Age-related Cognitive Changes Research Articles

Real-Life Language Use Across Different Interlocutors: A Naturalistic Observation Study of Adults Varying in Age

Amid the growing interest in studying language use in real life, this study, for the first time, examined age effects on real-life language use, as well as within-person variations across different interlocutors. We examined speech samples collected via the Electronically Activated Recorder (i.e., portable audio recorder that periodically records ambient sounds) for a larger project. This existing dataset included more than 18,000 sound snippets (50-s long) from 53 American couples (breast cancer patients and their spouses; aged 24 to 94 years) in their natural environments. Sound snippets that included participant speech were coded for different interlocutors and given scores on three linguistic measures that are associated with age-related cognitive changes: usage of unique words, usage of uncommon words, and grammatical complexity. Multilevel models showed that there were no age effects on the three linguistic measures when interlocutors were not taken into account. We found that interlocutors influenced usage of unique words and grammatical complexity. More specifically, compared to talking with their spouse, participants used fewer unique words with children and friends; and used simpler grammatical structures with children, strangers, and in multiparty conversations. Next, we found that interlocutors influenced the associations between age and language use. More specifically, young adults used more unique words and more uncommon words with children than older adults. They used more uncommon words with friends and uttered more complex grammatical structures with strangers than older adults. Our results offer preliminary evidence for a new perspective to understand real-life language use: focusing not only on individual characteristics (i.e., age), but also context (i.e., interlocutors). This perspective should be useful to researchers who are interested in collecting “big data” and understanding cognitive activities in real life.

The Age-Related Central Auditory Processing Disorder: Silent Impairment of the Cognitive Ear.

Age-related hearing loss (ARHL), also called presbycusis, is a progressive disorder affecting hearing functions and among the elderly has been recognized as the third most frequent condition. Among ARHL components, the age-related central auditory processing disorder (CAPD) refers to changes in the auditory network, negatively impacting auditory perception and/or the speech communication performance. The relationship between auditory-perception and speech communication difficulties in age-related CAPD is difficult to establish, mainly because many older subjects have concomitant peripheral ARHL and age-related cognitive changes. In the last two decades, the association between cognitive impairment and ARHL has received great attention. Peripheral ARHL has recently been defined as the modifiable risk factor with the greatest impact on the development of dementia. Even if very few studies have analyzed the relationship between cognitive decline and age-related CAPD, a strong association was highlighted. Therefore, age-related CAPD could be a specific process related to neurodegeneration. Since these two disorders can be concomitant, drawing causal inferences is difficult. The assumption that ARHL, particularly age-related CAPD, may increase the risk of cognitive impairment in the elderly remains unchallenged. This review aims to summarize the evidence of associations between age-related CAPD and cognitive disorders and to define the diagnostic procedure of CAPD in the elderly. Finally, we highlight the importance of tailoring the rehabilitation strategy to this relationship. Future longitudinal studies with larger sample sizes and the use of adequate assessment tools that can disentangle cognitive dysfunction from sensory impairments are warranted.

Associations between education and age-related cognitive changes from early adulthood to late midlife.

The aims of the study were to explore general trends and individual differences in cognitive changes from early adulthood to late midlife and to investigate associations between education and cognitive changes. We used data from the Lifestyle and Cognition Follow-Up Study 2015 on 1,543 Danish men born in 1950-1961. Test scores on the 78-item intelligence test used by the Danish conscription authorities, Børge Priens Prøve (BPP), completed at draft board examination (baseline, mean age = 20 years) and at follow-up (mean age = 61 years) were used to measure cognitive changes. The mean change in BPP scores was -2.94 (SD = 5.57), and a retest correlation of 0.81 between the baseline and follow-up BPP scores was observed. In spite of the substantial retest correlations, the 8.3% of the sample with statistically reliable change had a mean decline in BPP scores of -13.41 (SD = 2.56). In latent change score models adjusted for year of birth and retest interval, more years of education was associated with larger decline in BPP scores, but the association was reversed when further adjusting for baseline BPP scores. Moreover, significant interactions indicated that more years of education was associated with less cognitive decline in men with relatively low or average BPP scores at baseline, whereas no influence of education was found in men with high baseline scores. Hence, more years of education may compensate for low or average intelligence by increasing cognitive reserve in these individuals or by influencing mediating lifestyle and occupational factors. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Cognitive Self-Efficacy and Mental Health Ratings after a Memory Skills Group for Older Veterans with PTSD

