When do you consider prescribing medications such as Aricept in patients with Down Syndrome who start having memory issues?

By age 60, there's a 60% chance that most people with Down syndrome will begin developing symptoms or signs of Alzheimer's disease. However, it’s important to also keep in mind that there are many other reasons why a person with Down syndrome may show signs of decline and it may not be Alzheimer's disease or it may not be dementia. It might be a lot of other things, especially if they're younger (i.e., 30-40 years old) including depression, sleep apnea, thyroid dysfunction, or social issues. So,...

Families approach behavioral neurologist with different intentions. If maximizing function us the goal then finding and treating the ineptly named "reversible causes of dementia" + treating their mood disorder is the optimal strategy. Sometimes they want to know if AD is present for prognostic reasons then CSF biomarkers may be used, as AD in Down syndrome follows the same CSF biomarker pattern as other young onset ADs. If positive then might as well trial a cholinesterase inhibitor.