Natural history and clinical impact of epilepsy in adults with Down syndrome: a multicentre clinical study.

Epilepsy develops rapidly after Alzheimer's onset in adults with Down syndrome, affecting over 56% within nine years and significantly reducing survival.

• Why it matters: Understanding epilepsy's progression in Down syndrome is crucial because it worsens prognosis and accelerates cognitive decline, yet its timing and impact remain poorly characterized.
• What they did: A multicentre, longitudinal study analyzed 4,804 adults with Down syndrome, assessing epilepsy prevalence, incidence, timing relative to Alzheimer's, and EEG abnormalities over a period from 2012 to 2025.
• The result: Findings reveal a sharp increase in epilepsy after Alzheimer's symptoms emerge, with associated higher mortality and faster cognitive decline, highlighting the need for targeted prevention and treatment strategies.