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Predicting Functional Changes in Down Syndrome During the COVID-19 Pandemic: The Role of Biopsychosocial Determinants of Health

Jo, E.; Wall, C.; Allen, L. K.; Wheeler, N.; Baumer, N.; D'Aguilar, A.; York, T. P.; Capone, G.; Jackson-Cook, C.; Amstadter, A. B.; Brown, R. C.

2026-05-21 psychiatry and clinical psychology
10.64898/2026.05.19.26353577 medRxiv
Show abstract

Background: Biopsychosocial factors associated with functional changes, including changes in personality, communication, movement, and weight, were evaluated in individuals with Down syndrome (DS) during the COVID-19 pandemic. Method: Caregivers of individuals with DS (aged [≥]12, n = 118) completed an online survey. Elastic net regression with bootstrap resampling assessed 31 candidate predictors. Results: Pandemic-related mental health was most strongly associated with functional changes ({beta} = 0.388). Healthcare access barriers were also reliably selected: inability to access mental health treatment, difficulty affording insurance, difficulty accessing specialists, and residing in a low-income health professional shortage area. The model explained 35.2% of variance. Conclusions: Mental health and healthcare access barriers were biopsychosocial correlates of functional changes for people with DS during COVID-19.

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