Treating dementia in Down syndrome

A new study from researchers at King's College London and UCL has confirmed that people with Down syndrome who develop dementia can benefit from commonly used Alzheimer’s drugs, despite having often being excluded from drug trials.

The work, led by Professor André Strydom, Professor of Intellectual Disabilities at the Institute of Psychiatry, Psychology & Neuroscience, was recently published in the British Journal of Psychiatry and is the largest investigation into the clinical effect of drugs used to treat dementia in people with Down syndrome.

Down syndrome is one of the most common genetic causes of intellectual disability and there are around 60,000 people in the UK with the condition. People with Down syndrome are at much higher risk of developing early-onset Alzheimer’s dementia, a degenerative condition which affects independence and quality of life, and incurs high costs for health and social care services.

Although there is no cure for Alzheimer’s dementia, drugs such as donepezil have been shown to effectively alleviate symptoms and slow disease progression. But people with Down syndrome have often been excluded from drug trials and therefore clinicians and patients have little information to guide treatment decisions. 

The researchers found that people with Down syndrome who had been prescribed anti-dementia drugs after a diagnosis tended to live longer and demonstrated a slower rate of decline than people who did not take the drugs.

Analysing data on more than 1,000 people with Down syndrome, the study showed that people who were treated with anti-dementia drugs lived on average 5.59 years after diagnosis, whereas those who were not given drug treatment lived for an average of 3.45 years.

The researchers also observed a positive effect on maintaining cognitive function, including memory and orientation, in people who were prescribed the drugs.

In addition, the data revealed significant regional differences in the proportions of people with Down syndrome who receive anti-dementia drugs.

Professor Strydom said:

‘Our results are good news for individuals with Down syndrome and their caregivers, but it also suggests that having Down syndrome should not be a barrier to treatment with drugs for dementia. More needs to be done to ensure all individuals with Down syndrome who have dementia are considered for treatment.’ 

Notes to editors 

Paper reference:

‘Impact of cholinesterase inhibitors or memantine on survival in adults with Down syndrome and dementia: clinical cohort study’ by Eady et al., British Journal of Psychiatry, DOI: 10.1192/bjp.2017.21

To contact the authors, or for further media information, please contact: Robin Bisson, Senior Press Officer, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, robin.bisson@kcl.ac.uk / +44 20 7848 5377 / +44 7718 697176.