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Down's syndrome, dementia and macrocytosis

Published online by Cambridge University Press:  13 June 2014

Vee Prasher
Affiliation:
Monyhull Hospital, Monyhull Hall Road, Kings Norton, Birmingham B30 3QQ, England
Jay Viswanathan
Affiliation:
Monyhull Hospital, Birmingham, England
Roger Holder
Affiliation:
Department of Statistics, University of Birmingham, Birmingham, England

Abstract

Objective: No definitive peripheral biological marker has yet been found to correlate with Alzheimer's disease (AD). This study investigated the role of macrocytosis as a marker which could significantly improve our understanding of AD in the Down's syndrome (DS) population.

Methods: This study investigated the possible association between raised mean corpuscular volume (MCV) and AD in 150 adults with DS over a five year study period.

Results: A raised MCV is common in the DS population. A statistically significant association between a further elevated MCV and clinically diagnosed AD in adults with DS was found.

Conclusions: The findings suggest that further research into the association between macrocytosis and DS could improve our understanding of the underlying biological mechanisms of AD. The measurement of MCV should be undertaken in all DS individuals with a diagnosis of possible or definite dementia. A significant raised MCV (above 97fl for males and 99fl for females) may further improve the clinical diagnosis. A single MCV measurement, however, cannot be recommended as a diagnostic test for AD in adults with DS.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 2002

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References

1.Burns, A. Clinical diagnosis of Alzheimer's disease. Dementia 1991, 2; 186194.Google Scholar
2.Goodall, HB, McHarg, JF, Anderson, JM, Robertson, J. Acanthocytosis in disparate clinical states-myelodysplasia and Alzheimer's disease. Leukemia Research 1991; 15 (Supplement): 19.CrossRefGoogle Scholar
3.Goodall, HBet al.Irregular distortion of the erythrocytes (Acanthocytes, Spur Cells) in senile dementia. Disease Markers 1994; 12: 2341.CrossRefGoogle ScholarPubMed
4.Eastham, RD, Jancar, J. Macrocytosis in Down's syndrome and during long-term anticonvulsant therapy. J Clin Pathology 1970; 23: 296298.CrossRefGoogle ScholarPubMed
5.Eastham, RD, Jancar, J. Macrocytosis and Down's syndrome. Br J Psychiatry 1983; 143: 203204.CrossRefGoogle ScholarPubMed
6.Hewitt, KE, Carter, G, Jancer, J. Ageing in Down's syndrome. Br J Psychiatry 1985; 147: 5862.CrossRefGoogle ScholarPubMed
7.Terman, LM, Merrill, MA. Measuring Intelligence. Boston: Houghton Mifflin, 1937Google Scholar
8.Lansdall-Welfare, RW, Hewitt, KE. Macrocytosis and cognitive decline in Down's syndrome. Br J Psychiatry 1986; 148: 482–3.CrossRefGoogle Scholar
9.Akin, K. Macrocytosis and leukopenia in Down's syndrome. J Am Med Association 1988; 259: 842.CrossRefGoogle ScholarPubMed
10.Wachtel, TJ, Peuschel, SM. Macrocytosis in Down syndrome. Am J Mental Retardation 1991; 95: 417–20.Google ScholarPubMed
11.Prasher, VP. Increase in mean cell volume – a possible peripheral marker for Alzheimer's disease? J Int Geriatric Psychiatry 1997; 12: 130–1.3.0.CO;2-C>CrossRefGoogle ScholarPubMed
12.Prasher, VP. Down syndrome, dementia and macrocytosis. Br J Developmental Disabilities 1994; 90: 131134.CrossRefGoogle Scholar
13.World Health Organisation. The ICD-10 Classification of Mental and Behavioural Disorders. Diagnostic Criteria for Research. Geneva: WHO, 1993Google Scholar
14.Prasher, VP. Screening of physical morbidity in adults with Down syndrome. Down's Syndrome Research and Practice 1994; 2: 5966.CrossRefGoogle Scholar
15.World Health Organisation. The ICD-10 Classification of Mental and Behavioural Disorders. Clinical Descriptions and Diagnostic Guidelines. Geneva: WHO, 1992Google Scholar
16.World Health Organisation. ICD-10 Symptom Checklist for Mental Disorders. Version 1.1. Geneva: WHO, 1994Google Scholar
17.Roth, Met al.CAMDEX. A standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. Br J Psychiatry 1986; 149: 698709.CrossRefGoogle Scholar
18.Aylward, EHet al.Diagnosis of dementia in individuals with intellectual disability. J Intellectual Disability Res 1997; 41, 152164.CrossRefGoogle ScholarPubMed
19.Tycko, DH. Flow-cytometric light scattering measurement of red blood cell volume and haemoglobin concentration. Applied Optics 1985; 24: 13551365.CrossRefGoogle Scholar
20.Dickinson, MJ, Singh, I. Down's syndrome, dementia, and superoxide dismutase. Br J Psychiatry 1993; 162: 811–7.CrossRefGoogle ScholarPubMed
21.Bosman, GJet al.Erythrocyte membrane changes of individuals with Down's syndrome in various stages of Alzheimer-type dementia. Neurobiology of Aging 1993, 14; 223–8.CrossRefGoogle ScholarPubMed
22.Lee, GRet al.Clinical Haematology. Philadelphia: Lea and Febiger, 1993Google Scholar
23.Nakamura, E, Tanaka, S. Biological ages of adult men and women with Down's syndrome and its changes with aging. Mechanisms of Ageing and Development 1998; 105: 89103.CrossRefGoogle ScholarPubMed
24.Okamoto, Net al.Premature aging syndrome with osteosarcoma, cataracts, diabetes mellitus, osteoporosis, erythroid macrocytosis, severe growth and developmental deficiency. Am J Medical Genetics 1997; 69: 169170.3.0.CO;2-J>CrossRefGoogle ScholarPubMed
25.Hanin, Iet al.Elevated red blood cell/plasma choline ratio in dementia of the Alzheimer type: clinical and polysomnography correlates. Psychiatry Research 1984; 13: 167173.CrossRefGoogle Scholar
26.Greenwald, BSet al.Alzheimer's disease, dexamethasone suppression, dementia severity, and affective symptoms. Am J Psychiatry 1986; 143: 442446.Google ScholarPubMed
27.Sinet, PM. Metabolism of oxygen derivatives in Down's Syndrome. Annals of the New York Academy of Sciences 1982; 396: 8394.CrossRefGoogle ScholarPubMed
28.Marcus, DLet al.Increased peroxidation and reduced antioxidant enzyme activity in Alzheimer's disease. Exp Neurology 1998; 150: 40–4.CrossRefGoogle ScholarPubMed
29.Subbarao, KV, Richardson, JS, Ang, L. Autopsy samples of Alzheimer's cortex show increase peroxidation in vitro. J Neurochemistry 1990; 55: 342345.CrossRefGoogle ScholarPubMed
30.Blass, JPet al.Red blood cell abnormalities in Alzheimer disease. J Am Geriatric Society 1985; 33: 401–5.CrossRefGoogle ScholarPubMed