Relay Podcast - Down Syndrome and Alzheimer's Disease PIA

Welcome to the seventh season of the Dementia Researcher X ISTAART PIA Relay Podcast. Across six episodes, leading early career and senior researchers hand the mic from one ISTAART PIA to the next, giving you an honest, peer-to-peer tour of where dementia research is actually heading, from wearables and biomarkers to policy and trial design, in the run-up to AAIC.

Almost everyone born with Down syndrome overproduces the amyloid precursor protein from birth, which makes it one of the clearest natural windows we have into how Alzheimer's begins. Dr Patrick Lao, Assistant Professor at Columbia and Programmes Chair of the ISTAART Down Syndrome and Alzheimer's Disease PIA, comes from a medical physics background and uses multimodal neuroimaging to map the disease across its genetic and sporadic forms. With host Lillian Morgado, he explains amyloid and tau PET, Thal phases and Braak staging, and how chronological age can stand in for disease stage in this population, with a typical symptom onset around 54. They talk about why people with Down syndrome were long left out of anti-amyloid trials and how that is now changing, and the risk and resilience research asking why some people fall off the expected timeline. Patrick also previews the PIA's AAIC PIA Day session on returning results, plus the separate DSAD/ADAD conference coming to London next year.

Takeaways

• Genetic forms of Alzheimer's, including Down syndrome, let researchers study the earliest disease pathways before symptoms appear.
• In Down syndrome, chronological age can approximate disease stage, with symptoms typically expected around age 54.
• Imaging shows where amyloid and tau sit in the brain, the spatial detail a blood test cannot give.
• People with Down syndrome were historically excluded from anti-amyloid trials; that is shifting, with a lecanemab safety extension now underway.
• Not everyone follows the population timeline, and risk and resilience work asks what pushes onset earlier or later.

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The Alzheimer’s Association International Society to Advance Alzheimer’s Research and Treatment (ISTAART) convenes the global Alzheimer’s and dementia science community. Members share knowledge, fuel collaboration and advance research to find more effective ways to detect, treat and prevent Alzheimer’s and other dementias. Professional Interest Areas (PIA) are an assembly of ISTAART members with common subspecialties or interests.

There are currently 30 PIAs covering a wide range of interests and fields, from Neuroimaging to Diversity and Disparities and everything in between.

Find out more at https://istaart.alz.org/

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