More than half of older adults with Down syndrome have dementia

  • JAMA Neurol

  • de Susan London
  • Clinical Essentials
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Takeaway

  • Roughly a fifth of patients with Down syndrome aged 40-54 years and more than half of those aged 55 years and older had dementia claims.

Why this matters

  • Findings have implications for identifying prodromal presentations and planning dementia services and supports for adults.

Key results

  • Among patients aged 40-54 years:
    • 18.8% had a dementia claim.
    • Dementia incidence was 49 cases per 1000 person-years.
  • Among patients aged ≥55 years:
    • 52.2% had a dementia claim.
    • 32.7% had an Alzheimer’s disease claim.
    • Dementia incidence was 102 cases per 1000 person-years.
  • Probability of an incident dementia claim over 11 years:
    • 40% for patients aged 40-54 years at baseline.
    • 67% for patients aged ≥55 years at baseline.
  • Prevalence of dementia:
    • Similar for men and women aged
    • Higher for women vs men aged 40-54 years (prevalence ratio, 1.23).
    • Similar for men and women aged ≥55 years.

Study design

  • Retrospective cohort study of 2968 adults aged ≥21 years with Down syndrome in Wisconsin covered by Medicaid during 2008-2018.
  • Main outcome: dementia (ascertained from claims).
  • Funding: National Institute of Child Health and Human Development; National Center for Advancing Translational Sciences; Agency for Health Care Research and Quality.

Limitations

  • Reliance on claims data.
  • Unknown generalizability.