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A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
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Clinical Manifestations.

Diana K Valencia1, Wayne Silverman1, Sigan L Hartley2

  • 1University of California, Irvine, Irvine, CA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Many adults with Down syndrome (DS) experience cognitive decline, but some stabilize or revert. Medical conditions and life stressors were linked to non-progression, while psychiatric issues were seen in temporary decline, aiding accurate Alzheimer's dementia diagnosis.

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Area of Science:

  • Neurology
  • Genetics
  • Psychiatry

Background:

  • High lifetime risk of Alzheimer's dementia (AD) in adults with Down syndrome (DS).
  • Need for accurate diagnosis of prodromal AD, distinguishing it from temporary or treatable cognitive declines.
  • DS population presents a unique genetic model for studying AD pathogenesis.

Purpose of the Study:

  • Investigate factors associated with atypical cognitive decline in DS.
  • Identify medical, psychiatric, and life factors influencing temporary or non-progressing cognitive decline over three years.
  • Differentiate trajectories of cognitive change in DS individuals at risk for AD.

Main Methods:

  • Longitudinal study of 38 adults with DS (ages 43-62) from the ABC-DS cohort.
  • Classification into progressors, reverters, or non-progressors based on cognitive and clinical data.
  • Analysis of comorbidities, life stressors, amyloid PET scans, and plasma AD biomarkers.

Main Results:

  • 31.6% of individuals with MCI-DS did not progress to dementia, despite high amyloid PET levels.
  • Non-progressors were younger and had higher rates of seizure disorder, hearing impairment, and social stressors (friend moving away).
  • Reverters showed a higher incidence of psychotic disorders; both atypical groups had lower COVID-19 infection rates.

Conclusions:

  • A significant proportion of adults with DS and MCI-DS exhibit non-progressive cognitive decline.
  • Medical comorbidities and life stressors correlate with stable cognitive trajectories.
  • Psychiatric conditions are associated with temporary cognitive fluctuations, highlighting the need for comprehensive assessment in DS prodromal AD diagnosis.