The Down Alzheimer Barcelona Neuroimaging Initiative (DABNI) and its contributions to understanding Alzheimer's disease in Down syndrome: A decade of discovery.

Down syndrome (DS) is a genetic form of Alzheimer's disease (AD) that offers crucial insights into AD pathogenesis. The Down Alzheimer Barcelona Neuroimaging Initiative (DABNI) is a population-based multimodal biomarker cohort studying AD's natural history and clinical trials in DS. DABNI included 1135 participants (mean age 42.82, 46.3% female). At baseline, 673 participants were cognitively stable, 113 had prodromal AD, 239 had AD dementia, and 110 were uncertain due to non-AD conditions. Over 10 years, > 10000 clinical visits were conducted; follow-up showed that progression to symptomatic AD before age 40 was rare, but rates increased after age 50 (> 50% within 5 years). Neuropsychological and biomarker assessments demonstrated excellent diagnostic performance and a predictable sequence of changes, similar to autosomal dominant AD. DABNI participates in AD clinical trials and produced approximately 100 publications. The 10-year DABNI study provided critical insights into DS-associated AD (DSAD) and serves as a key platform for DS clinical trials. HIGHLIGHTS: Down Alzheimer Barcelona Neuroimaging Initiative (DABNI) is a population-based multimodal cohort studying Alzheimer's disease in Down syndrome. Over 10 years, 1135 participants contributed to more than 10000 clinical visits and extensive biomarker studies. DABNI findings have transformed the understanding of Alzheimer's disease in Down syndrome, reinforcing its classification as a genetic form of the disease. The cohort integrates clinical care and research, enhancing early detection and patient management. DABNI supports clinical trials and has produced over 100 publications advancing Down syndrome-related Alzheimer's research.