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We would like to congratulate Lott et al¹ for their interesting article regarding the potential value of acetylcholinesterase inhibitors for the treatment of dementia in people with Down syndrome (DS). Dementia is increasingly common in DS, with 25% to 35% of the DS population aged 50 to 60 years being affected^2-3; however, research on therapeutic interventions for dementia in this group remains sparse.

The interpretation of results regarding response to cognitive enhancers in this population has to be made in light of what is expected regarding cognitive decline in older people with DS. Recent preliminary data from our prospective study of age-related cognitive changes in DS indicate that it is very difficult to reliably measure cognitive decline in these individuals. For example, 10 people with DS and dementia (5 women; mean age, 49.2 years; range, 40-58 years) who were receiving no treatment showed a 14% improvement on neuropsychological measurements . . . [Full Text of this Article]

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