Lifestyle Composite and Resilience to Alzheimer's Disease Pathology in Down Syndrome

Background: People with Down syndrome (DS) have a high risk for Alzheimer's disease (AD). Identifying resiliency factors for AD is of critical importance to the DS community. Method: Participants were 63 adults with DS. Measures included amyloid-beta PET scans (amyloid age), National Task Group-Early Detection Screen for Dementia (NTG-EDSD), and Down Syndrome Mental Status Examination (DSMSE). Lifestyle composites were created by assessing time spent in leisure, employment, and physical activity across 7 days through informant reports and accelerometry. Results: There was a significant moderation effect of the lifestyle composite on the association between amyloid age and the NTG-EDSD and DSMSE. Participants with a higher lifestyle composite (higher leisure, employment engagement, and physical activity) had fewer dementia symptoms than those with a lower lifestyle composite score of a similar amyloid age. Conclusions: Modifiable lifestyle factors may allow adults with DS to maintain cognitive functioning for longer in the face of AD pathology.