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BackgroundThe Down syndrome population has been disproportionately affected by Coronavirus 2019 (COVID-19) in terms of experiencing severe illness and death. Societal efforts to curb the spread of COVID-19 may also have taken a heavy toll on the daily lives of individuals with Down syndrome.Objective/hypothesisThe goal of the study was to understand how the COVID-19 pandemic has altered daily life (including residence, employment, and participation in adult disability day programs) and influenced the mood and behavior of adults with Down syndrome.MethodsBetween September 2020 and February 2021, caregivers of 171 adults with Down syndrome (aged 22-66 years) located across the United States and in the United Kingdom enrolled in the Alzheimer's Biomarker Research Consortium on Down Syndrome (ABC-DS) completed a survey.ResultsThe residence of 17% of individuals was altered, and 89% of those who had been employed stopped working during the pandemic. One-third (33%) of individuals were reported to be more irritable or easily angered, 52% were reported to be more anxious, and 41% were reported to be more sad/depressed/unhappy relative to prepandemic. The majority of changes in mood and behavior were of modest severity.ConclusionsThe COVID-19 pandemic has had widespread effects on the daily life and mood and behavior of adults with Down syndrome. In the short term, caregivers and providers should be prepared to help adults with Down syndrome with changes in daily routines, residence, employment, or adult disability day programs as society shifts away from COVID-19 safety protocols.

Autistic youth are at risk for internalizing mental health problems such as depression and anxiety. Similarly, parents of autistic youth report higher levels of depression than parents of typically developing children. The goal of this study was to examine bidirectional associations between parent depression symptoms and the internalizing problems of autistic youth in 188 families across four time points (T1-T4; spaced 12 months apart). A cross-lagged panel model revealed that mother (T1 and T2) and father (T1) depression symptoms positively predicted the youth's internalizing problems 12 months later. The youth's internalizing problems at T3 positively predicted maternal depression symptoms at T4. Future research should explore genetic and environmental pathways that link parent depression and internalizing problems in autistic youth., Author(s): Brianna Piro-Gambetti [sup.1] [sup.2] [sup.4] , Jessica Greenlee [sup.1] [sup.3] , Emily J. Hickey [sup.1] , Jennifer M. Putney [sup.1] [sup.2] , Emily Lorang [sup.1] , Sigan L. Hartley [...]

Adults with Down syndrome (DS) experience high risk for Alzheimer's disease (AD), but there is variability in the timing of transition from a cognitively stable state to prodromal AD and dementia. The present study examined the association between a modifiable lifestyle factor, employment complexity, and cognitive decline across two time points in adults with DS. Employment complexity, defined as the degree of problem-solving or critical thinking required for employment activities, was operationalized using the Dictionary of Occupational Titles, a system which classifies occupations based on three categories: Data, People, and Things. Eighty-seven adults with DS (M = 36.28 years, SD = 6.90 years) were included in analyses. Partial correlations revealed that lower employment complexity involving People and Things were associated with increased dementia symptoms. Lower employment complexity involving Things was also associated with memory decline. These findings have implications for vocational programs focused on job training and placement for adults with DS. [ABSTRACT FROM AUTHOR]

Introduction: Within two-parent households, the parent-couple subsystem (marital or romantic partner relationship) is posited to shape the mental health of both parents and children. Autistic children and their parents have an elevated-risk for mental health problems. The present study longitudinally examined the mediating role of the quality of the parent-couple relationship in time-ordered pathways between changes in the mental health problems of autistic children and in parent depression symptoms at a within-family level. Methodology: Using four time points of data collected on 188 families of autistic children (aged 5-12 years) across 3 years, the bidirectional associations between parent-couple relationship satisfaction, parent depressive symptoms, and child internalizing and externalizing mental health problems were investigated. Two multi-group (grouped by parent gender) complete longitudinal mediation models in structural equation modeling using Mplus software were conducted. Results: Parent-couple relationship satisfaction mediated: (1) the association between higher parent depressive symptoms and higher child internalizing mental health problems 12 months later for both mothers and fathers, and (2) the association between higher child externalizing mental health problems and higher father depression symptoms 12 months later. Father depression symptoms mediated a pathway from lower parent-couple satisfaction to higher child internalizing mental health problems 12 months later, and mother depression symptoms mediated the pathway from higher child externalizing mental health problems to lower parent-couple satisfaction 12 months later. Conclusion: Findings highlight the bidirectional and complex ways that parent and child mental health and the quality of the parent-couple relationship are entwined across time in families of autistic children. Family-wide interventions that address the needs of multiple family members and family systems are best suited to improve the mental health of parents and autistic children. [ABSTRACT FROM AUTHOR]

