabeth, Mapstone Mark, Christian Bradley T, Hartley Sigan L
Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Behavioral Health Service Line, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Alzheimers Dement. 2025 Apr;21(4):e70211. doi: 10.1002/alz.70211.
Gait abnormalities are associated with Alzheimer's disease (AD) in the general population, but it is unclear if the same is true for individuals with Down syndrome (DS). This study examined gait across 32 months in relation to neuroimaging biomarkers (amyloid beta [Aβ], neurofibrillary tangles [NFTs], and hippocampal volume), cognitive decline, and clinical AD status in adults with DS.
Participants were 218 adults with DS who underwent Aβ and NFT positron emission tomography (PET) and magnetic resonance imaging (MRI) scans, cognitive testing, and gait assessments at baseline and 32 months. Residual change regression models were conducted.
Higher baseline Aβ PET and NFT PET and lower MRI hippocampal volume were associated with gait declines across 32 months. Cognitive declines were associated with gait declines. Participants with clinical dementia at 32 months had greater gait decline than those who were cognitively stable.
Gait impairments are a key feature of DS-associated AD (DSAD). Gait assessments could offer a quick, cost-effective, non-invasive screen for DSAD.
Those with clinical status of dementia had lower gait performance than those who were cognitively stable. Higher baseline amyloid beta and neurofibrillary tangle volume was associated with more gait impairments. Lower baseline hippocampal volume was associated with more gait impairments. Greater decline in gait performance was associated with cognitive decline. Greater decline in gait performance was associated with more dementia symptoms.
在普通人群中，步态异常与阿尔茨海默病（AD）相关，但对于唐氏综合征（DS）患者是否同样如此尚不清楚。本研究调查了DS成年患者在32个月内的步态，以及其与神经影像生物标志物（淀粉样β蛋白[Aβ]、神经纤维缠结[NFTs]和海马体积）、认知衰退和临床AD状态之间的关系。
218名患有DS的成年人参与了研究，他们在基线期和32个月时接受了Aβ和NFT正电子发射断层扫描（PET）、磁共振成像（MRI）扫描、认知测试以及步态评估。采用了残差变化回归模型。
较高的基线Aβ PET和NFT PET以及较低的MRI海马体积与32个月内的步态衰退相关。认知衰退与步态衰退相关。32个月时患有临床痴呆症的参与者比认知稳定的参与者步态衰退更严重。
步态障碍是唐氏综合征相关AD（DSAD）的一个关键特征。步态评估可为DSAD提供一种快速、经济高效且无创的筛查方法。
患有痴呆症临床状态的人的步态表现低于认知稳定的人。较高的基线淀粉样β蛋白和神经纤维缠结体积与更多的步态障碍相关。较低的基线海马体积与更多的步态障碍相关。步态表现的更大衰退与认知衰退相关。步态表现的更大衰退与更多的痴呆症状相关。
