Association of biological sex with Alzheimer’s disease prevalence and cognitive decline in adults with Down syndrome. (A) Point prevalence of symptomatic Alzheimer’s disease by 5-year age intervals. Group differences were assessed with Pearson's chi-squared analysis (for details, see Supplementary Table 2). (B) Survival analysis showing the probability of developing symptomatic Alzheimer’s disease by age and sex. The P-value refers to log-rank test analysis. (C) Scatterplots illustrating the distribution of age at diagnosis of symptomatic Alzheimer’s disease. The graph shows the individual data points, the means and the nonparametric bootstrapped 95% confidence intervals. The P-value refers to a t-test (for details, see Supplementary Table 2). (D–F) Neuropsychological performance by age and sex at the CAMCOG-DS (D), immediate (E), and delayed (F) recall at the mCRT, with bands representing the 95% confidence intervals. A significant difference between LOESS curves was defined as the age at which the curves diverged visually and the 95% confidence intervals did not overlap (P < 0.05). CAMCOG-DS, Cambridge Cognitive Examination for Older Adults with Down Syndrome; mCRT, modified cued recall test; F, female; M, male.