Families of youth with autism spectrum disorder (ASD) are vulnerable to maladaptive psychosocial experiences, including elevated youth emotional and behavioral problems (EBPs) and poor parent couple relationship outcomes. Yet, the extent to which these family psychosocial experiences are intertwined has been given little research attention. The present study longitudinally investigated the bidirectional associations between parent couple conflict (PCC) and youth EBPs in 188 families of children and adolescents with ASD (initially aged 5 to 12 years) across four time points (T1, T2, T3, T4), each spaced 12 months apart. Mother- and father-report of youth EBPs and PCC were entered into a cross-lagged panel model. After adjusting for youth age and intellectual disability status and parent education and couple relationship length, the results indicated that father-report of PCC predicted increased youth EBPs 12 months later (T1→T2 and T2→T3). In addition, father-report of youth EBPs predicted increased PCC 12 months later (T3→T4). Mother-report did not demonstrate cross-lagged effects. The findings suggest that fathers' perceptions of PCC and youth emotional and behavioral functioning are transactionally related, highlighting the need for family-wide interventions. [ABSTRACT FROM AUTHOR]

Theory and research on the general population suggest that parents' marital relationship quality is associated with children's emotional and behavioral functioning directly, as well as indirectly, by affecting parenting attitudes and behaviors. However, little has been done to investigate the potential connection among parent marital satisfaction, parenting styles, and outcomes for autistic children. Using longitudinal data collected from 188 couples parenting an autistic child, this study tested the time‐ordered indirect effect of parent marital satisfaction (assessed at Time 1) on the internalizing and externalizing symptoms (assessed at Time 3) of autistic children (originally aged 5–12 years) via parenting styles (assessed at Time 2) using actor–partner interdependence modeling extended to mediation. Results indicated that a lower level of marital satisfaction at Time 1 predicted impaired child outcomes at Time 3 via its impact on parenting style at Time 2. For both parents, lower marital satisfaction predicted more child externalizing symptoms via reports of more authoritarian parenting style. Lower marital satisfaction in mothers at Time 1 was also associated with higher levels of child internalizing symptoms at Time 3 via increased authoritarian parenting in mothers. No partner effects were found. A family‐wide approach that includes support for the parent marital relationship, which may have downstream effects on parenting, is important for promoting optimal emotional and behavioral health in autistic children. [ABSTRACT FROM AUTHOR]

Background: Higher engagement in moderate‐to‐vigorous physical activity (PA) is related to better cognitive functioning in neurotypical adults; however, little is known about the impact of PA on cognitive aging in adults with Down syndrome (DS). Individuals with DS have three copies of the chromosome 21, which includes the gene for the amyloid precursor protein, resulting in an increased risk for/earlier onset of Alzheimer's disease. The goal of this study was to understand the relationship between moderate PA engagement and memory functioning in non‐demented adults with DS. Method: Adults with DS participated in an ancillary Lifestyle study linked to the Alzheimer's Biomarkers Consortium for Down Syndrome (N = 54). Participants completed the Cued Recall Test (CRT) to measure episodic memory. The total free + cued CRT score was used in analyses. Participants wore a wrist‐worn accelerometer (GT9X) for 7 days to measure PA. Moderate PA was classified using the Freedson cutpoints in ActiLife software and was defined as the daily average minutes. Structural MRI data were acquired within 18 months of actigraphy/cognitive data collection. Hippocampal volume was extracted using Freesurfer v5.3. Associations between moderate PA engagement, memory, and hippocampal volume were evaluated with hierarchical linear regressions controlling for relevant covariates (age, body mass index (BMI), intracranial volume (ICV)). Result: Participants were 37.81 years old (SD = 8.15 years) and 55.6% female. They spent ∼10.67% of their time engaged in moderate PA (SD = 7.48%). Participants recalled an average of 32.09 items on the CRT (SD = 6.09, range = 7‐36). After controlling for age and BMI, greater moderate PA engagement was associated with higher total recall score (b = 0.279, p = 0.044). After controlling for age and ICV, moderate PA engagement was not significantly associated with hippocampal volume (p = 0.48). Greater hippocampal volume was associated with higher total recall score after controlling for age and ICV (b = 0.496, p = 0.004). Conclusion: A higher proportion of time spent engaging in moderate PA was related to better memory function in adults with DS. While greater hippocampal volume was related to better memory performance, it was not associated with moderate PA engagement. Greater moderate PA engagement may be a promising lifestyle behavior to preserve memory in aging adults with DS. [ABSTRACT FROM AUTHOR]

Autistic children and their parents are at risk for mental health problems, but the processes driving these connections are unknown. Leveraging three data cycles (spaced M = 11.76 months, SD = 2.77) on 162 families with autistic children (aged 6-13 years), the associations between parent-child relationship quality (warmth and criticism), child mental health problems, and parent depression symptoms were examined. A complete longitudinal mediation model was conducted using structural equation modeling. Father depression mediated the link between child mental health problems and father critical comments ( β = -0.017, p = 0.018; CI [-.023 - -.015]). Father report of child mental health problems mediated the association between father depression and father critical comments ( β = 0.016, p = 0.040; CI [0.003-0.023]) as well as the association between father positive remarks and father depression ( β = -0.009, p = 0.032; CI [-0.010 - -0.009]). Additionally, father positive remarks mediated the connection between father depression and child mental health problems ( β = 0.022, p = 0.006; CI [0.019-0.034]). No mediation effects were present for mothers. Findings highlight that the mental health of parents and autistic children are intertwined. Interventions that improve the parent-child relationship may reduce the reciprocal toll of parent and child mental health problems.

