The investigators are assessing acceptability, appropriateness, and feasibility of an remote choreographed exercise intervention using validated scales alongside qualitative data among young adults with Down Syndrome. Participants will take part in a 12-week exercise program with two 35-minute session per week delivered in a group setting. The aims of the project are to:

• Assess the feasibility of a 12 week remotely delivered group dance intervention.
• Assess changes in aerobic fitness and cognitive function in response to a 12 week remotely delivered group dance intervention.
• Assess the intensity and total energy expenditure of remotely delivered group dance sessions.

The incidence of Alzheimer's disease for persons with Down syndrome exceeds 90%, and physical activity engagement has demonstrated potential to delay onset of Alzheimer's disease for this population. Adults with Down syndrome participate in less physical activity than their counterparts without disability, partially due to unique barriers preventing engagement in typical modalities of physical activity for this population. Dance, which is characterized by rhythmic physical movements offers the potential for social engagement, and stimulation of brain functions may offer a reasonable alternative to traditional physical activity modalities. However, empirical evidence to support the feasibility of a remotely delivered group dance intervention and evaluation of the intensity and energy expenditure achieved by a dance intervention for adults with Down syndrome are currently unavailable and will be the focus of the proposed pilot trial. Adults with Down will be asked to attend 35 minute remotely delivered (Zoom®) group dance sessions twice weekly across 12 weeks to assess the acceptability, appropriateness, and feasibility of the intervention, energy expenditure achieved during the exercise sessions, and evaluate change in aerobic fitness and cognitive function after 12 weeks.

Inclusion Criteria:

• Diagnosis of Down syndrome
• Sufficient functional ability to communicate through spoken language
• No plans to relocate outside the study area over the next 12 weeks
• Possession of a personal device that allows for connectivity to the internet and participate in 2x weekly group video calls
• Ability to participate in Moderate to vigorous physical activity

Exclusion Criteria:

• Serious medical risk (e.g., cancer, recent heart attack, stroke, pregnancy, angioplasty as determined by the research staff
• unwilling to participate in outcomes assessments
• uninterested

All 20 enrolled participants were assigned to the single treatment arm.

From enrollment to end of intervention, 12 weeks.

Safety was assessed via the number and type of adverse events during the intervention in accordance with the National Institute on Aging guidelines. This included the severity of the event (mild, moderate, severe), relatedness to intervention (not related, possibly related, definitely related) and if it was considered a Serious Adverse Event (resulting in death, hospitalization, medical event, or disability) .

The sample size was small (n = 20) and the program duration short (12 weeks), which limits generalizability and makes it unclear whether usability and outcomes would be sustained over longer interventions. The sample was also relatively young (mean age 28.3 years), and none required assistive devices for ambulation, potentially limiting applicability to older adults or those with additional mobility impairments.