Boyle Rory, Koops Elouise A, Ances Beau, Andrews Elizabeth J, Arenaza-Urquijo Eider M, Benjanin Alexandre, Brickman Adam M, Buckley Rachel F, Clas Giulia S, Costello Emmet, Coughlan Gillian T, Conley Alexander C, Deng Feng, de Paula Faria Daniele, Edwards Natalie, Flores-Aguilar Lisi, Fortea Juan, Ghazi Saidi Ladan, Head Elizabeth, Hom Christy L, Koenig Katherine, Lao Patrick, Lengyel Imre, Li Yi-Ju, Loi Samantha, Loughrey David, McGlinchey Eimear, Newhouse Paul, Pertierra Lucía, Prokopiou Prokopis C, Qi Qing, de Paula França Resende Elisa, Russell Jason, Scanlon Catherine E, Schneider Christoph, Schultz Stephanie A, Seto Mabel, Shaka Sophia, Soldan Anja, Vaqué Alcázar Lídia, Weng Yihe, Wilson Jo Ellen, Zaman Shahid H, Zsadányi Sára E, Hartley Sigan
Penn Frontotemporal Degeneration Center, Perelman School of Medicine, Richards Medical Laboratories, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Alzheimers Dement. 2025 Apr;21(4):e70151. doi: 10.1002/alz.70151.
Due to the high prevalence of Alzheimer's disease (AD) in adults with Down syndrome (DS), trisomy 21 is now considered a genetic form of AD (DSAD). A better understanding of factors that can prevent or delay AD is vital to improve outcomes for adults with DS. In this narrative review, we apply AD and cognitive aging research frameworks to study resistance and resilience in DSAD. Given the variability in the timing of pathology and symptoms, we discuss the evidence supporting the role of genetic, biological, socio-behavioral, lifestyle, and environmental factors in resistance and resilience to DSAD. We also consider how co-occurring health conditions in DS may influence resistance and resilience, and how methods from AD research can be applied to DSAD. Ultimately, this framework aims to guide future research and translate findings into clinical interventions to improve outcomes in DSAD. Highlights Definitions of resistance and resilience in the genetic form of Alzheimer's disease (DSAD) are proposed for guiding the field. Variability in the timing of AD pathology and symptoms suggests the potential for resistance and resilience mechanisms in DSAD. Genetic, biological, socio-behavioral, lifestyle, and environmental factors have the potential to build resistance or resilience in DSAD. Future research will require longitudinal and experimental designs, life course approaches, and large cohort studies.
由于唐氏综合征（DS）成人中阿尔茨海默病（AD）的高患病率，21三体现在被认为是AD的一种遗传形式（DSAD）。更好地理解可以预防或延缓AD的因素对于改善DS成人的预后至关重要。在这篇叙述性综述中，我们应用AD和认知衰老研究框架来研究DSAD中的抵抗力和复原力。鉴于病理和症状出现时间的变异性，我们讨论了支持遗传、生物学、社会行为、生活方式和环境因素在DSAD抵抗力和复原力中作用的证据。我们还考虑了DS中共存的健康状况如何影响抵抗力和复原力，以及AD研究中的方法如何应用于DSAD。最终，这个框架旨在指导未来的研究，并将研究结果转化为临床干预措施，以改善DSAD的预后。要点 提出了唐氏综合征型阿尔茨海默病（DSAD）中抵抗力和复原力的定义，以指导该领域的研究。AD病理和症状出现时间的变异性表明DSAD中存在抵抗力和复原力机制的潜力。遗传、生物学、社会行为、生活方式和环境因素有可能在DSAD中建立抵抗力或复原力。未来的研究将需要纵向和实验设计、生命历程方法以及大型队列研究。
