TriAL21 study is an interventional, open, one arm, prospective, national and single center study. A total of 200 patients with Down syndrome, aged 35 years and over, without diagnosis of Alzheimer's disease will be enrolled into the study. Participating centre is Institut Jérôme Lejeune; outpatient's clinic dedicated to treating patients with cognitive deficiencies of genetic origin including patients with Down syndrome.
The aim of the study is to describe and follow a cohort of patients with Down syndrome without diagnosis of Alzheimer's disease at inclusion, in order to identify factors influencing the age of onset of the disease. The total study duration will be approximately 4 years. * Inclusion period : 2 years * Follow-up period per patient : 2 years Patients will be then followed during 10 years for routine medical follow-up. In case of Alzheimer's disease onset during this period, all data regarding diagnosis of AD will be collected for the study. Data about dementia evolution and mortality in case of AD diagnosis during the study will also be collected during this follow-up period.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
200
Optional Lumbar Puncture will be performed at inclusion visit Optional Neuro-Imaging (MRI (Magnetic Resonance Imaging) will be performed within 3 months after inclusion visit
Institut Jérôme Lejeune
Paris, France
RECRUITINGAge of onset of Alzheimer's disease
age (year)
Time frame: 2 years
Gender that could influence the age of onset of the disease as determined by medical record review
Time frame: 2 years
Level of intellectual diasability that could influence the age of onset of the disease as determined by medical record review
Time frame: 2 years
Family history of Alzheimer's disease that could influence the age of onset of the disease as determined by medical record review
Time frame: 2 years
Cardio-vascular risk factors that could influence the age of onset of the disease as determined by medical record review
Time frame: 2 years
Down syndrome comorbidies that could influence the age of onset of the disease as determined by medical record review
Time frame: 2 years
Genetic's factor other than APP that could influence the age of onset of the disease as determined by medical record review
Time frame: 2 years
Head trauma that could influence the age of onset of the disease as determined by medical record review
Time frame: 2 years
Age of menopause that could influence the age of onset of the disease as determined by medical record review
Time frame: 2 years
Evaluation of neuropsychological evolution using Katz Index of Independence in Activities of Daily Living (Katz ADL) score
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Questionnaire about Activities of Daily Living such as bathing, toileting, continence, dressing, transferring and feeding Scoring : Independence: 1 point - Partial dependence 0.5 point - Full dependence: 0 point
Time frame: 2 years
Evaluation of neuropsychological evolution using Lawton-Brody Instrumental Activities of Daily Living scale ( IADL)
Questionnaire about strumental Activities of Daily Living such as ability to use telephone, responsibility for taking medication, travels independently on public transportation, ability to handle finances Scoring : 0 or 1
Time frame: 2 years
Evaluation of neuropsychological evolution using Dementia Screening Questionnaire for Individuals with Intellectual Disabilities (DSQIID) score
Dementia Screening for Individuals with Intellectual Disabilities Questionnary is a autonomy and psychobeahavioral questionnaire to gather information from carers of people with Down's syndrome about the symptoms of dementia
Time frame: 2 years
Evaluation of neuropsychological evolution using Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and Others with Intellectual Disabilities score
Camdex-Ds. Based on an informant interview to aid the diagnosis of dementia in people with DS according to the DSM-IV et ICD criteria for dementia.
Time frame: 2 years
Evaluation of neuropsychological evolution using Cambridge Cognition Examination score
It is part of the CAMDEX-DS. Section 2 involves the direct assessment of patient. It contains seven different subscales and has 46 items. it gives a total score of 108. Decline between assessment at Time 1 and assessment at time 2 in association with CAMDEX confirm or evoque the AD diagnosis.
Time frame: 2 years
Evaluation of neuropsychological evolution using Cued Recall test score
It is a memory task. It consists in 12 items accompanied by a unique category cue, presented four a time in three trials. It generates two measures respectively for learning phase and delayed recall: a free recall score/12 and a total score/36 (FRS plus items recalled with cue) for the learnig phase. A free recall (FRS/12) and a total score (FRS plus items recalled with cue /12) for the delayed recall. Number of intrusions will be also recorded.
Time frame: 2 years
Evaluation of neuropsychological evolution using Cancellation task
Measure of task accuracy (total number of correct responses, range score 0-16) and total time performance (in seconds) were included in the analyses.
Time frame: 2 years
Evaluation of neuropsychological evolution using Leiter III assessment score
It is a nonverbal measure of intelligence \& cognitive abilities. It includes four subtests whose raw scores are converted to normalised scaled scores (mean \[M\] = 10, standard deviation \[SD\] = 3). It gives an IQ standard score (M = 100; SD = 15).
Time frame: 2 years
Identification of prodromal Alzheimer's disease markers using brain imaging
Whole brain volumetry calculation, hippocampus volume calculation, white matter lesions volumetry calculation
Time frame: 2 years
Identification of prodromal Alzheimer's disease markers using dosage (pg/mL) of biomarkers in cerebrospinal fluid
1-40 beta-amyloid, 1-42 beta-amyloid, tau, phosphorylated tau
Time frame: 2 years
Number of adverse event and serious adverse events related to trial procedures
Adverse events graded 3-4-5 according to CTCAE v5.0
Time frame: 2 years
Evaluation of survival assessed by vital status
Date and cause of death
Time frame: 2 years