Mass General study finds that adults with Down syndrome achieve minimal health-enhancing physical activity

BOSTON – Despite being genetically predisposed to obesity and osteoporosis, adults with Down syndrome are achieving only minimal health-enhancing physical activity throughout the day, according to a new study from researchers at Massachusetts General Hospital (MGH). In a paper published in the Journal of Applied Research in Intellectual Disabilities. The team reported that individuals with Down syndrome do not meet the recommended physical activity guidelines for adults set by the U.S. Department of Health and Human Services.  

Researchers followed the physical activity trends of 52 adults with Down syndrome followed at the MGH Down Syndrome Program. Each participant was asked to wear an accelerometry device at least 4 weekdays and 1 weekend day, and for up to 3 weeks, excluding sleep hours and during water or contact sports. They also calculated the body mass index (BMI) for each participant, combining information collected via direct measurements, survey, and the patient’s medical record about verbal status, dementia diagnosis, and living arrangements.

They found that adults with Down syndrome who live alone had more daily steps and greater light physical activity levels compared to adults living with families or in group homes, but the full cohort had low daily step counts and large amounts of unhealthful sedentary time. Still, even adults who lived alone were not meeting the physical activity recommendations when the researchers looked at their total daily physical activity counts, suggesting that while independent living and lifestyle may offer some health prevention benefits, physical activity still remains insufficient for most adults with Down syndrome. In addition, no differences in physical activity levels were found based on verbal or dementia status, sex or ethnicity, highlighting the universal challenges for patients with Down syndrome of achieving adequate physical activity levels.

“Our findings strongly suggest that inadequate physical activity levels remains a significant health issue for adults with Down syndrome,” says Nicolas Oreskovic, MD, MPH, medical director of the Intregrated Care Management Program at Mass General for Children, and lead author of the study. “These findings are concerning, given the increased risk of obesity and metabolic complications in this population.”

The majority of adults with Down syndrome are overweight or obese, and co-morbidities such as sleep apnea, diabetes, skin infections and bone diseases can be exacerbated by weight, making its management, including exercise and proper nutrition, a priority. Physical activity has also shown promise in combating Alzheimer’s disease, which is increasingly common in adults with Down syndrome as they age.

“To date, no national study has assessed physical activity levels in individuals with Down syndrome. Most physicians use caregiver-reported information about their love one’s level of physical exertion. If even available, it can be unreliable, making it difficult for the medical community to establish what are ‘typical’ daily physical activity levels. Changing that was a major objective of this study,” says Oreskovic.

Senior author Brian Skotko, MD, MPH, the Emma Campbell Endowed Chair on Down Syndrome at Massachusetts General Hospital, added, “We hope that this study will be empowering—an objective measurement of physical activity can help clinicians, patients, and families have honest and important conversations about healthy lifestyles.”

According to Oreskovic, individuals with Down syndrome can use daily activities as opportunities to increase exercise. He recommends finding forms of physical activity that are exciting, and can engage family and friends, such as taking group walks, dancing, and bowling, all common forms of physical activity that are popular in the Down syndrome community.

 

About the Massachusetts General Hospital

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH Research Institute conducts the largest hospital-based research program in the nation, with an annual research budget of more than $1 billion and comprises more than 8,500 researchers working across more than 30 institutes, centers and departments. In August 2020 the MGH was named #6 in the nation by U.S. News & World Report in its list of "America’s Best Hospitals."