ABSTRACTObjectives: Mental health factors, such as PTSD, can exacerbate typical age-related cognitive changes and lead individuals to have subjective concerns for which few interventions presently exist. This study evaluates self-reported mental health outcomes following a psychoeducational memory skills program designed for veterans over 50 with subjective memory concerns in the context of PTSD. It was hypothesized that outcomes would improve following program participation and that baseline cognitive self-efficacy would moderate improvements in self-reported depression and life satisfaction.Methods: Veterans (n = 101, age ≥ 51) participated in an 8-week memory skills program and completed baseline and post-program assessment data as part of a quality improvement project.Results: Life satisfaction and cognitive self-efficacy demonstrated significant improvement following participation in the memory skills program. Cognitive self-efficacy was found to significantly modify change in depressive symptoms.Conclusions: We found improvement in mental health outcomes following participation in a psychoeducational memory skills program, with differential impact on depressive symptoms for those with low baseline cognitive self-efficacy.Clinical Implications: Participation in this intervention led to improved life satisfaction and cognitive self-efficacy. Cognitive self-efficacy, in turn, appeared to have implications for improving depressive symptomology and may be a useful target of memory skills education.

Supplemental Material for Associations Between Education and Age-Related Cognitive Changes From Early Adulthood to Late Midlife

Supplemental Material for Associations Between Education and Age-Related Cognitive Changes From Early Adulthood to Late Midlife

Research Institute of Internal and Preventive Medicine, Branch, Federal Research Center, Institute of Cytology and Genetics, Siberian Branch, Russian Academy of Sciences

Age-related cognitive changes in the Russian population have not been sufficiently studied.Objective: to assess the time course of changes in cognitive functions (CF) in two serial measurements 9 years apart in the urban population of middle, elder, and senile age and their relationship to education level.Patients and methods. A random male and female sample of45-69-year-old Novosibirsk residents (n=9360; HAPIEE project) was surveyed. CF was tested by standard methods. Resurvey was conducted in a random subsample (n=1663) included in this analysis. The mean follow-up period was 8.8 years (SD 1.1).Results and discussion. The test for semantic verbal fluency revealed its dynamic decline in all age groups, which was steeper in women than in men (p<0.001). Persons aged 70 years and older showed negative changes in memory, verbal fluency, and attention (p<0.001). Persons with primary (6%) and vocational (26%) education had steeper rates of decline in delayed recall (p=0.011; 0.038) than those with university education (35%).Conclusion.It is established that a dynamic decrease in CF begins at the age of55—59years; it is steeper among those aged 70 years and older. An age-related decline in memory function is accelerated in persons with lower educational levels.

Growth Hormone-Releasing Hormone Modulation of Neuronal Exosome Biomarkers in Mild Cognitive Impairment.

Age-related changes in cognition are linked to decreased expression of somatotropins, GHRH and IGF-1. Mild cognitive impairment (MCI) and Alzheimer's disease (AD) are heterogeneous conditions. The loss of GHRH signaling in the brain may be mechanistically involved in AD pathogenesis. The consequent need to identify AD at an early and perhaps more treatable stage has fueled research into blood-based, exosome biomarkers. Plasma exosomes from participants enrolled in a randomized, double-blind, placebo-controlled 20-week trial of GHRH administration, were isolated, precipitated, and enriched by immuno-absorption with anti-L1CAM antibody (neural adhesion protein) from adults with MCI and age-matched, cognitively normal controls (CNC). Extracted protein cargo from neuronally-derived exosomes (NDEs) were assessed by ELISAs for protein levels implicated in AD neuropathology and for synaptic proteins altered by AD. Plasma NDE concentrations of Aβ1-42 were significantly increased while plasma NDE concentrations of NRGN, synaptophysin, synaptotagmin, and synaptopodin were significantly decreased in patients with MCI, independent of GHRH treatment. Plasma NDE concentrations of ptau-S396 and GAP43 were not affected by cognitive status (CNC versus MCI) or by GHRH treatment. Aβ1-42, neurogranin (NRGN), synaptophysin, synaptotagmin, and synaptopodin demonstrated the highest diagnostic accuracy for distinguishing between CNC and MCI patients, while synaptophysin and synaptotagmin demonstrated moderate accuracy in distinguishing between placebo-treated and GHRH-treated, MCI patients.

