Introduction There is a critical need to identify measures of cognitive functioning sensitive to early Alzheimer's disease (AD) pathophysiology in Down syndrome to advance clinical trial research in this at‐risk population. The objective of the study was to longitudinally track performance on cognitive measures in relation to neocortical and striatal amyloid beta (Aβ) in non‐demented Down syndrome. Methods The study included 118 non‐demented adults with Down syndrome who participated in two to five points of data collection, spanning 1.5 to 8 years. Episodic memory, visual attention and executive functioning, and motor planning and coordination were assessed. Aβ was measured via [C‐11] Pittsburgh Compound‐B (PiB) PET. Results PiB was associated with level and rate of decline in cognitive performance in episodic memory, visual attention, executive functioning, and visuospatial ability in models controlling for chronological age. Discussion The Cued Recall Test emerged as a promising indicator of transition from preclinical to prodromal AD.

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Background This study examined the association between executive functioning and language in young adults with Down syndrome (DS). Method Nineteen young adults with DS (aged 19–24 years) completed standardised measures of overall cognition, vocabulary, verbal fluency and executive function skills. Results Friedman's analysis of variance (χ2(3) = 28.15, P < .001) and post hoc comparisons indicated that, on average, participants had a significantly lower overall non‐verbal than verbal cognitive age equivalent and lower expressive than receptive vocabulary skills. Using Spearman correlations, performance on a verbal measure of cognition inhibition was significantly negatively related to receptive vocabulary (ρ = −.529, adjusted P = .036) and verbal fluency (ρ = −.608, adjusted P = .022). Attention was significantly positively correlated with receptive (ρ = .698, adjusted‐p = .005) and expressive (ρ = .542, adjusted P = .027) vocabulary. Verbal working memory was significantly positively associated with receptive vocabulary (ρ = .585, adjusted P = .022) and verbal fluency (ρ = .737, adjusted P = .003). Finally, visuospatial working memory was significantly associated with receptive vocabulary (ρ = .562, adjusted P = .027). Conclusions Verbal and non‐verbal measures of executive functioning skills had important associations with language ability in young adults with DS. Future translational research is needed to investigate causal pathways underlying these relationships. Research should explore if interventions aimed at increasing executive functioning skills (e.g. attention, inhibition and working memory) have the potential to lead to increases in language for young adults with DS.

Introduction Drawing on the amyloid/tau/neurodegeneration (AT[N]) model, the study examined whether the tau positron emission tomography (PET) biomarker [ 18 F]AV‐1451 was associated with episodic memory problems beyond what was predicted by the amyloid beta (Aβ) PET in Down syndrome (DS). Methods Data from 123 non‐demented adults with DS ( M = 47 years, standard deviation = 6.34) were analyzed. The Cued Recall Test assessed episodic memory. Tau PET standardized update value ratio (SUVR) was assessed across Braak regions as continuous and binary (high tau [T H ] vs. low tau [T L ]) variable. Global PET Aβ SUVR was assessed as binary variable (Aβ– vs. Aβ+). Results In models adjusting for controls, tau SUVR was negatively associated with episodic memory performance in the Aβ+ but not Aβ– group. The Aβ+/T H group evidenced significantly worse episodic memory than the Aβ+/T L group. Discussion Similar to late‐onset and autosomal dominant Alzheimer's disease (AD), high tau was an indicator of early prodromal AD in DS.