Boyle, RoryRoryBoyleKoops, Elouise AElouise AKoopsAnces, BeauBeauAncesAndrews, Elizabeth JElizabeth JAndrewsArenaza-Urquijo, Eider MEider MArenaza-UrquijoBenjanin, AlexandreAlexandreBenjaninBrickman, Adam MAdam MBrickmanBuckley, Rachel FRachel FBuckleyClas, Giulia SGiulia SClasCostello, EmmetEmmetCostelloCoughlan, Gillian TGillian TCoughlanConley, Alexander CAlexander CConleyDeng, FengFengDengde Paula Faria, DanieleDanielede Paula FariaEdwards, NatalieNatalieEdwardsFlores-Aguilar, LisiLisiFlores-AguilarFortea, JuanJuanForteaGhazi Saidi, LadanLadanGhazi SaidiHead, ElizabethElizabethHeadHom, Christy LChristy LHomKoenig, KatherineKatherineKoenigLao, PatrickPatrickLaoLengyel, ImreImreLengyelLi, Yi-JuYi-JuLiLoi, SamanthaSamanthaLoiLoughrey, DavidDavidLoughreyMcGlinchey, EimearEimearMcGlincheyNewhouse, PaulPaulNewhousePertierra, LucíaLucíaPertierraProkopiou, Prokopis CProkopis CProkopiouQi, QingQingQide Paula França Resende, ElisaElisade Paula França ResendeRussell, JasonJasonRussellScanlon, Catherine ECatherine EScanlonSchneider, ChristophChristophSchneiderSchultz, Stephanie AStephanie ASchultzSeto, MabelMabelSetoShaka, SophiaSophiaShakaSoldan, AnjaAnjaSoldanVaqué Alcázar, LídiaLídiaVaqué AlcázarWeng, YiheYiheWengWilson, Jo EllenJo EllenWilsonZaman, Shahid HShahid HZamanZsadányi, Sára ESára EZsadányiHartley, SiganSiganHartley2025-05-052025-05-052025-04https://boris-portal.unibe.ch/handle/20.500.12422/210408Due to the high prevalence of Alzheimer's disease (AD) in adults with Down syndrome (DS), trisomy 21 is now considered a genetic form of AD (DSAD). A better understanding of factors that can prevent or delay AD is vital to improve outcomes for adults with DS. In this narrative review, we apply AD and cognitive aging research frameworks to study resistance and resilience in DSAD. Given the variability in the timing of pathology and symptoms, we discuss the evidence supporting the role of genetic, biological, socio-behavioral, lifestyle, and environmental factors in resistance and resilience to DSAD. We also consider how co-occurring health conditions in DS may influence resistance and resilience, and how methods from AD research can be applied to DSAD. Ultimately, this framework aims to guide future research and translate findings into clinical interventions to improve outcomes in DSAD. Highlights Definitions of resistance and resilience in the genetic form of Alzheimer's disease (DSAD) are proposed for guiding the field. Variability in the timing of AD pathology and symptoms suggests the potential for resistance and resilience mechanisms in DSAD. Genetic, biological, socio-behavioral, lifestyle, and environmental factors have the potential to build resistance or resilience in DSAD. Future research will require longitudinal and experimental designs, life course approaches, and large cohort studies.enbrain maintenancebrain reservecognitive reservecognitive resiliencedementiatrisomy 21600 - Technology::610 - Medicine & healtharticle10.48620/877894028988910.1002/alz.70151