% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Soriano:279349,
      author       = {Soriano, Laura Del Hoyo and Sandkühler, Katja and Videla,
                      Laura and Benejam, Bessy and Carmona-Iragui, Maria and
                      Wlasich, Elisabeth and Kustermann, Julia and Barroeta,
                      Isabel and Vaqué-Alcázar, Lídia and Rodríguez-Baz,
                      Íñigo and Bejanin, Alexandre and Fernández, Susana and
                      Arranz, Javier and Arriola-Infante, Jose Enrique and
                      Maure-Blesa, Lucia and Juan, Aida San and Nübling, Georg
                      and Wagemann, Olivia and Stockbauer, Anna and Hassenstab,
                      Jason and Levin, Johannes and Fortea, Juan},
      title        = {{D}iscrepancies in assessing intellectual disability levels
                      in adults with {D}own syndrome: {I}mplications for dementia
                      diagnosis.},
      journal      = {Alzheimer's and dementia},
      volume       = {21},
      number       = {6},
      issn         = {1552-5260},
      address      = {Hoboken, NJ},
      publisher    = {Wiley},
      reportid     = {DZNE-2025-00726},
      pages        = {e70307},
      year         = {2025},
      abstract     = {Cut-offs derived from baseline cognitive assessments,
                      stratified by intellectual disability (ID) level, have been
                      proposed to diagnose symptomatic Alzheimer's disease (AD) in
                      Down syndrome (DS). However, discrepancies in ID
                      classification risk misclassification when applying cut-offs
                      across sites.This dual-center cohort study included 673
                      adults with mild to moderate ID at different AD stages. We
                      assessed ID classification discrepancies across sites and
                      the impact on Cambridge Cognitive Examination for Older
                      Adults with Down's Syndrome (CAMCOG-DS) cut-offs for AD
                      dementia diagnosis derived from receiver operating
                      characteristic analysis.Inter-rater agreement for ID level
                      classification was $95\%$ within sites but $60\%$ between
                      sites. While CAMCOG-DS score distributions in the whole
                      cohort were similar across sites, ID classification
                      discrepancies caused higher cut-offs in Barcelona for mild
                      and moderate ID compared to Munich. Applying site-specific
                      cut-offs to another cohort reduced sensitivity and
                      specificity.Standardizing ID classification is critical for
                      generalizable cut-offs to accurately diagnose AD dementia
                      based on neuropsychological assessments in DS.CAMCOG-DS
                      cut-offs by intellectual disability level classify dementia
                      in Down syndrome. ID classification discrepancies between
                      sites impact CAMCOG-DS diagnostic cut-offs. Applying
                      site-specific cut-offs to other cohorts reduces sensitivity
                      and specificity. Standardized ID classification is essential
                      for generalizable cognitive cut-offs. Use site-specific
                      cut-offs until ID classification is standardized.},
      keywords     = {Humans / Down Syndrome: complications / Intellectual
                      Disability: diagnosis / Female / Male / Neuropsychological
                      Tests: statistics $\&$ numerical data / Cohort Studies /
                      Middle Aged / Aged / Dementia: diagnosis / Alzheimer
                      Disease: diagnosis / AD21 (Other) / Alzheimer's disease
                      (Other) / Cambridge Cognitive Examination for Older Adults
                      with Down Syndrome (Other) / Down Alzheimer Barcelona
                      Neuroimaging Initiative (Other) / Down syndrome (Other) /
                      Down syndrome–associated Alzheimer's disease (Other) /
                      cut‐off points (Other) / dementia (Other) / diagnostic
                      performance (Other) / intellectual disability (Other)},
      cin          = {Clinical Research (Munich) / AG Simons},
      ddc          = {610},
      cid          = {I:(DE-2719)1111015 / I:(DE-2719)1110008},
      pnm          = {353 - Clinical and Health Care Research (POF4-353) / 351 -
                      Brain Function (POF4-351)},
      pid          = {G:(DE-HGF)POF4-353 / G:(DE-HGF)POF4-351},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40528393},
      pmc          = {pmc:PMC12173952},
      doi          = {10.1002/alz.70307},
      url          = {https://pub.dzne.de/record/279349},
}