If you have a loved one with Down Syndrome in your family, it's normal to have various questions, and perhaps even a little fear, about their health as they get older. In particular, you've probably heard the name "Alzheimer's Disease" a lot. You've probably wondered a lot about whether there's really a connection between these two diseases. Of course, there is. But before you get scared, let's talk about it clearly, simply, and simply.
Why are people with Down syndrome said to be at higher risk of Alzheimer's?
To understand this, we need to go back to the most basic part of our bodies. Those are our chromosomes . Simply put, these chromosomes are like the 'instructions' in every cell in our body. Everything from our hair color to our height is determined by the genes that these chromosomes contain. Normally, a person has two copies of each type of chromosome.
However, a person with Down syndrome has an extra copy of chromosome 21, that is, three copies . This is how it is related to Alzheimer's disease: The gene that instructs the production of a harmful protein (beta-amyloid) that is deposited in the brain when Alzheimer's disease develops is located on this same chromosome 21.
So, because there is an extra copy of chromosome 21, a person with Down syndrome produces more of this harmful protein in their brain. Over time, these proteins accumulate and deposit around brain cells, damaging those cells and starting to destroy them. This is what happens in Alzheimer's disease.
In addition, the bodies and brains of people with Down syndrome age more quickly than the average person (premature aging) . That is, the body of a 45-year-old person with Down syndrome may be similar to the body of a 65- or 70-year-old person in the general population. This rapid aging is also a major cause of early onset of Alzheimer's disease.
How do the symptoms appear? Are they different from typical Alzheimer's symptoms?
Yes, this is a very important point. The symptoms of Alzheimer's disease in someone with Down syndrome may be slightly different from the symptoms of a normal person. That's why it can sometimes be difficult to recognize this condition.
When we think of Alzheimer's, we usually think of memory loss. But for someone with Down syndrome, memory loss may not be the first symptom . Other changes may be noticed first.
Let's see what those changes are in the table below.
| Symptom | What it looks like in a person with Down syndrome |
|---|---|
| Daily work | Things that you used to be able to do on your own, such as getting dressed, eating, bathing, and making tea, require help. The interest and ability to do those things gradually diminishes. |
| Behavioral changes | Suddenly, they become stubborn, behave in a way that is unreasonable, become agitated, or start to stand aside silently, without any interest in the other side of it, without talking. |
| New Onset Seizures | This is a very important symptom. If someone who has never had seizures in their life starts having new seizures after the age of 40, it could be a sign of Alzheimer's disease. |
| Memory and thinking ability | Although memory loss may not be noticeable at first, it can occur over time. It becomes difficult to remember new things. The ability to choose right from wrong and make decisions decreases. |
| Difficulty speaking | You may start to speak less, have difficulty finding words, or slur your words. |
The most important thing is to see a change from your child's or family member's normal behavior (baseline) . Because they have some learning disabilities from birth, it can be difficult to recognize changes in memory. But if you feel, "This person wasn't like this before, and now they're different," that's the most important thing.
At what age does the risk increase?
Alzheimer's disease usually develops in the general population after the age of 65. However, for someone with Down syndrome, this risk occurs much earlier.
- Studies have found that by the age of 35 , about 25% (one in four) of people with Down syndrome may show symptoms of Alzheimer's.
- For many people, symptoms begin to become apparent in their mid-40s or early 50s.
- Overall, the likelihood of someone with Down syndrome developing Alzheimer's disease is three to five times higher than the general population.
What should I do as a guardian?
This information may scare you. But don't panic. Awareness is the best weapon. There are some very important things you can do.
1. Regular medical checkups: It is essential to take your child or family member to a doctor regularly. Especially after the age of 30, talk openly with your doctor about the risk of Alzheimer's.
2. Baseline Assessment: In your 30s, work with your doctor to assess your child's memory, daily functioning, and behavior. This will help you identify any changes in the future.
3. Be on the lookout for changes: You know him best. So, even the smallest changes you notice, write them down in a book with the date and time. Make notes like, "He couldn't put his shoes on by himself today," "He's been very upset since last week." This will be very helpful to the doctor.
4. Seek immediate medical attention: If you experience one or more of the symptoms listed above, don't wait until later to see your doctor . While Alzheimer's disease cannot be cured completely, there are a variety of treatments and strategies that can help manage symptoms, improve quality of life, and provide relief for both you and the patient.
Take-Home Message
- People with Down syndrome have a much higher genetic risk of developing Alzheimer's disease than the general population.
- Symptoms usually begin in the 40s or early 50s, much earlier than in the general population.
- Rather than memory loss, the first symptoms may include changes in behavior, inability to perform daily tasks, or new seizures.
- If you notice any obvious changes in your loved one's behavior, abilities, or daily habits, be sure to talk to your doctor about it.
- Early detection and proper medical management can improve the patient's quality of life and provide relief to you as a caregiver.
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