Adaptive and Maladaptive Behaviours and Their Cognitive Correlates in Aging Adults With Down Syndrome.
Yingying Yang, Sonia Conde, Romal Bhullar
PMID 42063326WHAT IT FOUND
In cognitively stable adults with Down syndrome, communication is the relative weakness and daily living the strength.
Memory and general cognitive ability predict adaptive functioning across all domains. No cognitive factor predicts maladaptive behaviour, which is uncommon in this group.
Key findings
01Written communication was the lowest-scoring subdomain (age-equivalent 7.27 years) and domestic independent living the highest (13.30 years). At the domain level, socialisation (standard score 53.67) was significantly higher than communication (46.36) and daily living (47.52).
02After accounting for age and severity of intellectual disability, general cognitive ability (DSMSE), memory (cued recall), and inhibitory control (Cats and Dogs task) each significantly predicted overall adaptive behaviour. All four cognitive domains (dementia symptoms, visuospatial construction, executive processing and speed, new learning and memory) were significant predictors.
0342.7% of participants scored zero on the Reiss Screen for maladaptive behaviour, and only 8.3% scored at or above the clinical cut-off. Neither demographic factors (age, gender, ID severity) nor any cognitive measure predicted maladaptive behaviour.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
Cross-sectional design: the cognitive-behaviour associations cannot be read as causal, and the direction of effects is untested. Only cognitively stable adults (no MCI or dementia) were included, so findings do not apply to those with cognitive decline or AD. Maladaptive behaviour analysis was limited by floor effects (42.7% scored zero) and severe non-normality, forcing a binary transformation that loses granularity. Adaptive and maladaptive behaviours were informant-reported (caregivers), not directly observed. The sample was 96.5% Caucasian (250 of 259), limiting generalisability. The Reiss Screen is a brief 26-item screening tool, not a comprehensive diagnostic instrument for psychopathology.
Declared interests
Funded by the National Institutes of Health (U01AG051406 and U01AG051412) through the Alzheimer's Disease Biomarker Consortium on Down Syndrome. Authors declare no conflicts of interest.
The easy way to misread this
Do not read the cognitive predictors as evidence that cognitive training will improve adaptive behaviour. This is a cross-sectional correlational study: it shows that people with better memory and inhibitory control also have better adaptive skills, but it does not show that improving those cognitive skills will change adaptive outcomes. The direction of causation is untested.
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