47-year-old woman with Down syndrome presented with the complaints of fear, anxiety, confusion and memory loss.Because of her change in behavior, fear, and anxiety, she became largely housebound and struggled with fatigue, took extended naps once or twice daily, and could no longer safely be left alone for extended periods. Her primary care physician referred her to a Memory Care Specialty center. Reversible causes of dementiawere ruled out with normal thyroid studies, vitamin B12, and vitamin 25-OH D3. Her HbA1c measured 4.8% and ruled out untreated diabetes. Paroxetine 20 mg, memantine 28 mg, and, as needed, alprazolam 0.5 mg daily with paleo diet with carb restriction to <100 g total per day was started. Despite her weight loss and medications, she continued to decline cognitively.ketogenic diet was started in the desperate hopes that nutritional ketosis could benefit the patient’s condition.
Results
All of the above
A therapeutic ketogenic diet was associated with significant cognitive improvement in this patient with concurrent Down syndrome and dementia.In this case of a patient with Down syndrome and Alzheimer’s disease, the patient and her family exhausted standard treatment options for 4 years while her cognitive and functional capacity continued to decline. Transition to a ketogenic diet of <20 g carbs per day improved her cognitive scores to baseline function, in association with improvements in behavioral and mood symptoms.
