Cognitive and Behavioral Domains That Reliably Differentiate Normal Aging and Dementia in Down Syndrome.

Harp, Jordan PKoehl, Lisa MPelt, Kathryn L VanHom, Christy LDoran, EricHead, ElizabethLott, Ira TSchmitt, Frederick A


It is currently strongly advised that all primary care of individuals with Down syndrome receive dementia screening. Researchers explore various screening methods in an effort to determine the method standard of care. The results support an abbreviated screening to identify at-risk individuals with Down syndrome in primary care settings as a way to guide referrals.


Primary care integration of Down syndrome (DS)-specific dementia screening is strongly advised. The current study employed principal components analysis (PCA) and classification and regression tree (CART) analyses to identify an abbreviated battery for dementia classification. Scale- and subscale-level scores from 141 participants (no dementia n = 68; probable Alzheimer's disease n = 73), for the Severe Impairment Battery (SIB), Dementia Scale for People with Learning Disabilities (DLD), and Vineland Adaptive Behavior Scales-Second Edition (Vineland-II) were analyzed. Two principle components (PC1, PC2) were identified with the odds of a probable dementia diagnosis increasing 2.54 times per PC1 unit increase and by 3.73 times per PC2 unit increase. CART analysis identified that the DLD sum of cognitive scores (SCS < 35 raw) and Vineland-II community subdomain (<36 raw) scores best classified dementia. No significant difference in the PCA versus CART area under the curve (AUC) was noted (D(65.196) = -0.57683; p = 0.57; PCA AUC = 0.87; CART AUC = 0.91). The PCA sensitivity was 80% and specificity was 70%; CART was 100% and specificity was 81%. These results support an abbreviated dementia screening battery to identify at-risk individuals with DS in primary care settings to guide specialized diagnostic referral.


Alzheimer Disease, Dementia, Learning Disabilities