A Systematic Review of Cognitive Impairments Associated With Kidney Failure in Adults Before Natural Age-Related Changes.

Recognition of cognitive impairment in chronic kidney disease (CKD) and its impact on functioning in adults is growing. The vast majority of studies to date have been conducted in older populations where CKD is more pronounced; however, the degree to which age-related cognitive changes could be influencing these findings remains unaddressed. This current study thus aimed to review cognitive impairment findings by stage in non-elderly CKD samples. PubMed and Medline via Scopus were searched for cross-sectional or cohort studies and randomized controlled trials that assessed cognitive function in individuals with CKD in any research setting. CKD studies including patients at any illness stage were included providing participants were below 65 years old, were not on peritoneal dialysis and had not undergone a kidney transplant. Fifteen studies, with a total of 9304 participants, were included. Cognitive function broadly deteriorated from stage 1 to stage 5. Early stage CKD was associated with a drop in speed of processing, attention, response speed, and short-term memory abilities. Moderate stage CKD was associated with deficits in executive functioning, verbal fluency, logical memory, orientation and concentration. People with end stage kidney disease manifested significant deficits in all previous cognitive domains, along with cognitive control, delayed and immediate memory, visuospatial impairment, and overall cognitive impairment. Cognitive impairment is evident across the stages of CKD, independent of age-related changes, for both lower-order and higher-order cognitive abilities. These impairments also increase between the stages, suggesting a cumulative effect. Future directions for research are discussed. (JINS, 2019, 25, 101-114).

Age-related changes in social decision-making: An electrophysiological analysis of unfairness evaluation in the Ultimatum Game

This study examines age-related differences in behavioral and neural responses to unfairness. Our sample was composed of younger, middle-aged, and older adults, who performed the Ultimatum Game in the proposer role, and in the respondent role during an EEG recording. We administered neurocognitive tests to identify whether patterns in decision-making are associated with age-related changes in cognition. Despite the worse performance in measures of executive functioning, older adults had the best economic strategy by accepting more unfair offers than younger and middle-aged adults. Regarding electrophysiological results, while younger adults showed higher medial frontal negativity (MFN) amplitudes after unfair than after fair offers, middle-aged and older adults had similar amplitudes after both conditions. Our results suggest that aging may be accompanied by an insensitivity to unfairness, which may underlie their higher rates of unfair offers acceptance.

Do Older Adults Select Appropriate Motor Strategies in a Stepping-Down Paradigm?

Selecting motor strategies in daily life tasks requires a perception of the task requirements as well as of one's own physical abilities. Age-related cognitive and physical changes may affect these perceptions. This might entail that some older adults select inappropriate movement strategies when confronted with daily-life motor tasks, which could lead to balance loss or falls. We investigated whether older adults select motor strategies in accordance with their actual physical ability. Twenty-one older adults were subjected to a stepping down paradigm, in which full-body kinematics of selected and reactive behavior were recorded. Stepping down from a curb can be done with either (1) a relatively low effort but more balance threatening heel landing, or (2) a more controlled but more demanding toe landing. The probability of selecting a toe landing grows with an increase in curb height. We determined the curb height at which participants switched from heel to toe landing during expected stepping down over different heights as an indicator of their perceived ability. During an unexpected step down trial, participants encountered a step down of 0.1 m earlier than expected, because part of the walkway was removed and covered by a black cloth. We evaluated participants' actual physical ability from the reactive behavior, with performance defined as the reduction in kinetic energy between the peak value after landing and the onset of the next step. To unravel whether the selected motor strategies corresponded with actual physical ability, the ability to recover from the unexpected step down was correlated to the height at which the participants switched movement strategy. The switching height was not correlated to the ability to recover from an unexpected step down (ρ = 0.034, p = 0.877). This finding suggests that older adults do not select their movement strategy in stepping down based on their actual abilities, or have an imprecise perception of their actual abilities. Future research should evaluate whether inappropriate motor strategy selection in a stepping down paradigm can explain accidental falls in older adults.

Superior Memory Reduces 8-year Risk of Mild Cognitive Impairment and Dementia But Not Amyloid β-Associated Cognitive Decline in Older Adults.

