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Cognitive impairment in adults with Down's syndrome

Similarities to early cognitive changes in Alzheimer's disease

Departments of Neurosciences (Drs. Brugge, Nichols, Salmon, Hill, and Trauner, and L. Aaron) and Psychiatry (Dr. Delis), University of California, San Diego, School of Medicine, La Jolla, CA.

Postmortem studies of brains from adults with Down's syndrome (DS) reveal a dramatic age-dependent increase in the incidence of neuropathology associated with Alzheimer's disease (AD). By the age of 40 years, virtually all DS individuals have AD neuropathology. Documentation of cognitive correlates of this phenomenon has been difficult, partly because of the preexisting mental retardation in DS. In the current study, we compared a group of adults with DS, 22 to 51 years old, with a matched control group on various behavioral measures such as savings scores, which are known to be sensitive in detecting early dementia in AD patients. By using the short delayed savings score from the California Verbal Learning Test (a test of verbal memory), a subgroup of DS adults was identified as memory-impaired. This group demonstrated a decline in performance on various other cognitive tests with advancing age, whereas another group identified as having non-memory-impaired DS, and the non-DS controls, showed no evidence of decline with age. These results provide evidence for the presence of early dementia among adults with DS within an age range in which neuropathologic manifestations of AD are predicted to be developing.

Address correspondence and reprint requests to Dr. Karen Brugge, Department of Psychiatry, Box 1007, New England Medical Center, 750 Washington Street, Boston, MA 02111.

Supported by NIA Physician Scientist Award AG00353-05; by the NINDS Multidisciplinary Research Center for the Study of the Neurological Basis of Language, Learning and Behavior Disorders in Children (NS 22343); and in part by the General Clinical Research Center Grant M01 RR00827.

Received May 22, 1993. Accepted for publication in final form July 28, 1993.

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