The impact of congenital heart disease on the timing of Alzheimer's disease in Down syndrome

Abstract INTRODUCTION The incidence of Alzheimer's disease (AD) in Down syndrome (DS) exceeds 90%. Approximately 50% of people with DS have congenital heart disease (CHD). Having CHD increases risk for early‐onset AD in populations without DS, but it is unclear if CHD influences AD in DS. METHODS Data from the Alzheimer Biomarker Consortium‐Down Syndrome (ABC‐DS) were used. Participants with CHD ( n = 82, mean age = 39.9 ± 8.5 years, 97.6% White race) were age‐ and sex‐matched to participants without CHD ( n = 82, mean age = 40.5 ± 8.1 years, 98.8% White race). Cognitive assessments and Centiloid load (CL) (positron emission tomography) were compared by CHD status. RESULTS People with CHD scored lower for visuospatial ability ( β = −3.515, p = 0.022) but had higher CL (29.8 ± 12.8 vs. 39.8 ± 12.8, β = 8.00, p = 0.036) and were projected to hit Aβ positivity at a younger age (37.6 and 42.1 years). DISCUSSION Presence of CHD may influence AD progression in DS. Highlights In adults with Down syndrome (DS), those with congenital heart disease (CHD) had higher amyloid beta and reached the threshold for an amyloid positivity at a younger age than those without CHD No differences in cognition were seen in the age‐ and sex‐matched sample based on CHD status; however, the average age of the sample may be too young to see cognitive changes CHDs may influence the timing of Alzheimer's disease (AD) in adults with DS