Do old patients with Down’s syndrome develop premature brain atrophy?

Summary

Evaluation of the clinical course and of CT examinations of 20 patients with Down’s syndrome over 40 years of age showed a secondary clinical deterioration in cerebral performance in 5 patients, with significant cerebral atrophy in CT in 4 of them. In the others, the only significant difference to a control group of 40 patients of the same age were age-dependent atrophic changes of the temporal lobes. These findings which are similar to the early stage of Alzheimer’s disease support the idea of a common genetic defect of both conditions

A common genetic defect is discussed in trisomy 21 and Alzheimer’s disease because of similar degenerative changes on post-mortem brain examinations and a reduced activity of the neurotransmitter system. But not every patient with Down’s syndrome (DS) becomes demented and CT studies were not able to show significant or increasing cerebral atrophy up to the age of 40 (Ieshima et al., 1984). In the present study, the degree of cerebral atrophy in DS of older age is correlated to the clinical course.