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Aging in Down Syndrome and the Development of Alzheimer's Disease Neuropathology
Open accessAbstract
Chromosome 21, triplicated in Down Syndrome, contains several genes that are thought to play a critical role in the development of AD neuropathology. The overexpression of the gene for the amyloid precursor protein (APP), on chromosome 21, leads to early onset beta-amyloid (Aβ) plaques in DS. In addition to Aβ accumulation, middle-aged people with DS develop neurofibrillary tangles, cerebrovascular pathology, white matter pathology, oxidative damage, neuroinflammation and neuron loss. There is also evidence of potential compensatory responses in DS that benefit the brain and delay the onset of dementia after there is sufficient neuropathology for a diagnosis of AD. This review describes some of the existing literature and also highlights gaps in our knowledge regarding AD neuropathology in DS. It will be critical in the future to develop networked brain banks with standardized collection procedures to fully characterize the regional and temporal pathological events associated with aging in DS. As more information is acquired regarding AD evolution in DS, there will be opportunities to develop interventions that are age-appropriate to delay AD in DS.
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“There is substantial evidence of neuropathology from early in life in DS,6,9,10,21 including defects in neuronal development, an increased ratio of inhibitory to excitatory neurons, alterations in neuronal dendritic spines dynamics, activation of microglia, astrocyte reactivity, and elevated production of inflammatory cytokines in the brain.22,23,24,25”
From Interferon signaling modulates Down syndrome-associated Alzheimer’s disease pathology in a mouse model (2025) · cites this paper as [6]
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“Individuals with Down syndrome (DS), caused by trisomy of chromosome 21 (chr21, T21), are strongly predisposed to Alzheimer’s disease (AD), due to triplication of the APP gene, with ∼100% penetrance of AD brain pathology by age 40 and variable onset of dementia thereafter.”
From Interferon signaling modulates Down syndrome-associated Alzheimer’s disease pathology in a mouse model (2025) · cites this paper as [6]
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McDonough, S. R., Rao, A. K., McAleer, J. M., Babrowicz, B. M., & Sharma, M. (2026) · Molecular Neurodegeneration Advances · doi:10.1186/s44477-026-00041-0
Metadata
- Authors
- Head, E., T. Lott, I., M. Wilcock, D., & A. Lemere, C.
- Affiliations
- University of Kentucky (US)
- ORCID
- Head, Elizabeth
- Venue
- Current Alzheimer Research
- Publisher
- Bentham Science Publishers Ltd.
- Published
- 2015-12-07
- Volume
- 13
- Issue
- 1
- Pages
- 18-29
- ISSN
- 1567-2050 (ISSN-L)
- PMC
- PMC4948181
- OpenAlex
- W2190781699
- Cited by
- 289
- References
- 160
- Citations by year
- 2026: 13 · 2025: 30 · 2024: 23 · 2023: 14 · 2022: 18 · 2021: 34 · 2020: 29 · 2019: 29 · 2018: 55 · 2017: 32 · 2016: 10 · 2015: 1
- FWCI
- 35.03
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Current Alzheimer Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Funders
- National Institutes of Health
- National Institute on Aging (R01AG040092, P50AG016573, R01AG16573)
- National Institute of Neurological Disorders and Stroke (NS079637, R01NS079637, R01NS136122)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD065160, R01HD064993)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- Down syndrome, Alzheimer's disease, Alzheimer's disease pathology, aging, chromosome 21, amyloid precursor protein, amyloid plaques, neurofibrillary tangles, cerebrovascular pathology, white matter pathology, oxidative damage, neuroinflammation, neuronal loss, dementia onset, brain banks
- MeSH terms
- Neuropathology, Age Factors, Aging, Alzheimer Disease, Animals, Down Syndrome, Humans, Amyloid beta-Protein Precursor, Neurofibrillary Tangles, tau Proteins
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