To prospectively examine 8-year risk of clinical disease progression to mild cognitive impairment (MCI)/dementia in older adults ≥60 with superior episodic memory (SuperAgers) compared to those cognitively normal for their age (CNFA). Additionally, to determine the extent to which SuperAgers were resilient to the negative effects of elevated amyloid-beta (Aβ+) on cognition. Participants were classified as SuperAgers based on episodic memory performance consistent with younger adults aged 30-44 and no impairment on non-memory tests (n = 179), and were matched with CNFA on age, sex, education, and follow-up time (n = 179). Subdistribution hazard models examined risk of clinical progression to MCI/dementia. Linear mixed models assessed the effect of Aβ on cognition over time. Prevalence of Aβ+ and APOE ε4 was equivalent between SuperAgers and CNFA. SuperAgers had 69%-73% reduced risk of clinical progression to MCI/dementia compared to CNFA (HR: 0.27-0.31, 95% CI: 0.11-0.73, p < .001). Aβ+ was associated with cognitive decline in verbal memory and executive function, regardless of SuperAger/CNFA classification. In the absence of Aβ+, equivalent age-related changes in cognition were observed between SuperAgers and CNFA. SuperAgers displayed resilience against clinical progression to MCI/dementia compared to CNFA despite equivalent risk for Alzheimer's disease (AD); however, SuperAgers had no greater protection from Aβ+ than CNFA. The deleterious effects of Aβ on cognition persist regardless of baseline cognitive ability. Thus, superior cognitive performance does not reflect resistance against the neuropathological processes associated with AD, and the observed resilience for SuperAgers may instead reflect neuropsychological criteria for cognitive impairment.

Sustainable and Healthy Organizations Promote Employee Well-Being: The Moderating Role of Selection, Optimization, and Compensation Strategies

The psychology of sustainability claims for a new kind of organization that promotes employee well-being as well as the search firm’s performance. In sustainable and healthy organizations, tasks are characterized by their significance, variety, autonomy, and feedback from the job. This way of organizing employees’ activities motivates them and can affect their well-being. However, due to a series of age-related physical and cognitive changes, older workers must constantly adapt to task demands to continue working and maintain their productivity. This research explores the moderating role of selection, optimization, and compensation strategies in the relationship between task characteristics (significance, variety, autonomy, and feedback from the job) on the one hand, and job satisfaction and organizational citizenship behaviors on the other. This study was carried out using a lagged design over a three-month interval. Participants were 183 Spanish workers aged between 45–55 years who completed two questionnaires (Time 1 and Time 2). The results support the moderating role of the optimization and compensation in the relationship between task characteristics and employee well-being. Elective selection and loss-based selection strategies do not moderate the relationship. These findings underscore that people who are actively involved in optimization and compensation strategies can age successfully at work. The implications of this study to improve the orientation practices of older workers are discussed.

Spousal Loss and Change in Cognitive Functioning: An Examination of Temporal Patterns and Gender Differences.

The study investigates whether the disadvantaged position of men in the adverse consequences of widowhood for health and mortality also exists for changes in cognitive health. We used data of up to 1,269 men and women aged 65 years and older who participated in the Longitudinal Aging Study Amsterdam in 3-yearly assessments between 1992 and 2012 (5,123 person-observations). All were married and without cognitive impairment (Mini-Mental State Examination ≥ 24) at baseline and up to 419 lost their spouse. In fixed effects regression models, the effect of spousal loss on change in four domains of cognitive functioning was estimated independently of age-related cognitive change. For women, a robust temporary decrease was found in the second year after spousal loss in the reasoning domain, but not in global cognitive functioning, processing speed, or memory. No robust effects were found for men. Considering that only one cognitive domain was affected and effects were temporary, cognitive functioning seems rather robust to the experience of spousal loss. Despite men having often been reported to be in a disadvantaged position in other health domains, our analyses indicate no such pattern for cognitive functioning.

Unpacking older drivers’ mobility at roundabouts: Their visual-motor coordination through driver–vehicle–environment interactions

