Volunteers with Down's syndrome included in Alzheimer's trials

Volunteers with Down’s syndrome may play a key role in finding new treatments for Alzheimer’s disease. Research shows that people with Down's have higher levels of a protein connected to dementia. Dementia rates are expected to rise significantly in the coming decades. A study predicts that the number of Americans developing dementia will increase from 500,000 in 2020 to 1 million by 2060. Although some drugs for Alzheimer’s exist, there is still skepticism about their effectiveness. People with Down’s syndrome are at a much higher risk of developing Alzheimer’s. Studies show that 70-88% of them will have the disease by age 65, compared to just 8-10% in the general population. Most past trials have excluded individuals with Down's, making it hard to know if existing Alzheimer’s treatments are safe or effective for them. The reason for the connection between Down's syndrome and Alzheimer’s is genetic. Those with Down's have an extra chromosome that leads to increased levels of a protein that forms harmful plaques in the brain. Almost all individuals with Down’s have these plaques by age 40 and, by age 55, many show signs of dementia. There is an ongoing search for medications that can clear these plaques. Recent drugs, like lecanemab and donanemab, show some promise but only a small benefit in slowing cognitive decline. Critics suggest that the drugs could be more effective if given earlier, which raises the idea of testing them on individuals with Down’s before Alzheimer’s symptoms appear. A new trial called ALADDIN plans to start soon, investigating donanemab in people with Down’s. Other studies have also begun to include these individuals in Alzheimer’s research. This shift is partly due to advocacy from people with Down’s and their families. While these trials could lead to new treatments, they also come with challenges. Researchers must carefully address the risks of side effects from the drugs in this group. If the trials demonstrate safety and effectiveness, early treatment could offer many with Down’s the chance to live well without Alzheimer’s. Ultimately, these research efforts could benefit a broader population if they improve ways to predict and treat Alzheimer’s before symptoms develop. This ongoing work hopes to clarify the current understanding of Alzheimer’s and lead to breakthroughs in therapy.