Trisomy and aging: anticipating cognitive decline and senior support

Table of contents

1. Understanding aging in Down syndrome

2. Signs of aging and cognitive decline

3. Prevention and slowing down decline

4. Support and adaptations

5. Structures and solutions for seniors

Understanding aging in Down syndrome {#understanding}

Early aging

People with Down syndrome age faster than the general population.

Biological age ≠ chronological age:

• A 50-year-old person with Down syndrome has a biological age equivalent to 60-70 years.

Onset of aging: From 40-50 years (vs 60-70 years in the general population).

Life expectancy

Major progress: In the 1980s, life expectancy ~30 years. Today: 60-65 years (or more with good care).

But: Still lower than the general population (average 80 years).

Causes of early aging

1. Genetics

Triple chromosome 21: Overproduction of certain proteins, accelerated oxidative stress, faster cellular aging.

2. Cardiovascular health

Frequent heart problems: Heart fatigue, less effective circulation.

3. Weakened immune system

More frequent infections: Wear and tear on the body.

4. Hypothyroidism

Common in those with Down syndrome, slows metabolism, accelerates aging.

Increased risk of Alzheimer's disease

Major fact: People with Down syndrome have a very high risk of developing Alzheimer's disease.

Alarming statistics:

• 50-70% of people with Down syndrome develop Alzheimer's after 60 years
• Earlier onset: from 40-50 years (vs 65+ in the general population)

Why?

Chromosome 21 contains the APP gene (precursor of the amyloid protein).

Triple dose of this gene → Accumulation of amyloid plaques in the brain → Alzheimer's.

Consequence: Accelerated cognitive decline, loss of autonomy.

Signs of aging and cognitive decline {#signs}

Physical signs of aging

From 40-50 years:

Similar to the general population, but earlier.

Signs of cognitive decline

Warning: Do not confuse normal aging with Alzheimer's.

Mild cognitive decline (normal aging):

Severe cognitive decline (suspected Alzheimer's):

Memory:

Language:

Behavior:

Autonomy:

If multiple signs are present: Urgent medical consultation.

Diagnosis of Alzheimer's in those with Down syndrome

More difficult to diagnose (baseline cognitive decline, communication difficulties).

Tools:

Regular follow-up recommended from age 40 (annual).

Prevention and slowing down decline {#prevention}

1. Regular cognitive stimulation

The brain = muscle: The more you use it, the less it declines.

Activities:

JOE: The ideal tool to prevent cognitive decline

Application specially designed for adults (teens and seniors).

More than 30 games to stimulate:

Recommended use: 15-20 min/day, every day.

Studies show: Regular cognitive stimulation = slowing down decline.

Discover JOE

2. Regular physical activity

Exercise = Alzheimer's prevention (scientifically proven).

Recommendations:

Adapt according to abilities (see dedicated article on adapted sports).

3. Balanced diet

Mediterranean diet recommended:

Hydration: Drink 1.5L water/day.

4. Quality sleep

Sleep = brain cleaning (elimination of waste, including amyloid protein).

Recommendations:

If sleep disturbances: Consult (sleep apnea frequent in those with Down syndrome).

5. Active social life

Isolation = Alzheimer's risk factor.

Maintain social ties:

Social stimulation = cognitive stimulation.

6. Regular medical follow-up

Annual screening:

Quickly treat any pathology (infections, deficiencies).

Support and adaptations {#support}

If mild cognitive decline

1. Maintain usual activities

Do not overprotect: Let them do things alone (with discreet supervision).

Structured routine: Provides reassurance, compensates for forgetfulness.

2. Memory aids

Visual calendar, to-do list, reminders (phone, alarms).

3. Simplification

Tasks in simple steps, short instructions.

4. Patience

More time to complete tasks.

No pressure.

If severe cognitive decline (Alzheimer's)

1. Medical treatment

Medications (acetylcholinesterase inhibitors) can slow progression (neurologist consultation).

2. Increased supervision

Risk of wandering, falls, accidents.

Secure home environment (locks, alarms).

3. Enhanced human support

Home aide, day care.

If significant loss of autonomy: Consider adapted accommodation (nursing home, specialized facility).

4. Adapted communication

Short, simple sentences, repeat if necessary.

Eye contact, gestures.

Encourage, reassure.

5. Maintain stimulation (adapted)

Even with Alzheimer's: Continue gentle stimulation (music, photos, caresses, walks).

JOE at an adapted level (simpler games).

Structures and solutions for seniors {#structures}

Home care

If sufficient autonomy, prefer home (familiarity, comfort).

Supports:

Day care

During the day in a facility (activities, meals, care), return home in the evening.

Benefits:

Structures:

Adapted accommodation

If significant loss of autonomy, need for constant care:

1. FAM (Medicalized Reception Center)

For aging disabled individuals, needing care.

2. MAS (Specialized Reception House)

For severe disabilities.

3. EHPAD (Accommodation Establishment for Dependent Elderly Persons)

Rare are the EHPADs accepting individuals with Down syndrome (often too young, specific needs).

But: Some EHPADs are developing specialized units for mental disabilities.

Inquire with MDPH, associations.

Testimonials

Isabelle, sister of Maxime, 55 years old

"Maxime is 55 years old. For the past 2-3 years, we have seen a decline. He forgets things, he is slower. We consulted: early Alzheimer's. It's hard. But we have put many things in place: he does JOE every day (it helps him stay cognitively active), we have a home aide for 3 hours a day, and we maintain his routine. He still lives at home, with our support. We take it one day at a time."

Sophie, mother of Nathan, 48 years old

"Nathan is 48 years old. I am aging too (72 years). I worry about the future. We anticipated: he has been in FAM for 2 years. At first, I was sad. But ultimately, it is good for him: he has friends, activities, trained staff. I see him every weekend. And I know he will be well taken care of when I am no longer there."

Conclusion: Anticipating for better living

The aging of people with Down syndrome is a reality, with its challenges: early aging, high Alzheimer's risk, cognitive decline. But by knowing the signs, implementing prevention strategies (cognitive stimulation with JOE, exercise, diet, social life), and anticipating support solutions, it is possible to preserve quality of life, autonomy, and dignity for as long as possible.

The keys to successfully supporting aging:

1. Monitoring from age 40 (annual assessments)

2. Active prevention: Cognitive stimulation (JOE), exercise, diet

3. Early detection of decline signs

4. Adaptation of support (aids, simplification)

5. Anticipation of accommodation solutions

6. Maintain social ties, reassuring routine

Aging with Down syndrome is possible. Aging well requires anticipation, love, and support. Accompany your loved one with gentleness, patience, and the right tools. Every day gained in quality of life is a victory.

DYNSEO resources to prevent cognitive decline:

Medical resources:

Aging is moving forward. With your support, your loved one with Down syndrome will age gently, safely, surrounded by love. It is the greatest gift.