While mobility and safety of older drivers are challenged by age-related cognitive changes, the increasingly complex road environment has placed a higher demand on their adaptability. Older drivers experience difficulties in regulating their operational level behaviors which rely on the second-to-second decision-making, e.g., using the visuospatial information to guide their steering. The roundabout maneuver is one of the critical scenarios for older drivers which requires efficient visual and motor coordination. Understanding older drivers’ visual-motor coordination at roundabouts will provide insights into the mobility and safety of older driver population, which is important yet to be explored. This paper contributes to new measurements in driving behavior through quantitative examinations on driver–vehicle–environment interactions. The drivers’ visual-motor coordination is conceptualized as a sequence of eye fixations coupling with the vehicle trajectory in a space–time path. The experimental data were from 38 older adults’ on-road driving recorded using context and location-aware enabled eye tracking and precise vehicle movement tracking. A visual-motor coordination composite indicator (VMCCI) was developed to measure the efficiency of visual-motor coordination in GIS based on the aggregate multiple parameters of visual and motor behaviors at entry, circulating and exit stage of a roundabout. The results show that the VMCCI is a sensitive indicator for identifying risky drivers, problematic road sections, problematic behaviors. Older drivers’ VMCCI was associated with the angle of deviation at roundabouts, particularly at the entry stage. Findings of this study have implications for actual roundabout designing practice, which will contribute to improve the safety of older drivers behind the wheel.

Cognitive and affective associations with an ecologically valid test of theory of mind across the lifespan.

Many studies have demonstrated that theory of mind (ToM) ability declines with increasing age. Research has found that ToM-age associations are often mediated by other cognitive abilities particularly executive function. However, older adults rarely complain about real-world ToM difficulties. It has been suggested that older adults may perform better in real-world situations compared with experimental settings. We examined performance on the Strange Stories Film Task (SSFT) which has been designed to assess ToM using naturalistic, video scenarios. Sixty adults aged between 17- and 95-years-old completed the SSFT, inhibitory control (Stroop) and working memory (letter-number sequencing) measures, the basic empathy scale (cognitive and affective empathy), and the broad autism phenotype questionnaire. ToM performance correlated significantly with age, whereas performance on a control task did not. Partial correlations and stepwise regression analyses demonstrated that performance on the three SSFT ToM measures was explained by a combination of executive function and empathy measures, with age explaining none of the variance. Using a naturalistic test of ToM, performance was shown to decline with age for ToM but not control scenarios. Across the lifespan, the variance in ToM performance was explained by cognitive abilities and empathy but not age. Age alone may not influence ToM ability, but may be associated with age-related changes in cognition and social-cognition. (PsycINFO Database Record

Erasure of striatal chondroitin sulfate proteoglycan-associated extracellular matrix rescues aging-dependent decline of motor learning.

Cognitive decline is a feature of aging. Accumulating evidence suggests that the brain extracellular matrix (ECM) is involved in the process of aging-dependent cognitive impairment and neurodegeneration by regulating synaptic neurotransmission and affecting neuroplasticity. Age-related changes in brain structure and cognition are not uniform across the whole brain. Being one of the most vulnerable brain regions to aging-dependent alterations, striatum is integral to several central nervous system functions, such as motor, cognition, and affective control. However, the striatal ECM is largely understudied. We first describe 2 major types of chondroitin sulfate proteoglycan (CSPG)-associated ECM in striatum: perineuronal nets and diffusive ECM. Both types of ECM accumulate in an aging-dependent manner. The accumulation of CSPG-associated ECM correlates with aging-dependent decline in striatum-related cognitive functions, including motor learning and working memory. Enzymatic depletion of CSPG-associated ECM in aged mice via chondroitinase ABC significantly improves motor learning, suggesting that changes in neural ECM CSPGs regulate striatal plasticity. Our study provides a greater understanding of the role of neural ECM underlying striatal plasticity, which is an important precursor to design appropriate therapeutic strategies for normal and pathologic aging.

ARE WE TALKING ABOUT THE SAME THING: AFRICAN AMERICANS’ RESPONSES TO THE BRFSS COGNITIVE IMPAIRMENT AND CAREGIVER MODULES IN OREGON

