The aim of this study is to adapt and validate the global deterioration scale (GDS) for the systematic tracking of Alzheimer’s disease (AD) progression in a population with Down syndrome (DS). A retrospective dual-center cohort study was conducted with 83 participants with DS (46.65 ± 5.08 years) who formed the primary diagnosis (PD) group: cognitive stability (n = 48), mild cognitive impairment (n = 24), and Alzheimer’s disease (n = 11). The proposed scale for adults with DS (GDS-DS) comprises six stages, from cognitive and/or behavioral stability to advanced AD. Two neuropsychologists placed the participants of the PD group in each stage of the GDS-DS according to cognitive, behavioral and daily living skills data. Inter-rater reliability in staging with the GDS-DS was excellent (ICC = 0.86; CI: 0.80–0.93), and the agreement with the diagnosis categories of the PD group ranged from substantial to excellent with κ values of 0.82 (95% CI: 0.73–0.92) and 0.85 (95% CI: 0.72, 0.99). Performance with regard to the CAMCOG-DS total score and orientation subtest of the Barcelona test for intellectual disability showed a slight progressive decline across all the GDS-DS stages. The GDS-DS scale is a sensitive tool for staging the progression of AD in the DS population, with special relevance in daily clinical practice.
In this study, we examined normative data and diagnostic accuracy of a pictorial screening test to detect memory impairment for mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in Spanish-speaking adults with intellectual disability (ID). A total of 94 volunteers with ID (60 controls, 17 MCI, and 17 AD), were evaluated by neuropsychological tests including the PMIS-ID in a cross-sectional validation study. Discriminative validity between the MCI, AD, and control group was analyzed by the area under the ROC curve. A cut-off score of 4.5 on the immediate recall trial had a sensitivity of 69% and a specificity of 80% to detect memory impairment (AUC = 0.685; 95% CI = 0.506–0.863) in the AD group. The PMIS-ID is a useful screening test to rule out a diagnosis of memory decline in people with moderate level of ID and AD, and it shows good psychometric properties.