Cognitive and behavioral domains that reliably differentiate normal aging and dementia in down syndrome

Jordan P. Harp, Lisa M. Koehl, Kathryn L. Van Pelt, Christy L. Hom, Eric Doran, Elizabeth Head, Ira T. Lott, Frederick A. Schmitt

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


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.

Original languageEnglish
Article number1128
JournalBrain Sciences
Issue number9
StatePublished - Sep 2021

Bibliographical note

Funding Information:
Funding: This research was funded by the National Institute on Aging, grant numbers P30 AG028383, 1T32AG057461, AG‐21912, P50‐16573, P30AG066519, and U01 AG051412, and the Na‐ tional Institute of Child Health and Human Development, grant number HDR01064993.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.


  • Cognition
  • Dementia
  • Down syndrome
  • Functional independence
  • Neuropsychological as-sessment
  • Primary care
  • Screening

ASJC Scopus subject areas

  • Neuroscience (all)


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