Health education and intervention messages are more effective when culturally appropriate for the targeted group.1 While the increase in cases of cognitive decline negatively affects the broader U.S. population, cognitive impairment, dementia, Alzheimer's disease and vascular dementia disproportionately affect African Americans.2 The Behavioral Risk Factor Surveillance System (BRFSS) is a randomized national telephone survey developed by the Centers for Disease Control and Prevention and administered by state health departments.2 The goal of BRFSS is to collect prevalence data concerning health-related risk behaviors and the use of preventive health services.3 Four focus groups (n=30) were completed with African Americans aged 45 and older living in Oregon. BRFSS cognitive impairment and caregiver surveys were administered, which guided subsequent group discussion. Participants were asked to reflect on experiences with cognitive decline and caregiving, how they make meaning of their experiences, and how they interpret survey terminology, such as “Alzheimer's disease,” “Memory loss,” “Confusion,” “Dementia,” and “Caregiving.” Discussion transcripts were coded using a content analysis approach. Data was interpreted within the Africana methodology, wherein the researcher is immersed in the research cultural worldview recognizing the interdependence of people and the environment remaining aware of the impact between researcher and research participant.4 BRFSS survey responses differed from focus group responses to the same questions. One survey response reported past-month care, while in discussion, 8 participants shared past-month activities they considered caregiving. Participants had expansive definitions of caregiving, such as therapeutic dance, and held widely differing interpretations of BRFSS terminology. Participants were unclear about what constituted age-related cognitive changes like memory loss and confusion, and what constituted dementia and Alzheimer's disease. Key terms used in cognitive health messaging are not universally understood. African American interpretations, as understood through their experiences with memory loss, confusion, Alzheimer's disease, dementia, and caregiving, can inform culturally responsive messages that more strongly resonate within the African American community, potentially prompting people to take actions towards better health. Understanding these perspectives is critical for improving dementia research especially in areas such as identifying subjective cognitive decline, caregiver intervention studies and treatment trials where efficacy of reported functional capacity is key.

Age-Related Cognitive Changes: The Importance of Modulating Factors

The study of age-related cognitive changes over the last years reveals a considerable variability in available results. The methodological heterogeneity observed in the aging field can significantly contribute to this observed variability, which creates a confusing scenario for beginners in this topic. The main aim of the present article is to extract a clear depiction of the current state of knowledge about age-related cognitive changes regardless of the methodological approach followed by researchers.

Genetic Risk for Age-Related Cognitive Impairment Does Not Predict Cognitive Performance in Middle Age.

Alzheimer's disease (AD) is characterized by memory loss and executive dysfunction, which correspond to structural changes to the medial temporal lobes (MTL) and prefrontal cortex (PFC), respectively. Given the overlap in cognitive deficits between healthy aging and the earliest stages of AD, early detection of AD remains a challenge. The goal of the present study was to study MTL- and PFC-dependent cognitive functioning in middle-aged individuals at genetic risk for AD or cognitive impairment who do not currently manifest any clinical symptoms. Participants (N = 150; aged 40-60 years) underwent genotyping of 47 single nucleotide polymorphisms (SNPs) in six genes previously associated with memory or executive functioning: APOE, SORL1, BDNF, TOMM40, KIBRA, and COMT. They completed two MTL-dependent tasks, the virtual Morris Water Task (vMWT) and transverse patterning discriminations task (TPDT), and the PFC-dependent reversal learning task. Although age was associated with poorer performance on the vMWT and TPDT within this middle-aged sample, there were no genotype-associated differences in cognitive performance. Although the vMWT and TPDT may be sensitive to age-related changes in cognition, carriers of APOE, SORL1, BDNF, TOMM40, KIBRA, and COMT risk alleles do not exhibit alteration in MTL- and PFC-dependent functioning in middle age compared to non-carriers.

Aging related cognitive changes associated with Alzheimer's disease in Down syndrome.

ObjectiveIndividuals with Down syndrome (DS) have an extremely high genetic risk for Alzheimer's disease (AD), however, the course of cognitive decline associated with progression to dementia is ill‐defined. Data‐driven methods can estimate long‐term trends from cross‐sectional data while adjusting for variability in baseline ability, which complicates dementia assessment in those with DS.MethodsWe applied an event‐based model to cognitive test data and informant‐rated questionnaire data from 283 adults with DS (the largest study of cognitive functioning in DS to date) to estimate the sequence of cognitive decline and individuals’ disease stage.ResultsDecline in tests of memory, sustained attention/motor coordination, and verbal fluency occurred early, demonstrating that AD in DS follows a similar pattern of change to other forms of AD. Later decline was found for informant measures. Using the resulting staging model, we showed that adults with a clinical diagnosis of dementia and those with APOE 3:4 or 4:4 genotype were significantly more likely to be staged later, suggesting that the model is valid.InterpretationOur results identify tests of memory and sustained attention may be particularly useful measures to track decline in the preclinical/prodromal stages of AD in DS whereas informant‐measures may be useful in later stages (i.e. during conversion into dementia, or postdiagnosis). These results have implications for the selection of outcome measures of treatment trials to delay or prevent cognitive decline due to AD in DS. As clinical diagnoses are generally made late into AD progression, early assessment is essential.