Down syndrome: Cognitive and behavioral functioning across the lifespan

Topic: Brain imaging, connectivity and assessment

Individuals with Down syndrome (DS) commonly possess unique neurocognitive and neurobehavioral profiles that emerge within specific developmental periods. These profiles are distinct relative to others with similar intellectual disability (ID) and reflect underlying neuroanatomic findings, providing support for a distinctive phenotypic profile. This review updates what is known about the cognitive and behavioral phenotypes associated with DS across the lifespan. In early childhood, mild deviations from neurotypically developing trajectories emerge. By school-age, delays become pronounced. Nonverbal skills remain on trajectory for mental age, whereas verbal deficits emerge and persist. Nonverbal learning and memory are strengths relative to verbal skills. Expressive language is delayed relative to comprehension. Aspects of language skills continue to develop throughout adolescence, although language skills remain compromised in adulthood. Deficits in attention/executive functions are present in childhood and become more pronounced with age. Characteristic features associated with DS (cheerful, social nature) are personality assets. Children are at a lower risk for psychopathology compared to other children with ID; families report lower levels of stress and a more positive outlook. In youth, externalizing behaviors may be problematic, whereas a shift toward internalizing behaviors emerges with maturity. Changes in emotional/behavioral functioning in adulthood are typically associated with neurodegeneration and individuals with DS are higher risk for dementia of the Alzheimer's type. Individuals with DS possess many unique strengths and weaknesses that should be appreciated as they develop across the lifespan. Awareness of this profile by professionals and caregivers can promote early detection and support cognitive and behavioral development.

Key findings

• This review updates what is known about the cognitive and behavioral phenotypes associated with DS across the lifespan.
• Characteristic features associated with DS (cheerful, social nature) are personality assets.
• Children are at a lower risk for psychopathology compared to other children with ID; families report lower levels of stress and a more positive outlook.
• Changes in emotional/behavioral functioning in adulthood are typically associated with neurodegeneration and individuals with DS are higher risk for dementia of the Alzheimer's type.

Study details

• Evidence strengthLow

Read the original

• DOI: 10.1002/ajmg.c.31439
• PubMed: 25989505
• Original source →

Free copy unknown: no free-copy check has an answer for this record yet. That does not mean it is paywalled.

@article{grieco2015-25989505,
  author  = {Grieco, J. and Pulsifer, M. and Seligsohn, K. and Skotko, B. and Schwartz, A.},
  title   = {{Down syndrome: Cognitive and behavioral functioning across the lifespan}},
  journal = {American journal of medical genetics. Part C, Seminars in medical genetics},
  year    = {2015},
  doi     = {10.1002/ajmg.c.31439},
  pmid    = {25989505},
  url     = {https://doi.org/10.1002/ajmg.c.31439}
}

Related studies in Down syndrome and Alzheimer's

• Perinatal choline supplementation improves cognitive functioning and emotion regulation in the Ts65Dn mouse model of Down syndrome Behavioral neuroscience · 2010-06-01 · usefulness score 36/100
• Neuropathological measures of increased tau phosphorylation across the Down syndrome lifespan Acta neuropathologica · 2026-03-22 · usefulness score 48/100
• Evolution of neuroinflammation across the lifespan of individuals with Down syndrome Brain : a journal of neurology · 2020-12-01 · usefulness score 48/100
• Down syndrome: age-dependence of PiB binding in postmortem frontal cortex across the lifespan Neurobiology of aging · 2017-03-14 · usefulness score 43/100
• Epilepsy Mechanisms in Down Syndrome: Genetic and Pathophysiological Perspectives Across the Lifespan Journal of Clinical Medicine · 2026-09-25 · usefulness score 32/100
• Cognitive enhancement by pharmacological and behavioral interventions: the murine Down syndrome model Biochemical pharmacology · 2012-08-08 · usefulness score 36/100

Similar studies

• The importance of understanding individual differences in Down syndrome 2016 · Down syndrome and Alzheimer's
• Psychiatric disorders in persons with Down syndrome 1991 · Down syndrome and Alzheimer's
• Executive dysfunction and its association with personality and behaviour changes in the development of Alzheimer's disease in adults with Down syndrome and mild to moderate learning disabilities 2008 · Down syndrome and Alzheimer's
• Cognitive executive function in Down's syndrome 2006 · Down syndrome and Alzheimer's
• A prospective 14-year longitudinal follow-up of dementia in persons with Down syndrome 2014 · Down syndrome and Alzheimer's
• Atypical aging in Down syndrome 2013 · Down syndrome and Alzheimer's

More on Down syndrome and Alzheimer's

• A review that covers this ground Psychiatric and behavioral disorders in persons with Down syndrome Mental retardation and developmental disabilities research reviews · 2007-01-01 · usefulness score 36/100
• Newest in this subject Differential endothelial cell remodeling in Down syndrome and APP duplication drives distinct blood brain barrier dysfunction bioRxiv · 2026-10-30 · Preprint — not yet peer-reviewed · usefulness score 16/100
• Newest in this subject Memory and Plasma pTau217 Refine Prognosis in Down Syndrome Annals of neurology · 2026-10-02 · Peer-reviewed · usefulness score 47/100

See all studies in Down syndrome and Alzheimer's →