Introduction: Drawing on the amyloid/tau/neurodegeneration (AT[N]) model, the study examined whether the tau positron emission tomography (PET) biomarker [ 18 F]AV-1451 was associated with episodic memory problems beyond what was predicted by the amyloid beta (Aβ) PET in Down syndrome (DS)., Methods: Data from 123 non-demented adults with DS ( M   = 47 years, standard deviation = 6.34) were analyzed. The Cued Recall Test assessed episodic memory. Tau PET standardized update value ratio (SUVR) was assessed across Braak regions as continuous and binary (high tau [T H ] vs. low tau [T L ]) variable. Global PET Aβ SUVR was assessed as binary variable (Aβ- vs. Aβ+)., Results: In models adjusting for controls, tau SUVR was negatively associated with episodic memory performance in the Aβ+ but not Aβ- group. The Aβ+/T H group evidenced significantly worse episodic memory than the Aβ+/T L group., Discussion: Similar to late-onset and autosomal dominant Alzheimer's disease (AD), high tau was an indicator of early prodromal AD in DS., Competing Interests: GE Healthcare holds a license agreement with the University of Pittsburgh for the [11C]PiB PET technology involved in this study. Dr. William Klunk is a co‐inventor of [11C]PiB and has financial interest in this license agreement. GE Healthcare did not provide financial support for this study nor did it have a role in designing the study, interpreting results, or manuscript writing. No other authors have relationships, activities, or interests to disclose related to this manuscript., (© 2022 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.)

Introduction: Adults with Down syndrome (DS) are predisposed to Alzheimer's disease (AD) and the relationship between cognition and glucose metabolism in this population has yet to be evaluated., Methods: Adults with DS (N = 90; mean age [standard deviation] = 38.0 [8.30] years) underwent [C-11]Pittsburgh compound B (PiB) and [F-18]fluorodeoxyglucose (FDG) positron emission tomography scans. Associations among amyloid beta (Aβ), FDG, and measures of cognition were explored. Interregional FDG metabolic connectivity was assessed to compare cognitively stable DS and mild cognitive impairment/AD (MCI-DS/AD)., Results: Negative associations between Aβ and FDG were evident in regions affected in sporadic AD. A positive association was observed in the putamen, which is the brain region showing the earliest increases in Aβ deposition. Both Aβ and FDG were associated with measures of cognition, and metabolic connectivity distinguished cases of MCI-DS/AD from cognitively stable DS., Discussion: Associations among Aβ, FDG, and cognition reveal that neurodegeneration in DS resembles sporadic AD with the exception of the putamen, highlighting the usefulness of FDG in monitoring neurodegeneration in DS., Competing Interests: GE Healthcare holds a license agreement with the University of Pittsburgh based on the technology described in this manuscript. Dr. Klunk is a co‐inventor of PiB and, as such, has a financial interest in this license agreement. GE Healthcare provided no grant support for this study and had no role in the design or interpretation of results or preparation of this manuscript. All other authors have no conflicts of interest with this work and had full access to all of the data in the study, and take responsibility for the integrity of the data and the accuracy of the data analysis., (© 2020 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.)

Introduction: There is a critical need to identify measures of cognitive functioning sensitive to early Alzheimer's disease (AD) pathophysiology in Down syndrome to advance clinical trial research in this at-risk population. The objective of the study was to longitudinally track performance on cognitive measures in relation to neocortical and striatal amyloid beta (Aβ) in non-demented Down syndrome., Methods: The study included 118 non-demented adults with Down syndrome who participated in two to five points of data collection, spanning 1.5 to 8 years. Episodic memory, visual attention and executive functioning, and motor planning and coordination were assessed. Aβ was measured via [C-11] Pittsburgh Compound-B (PiB) PET., Results: PiB was associated with level and rate of decline in cognitive performance in episodic memory, visual attention, executive functioning, and visuospatial ability in models controlling for chronological age., Discussion: The Cued Recall Test emerged as a promising indicator of transition from preclinical to prodromal AD., Competing Interests: GE Healthcare holds a license agreement with the University of Pittsburgh based on the technology described in this manuscript. William Klunk is a co‐inventor of PiB and, as such, has a financial interest in this license agreement. GE Healthcare provided no grant support for this study and had no role in the design or interpretation of results or preparation of this manuscript. All other authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis., (© 2020 the Alzheimer's Association.)