Alzheimer's polygenic risk scores are associated with cognitive phenotypes in Down syndrome

This study aimed to investigate the influence of the overall Alzheimer's disease (AD) genetic architecture on Down syndrome (DS) status, cognitive measures, and cerebrospinal fluid (CSF) biomarkers.

AD polygenic risk scores (PRS) were tested for association with DS-related traits.

The AD risk PRS was associated with disease status in several cohorts of sporadic late- and early-onset and familial late-onset AD, but not in familial early-onset AD or DS. On the other hand, lower DS Mental Status Examination memory scores were associated with higher PRS, independent of intellectual disability and APOE (PRS including APOE, PRS_APOE , p = 2.84 × 10^-4 ; PRS excluding APOE, PRS_nonAPOE , p = 1.60 × 10^-2 ). PRS_APOE exhibited significant associations with Aβ42, tTau, pTau, and Aβ42/40 ratio in DS.

These data indicate that the AD genetic architecture influences cognitive and CSF phenotypes in DS adults, supporting common pathways that influence memory decline in both traits.

Examination of the polygenic risk of AD in DS presented here is the first of its kind. AD PRS influences memory aspects in DS individuals, independently of APOE genotype. These results point to an overlap between the genes and pathways that leads to AD and those that influence dementia and memory decline in the DS population. APOE ε4 is linked to DS cognitive decline, expanding cognitive insights in adults.