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A prospective study of Alzheimer disease in Down syndrome
Lai F, Williams RS.. Archives of neurology, 1989-08-01
Topic: Amyloid, tau and blood-test diagnosis
Ninety-six individuals with Down syndrome over age 35 years were evaluated and followed up for evidence of nontreatable dementia. Dementia was judged to be present when a functional decline occurred in areas such as orientation, memory, verbal and motor skills, and self-care abilities. Forty-nine patients with Down syndrome fit this criterion, with an average onset of dementia at 54.2 +/- 6.1 years. The prevalence of dementia in the institutionalized Down syndrome population of our study (n = 53) was 8% (2/25 patients) between 35 and 49 years, 55% (11/20 patients) between 50 and 59 years, and 75% (6/8 patients) of those over 60 years old. Of note, 41 (84%) demented individuals with Down syndrome developed seizures. Ten (20%) had parkinsonian features. Adequately treated hypothyroidism was present in 27 (59%) of 46 demented patients with Down syndrome tested. The average duration of dementia in the 23 patients who died was 4.6 +/- 3.2 years. Computed tomographic scans in 43 patients all showed brain tissue loss, most pronounced in the temporal lobes. Brains from 12 autopsied cases showed large numbers of plaques and tangles in the same locations as in persons with Alzheimer disease.
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APA 7th
Lai, F., & Williams, R. S. (1989). A prospective study of Alzheimer disease in Down syndrome. Archives of neurology. https://doi.org/10.1001/archneur.1989.00520440031017
Vancouver
Lai F, Williams RS. A prospective study of Alzheimer disease in Down syndrome. Archives of neurology. 1989. doi:10.1001/archneur.1989.00520440031017. PMID: 2527024.
BibTeX
@article{lai1989-2527024,
author = {Lai, F. and Williams, R. S.},
title = {{A prospective study of Alzheimer disease in Down syndrome}},
journal = {Archives of neurology},
year = {1989},
doi = {10.1001/archneur.1989.00520440031017},
pmid = {2527024},
url = {https://doi.org/10.1001/archneur.1989.00520440031017}
}
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Key findings
- Of note, 41 (84%) demented individuals with Down syndrome developed seizures.
- Adequately treated hypothyroidism was present in 27 (59%) of 46 demented patients with Down syndrome tested.
- The average duration of dementia in the 23 patients who died was 4.6 +/- 3.2 years.
- Computed tomographic scans in 43 patients all showed brain tissue loss, most pronounced in the temporal lobes.
- Brains from 12 autopsied cases showed large numbers of plaques and tangles in the same locations as in persons with Alzheimer disease.
Why it matters
Of 96 adults with Down syndrome over 35 who were followed, 49 developed dementia, at an average age of 54.2 years. In the 53 who lived in institutions, the share with dementia rose with age, from 2 of 25 (8%) at 35–49 to 11 of 20 (55%) at 50–59 and 6 of 8 (75%) over 60. Most of those with dementia (84%) developed seizures, and all 12 brains examined at autopsy showed plaques and tangles in the same locations as in Alzheimer's disease.
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Study details
- Participants53
- Evidence strengthLow
How this study scored 49/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomized / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 47 of the 96 points we could judge it on, which is 49 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Archives of neurology) |
| Journal's citation record | 3 / 4 | Archives of Neurology: journal h-index 353 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1989 — older than 20 years, still counted |
| Sample size | 1 / 4 | 53 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 568 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 14.6 citations a year over 39 year(s) since 1989 |
| Impact for its field and year | 4 / 6 | Cited 14.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 55 other studies in this library |
| Still being cited | 2 / 4 | Cited 21 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | 0 / 3 | Eunice Kennedy Shriver Center: institution h-index 197 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 2527024) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 47 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 47 of the 96 points we could judge it on is 49 out of 100. |
| Total | 49 / 100 | — |
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