Adverse life experiences, mood symptoms, and quality of life in adults with down syndrome

Purpose Life expectancy for people with Down syndrome (DS) has increased, creating a need to understand how to optimize later-life quality of life (QOL). In the general population, adverse life experiences (ALES) are thought to alter QOL via several mechanisms, including the presence of mood disorders. Little is known about whether ALES predict later-life QOL in adults with DS and, if so, whether this association is driven by increased mood symptoms. Methods Data came from 133 adults with DS ( M age = 38.58 years, SD = 8.61) without dementia enrolled in the Alzheimer Biomarker Consortium-Down Syndrome. We used hierarchical linear regression to predict the effect of ALES and mood symptoms on QOL. We conducted an ordinary least squares path analysis to quantify the direct effect of ALES on QOL and the indirect effect through mood symptoms using 5000 bootstrap samples. Results ALES was not a significant predictor of QOL. Mood symptoms were significantly negatively associated with QOL. The path analysis indicated that adults with DS who experienced more ALES also had more mood symptoms, and mood symptoms were associated with lower QOL. The confidence interval for the indirect effect was below zero, indicating that mood symptoms significantly affected the relationship between ALES and QOL. The direct effect of ALES on QOL was not significant. Conclusion Mood symptoms are not simply a correlate of early adversity but an intervening variable through which the psychological and neurobiological effects of ALES may be expressed as poorer later-life QOL.