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This study aimed to develop and validate the CAMCOG\u2010DS\u2010II.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n In this multi\u2010language, multi\u2010site study, the psychometric properties of the CAMCOG\u2010DS\u2010II were evaluated against previously validated measures in 223 participants (mean age: 40.18 years) with DS across seven countries.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The CAMCOG\u2010DS\u2010II had a high completion rate, minimal floor\/ceiling effects (compared to the modified Cued Recall Test, the CANTAB Paired Associates Learning, and the Purdue Pegboard), strong validity and reliability, and performance was unaffected by language across sites. It differentiated between those with\/without AD and distinguished clinically rated cognitively stable and prodromal individuals.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n The CAMCOG\u2010DS\u2010II is a sensitive measure of cognitive performance in people with DS at risk of AD. Its cross\u2010language and site reliability support its potential use in AD\u2013DS clinical trials.<\/jats:p>\n <\/jats:sec>\n \n Highlights<\/jats:title>\n \n \n \n Developed and validated the Cambridge Cognitive Examination modified for use in people with Down syndrome (CAMCOG\u2010DS\u2010II) for Alzheimer's disease in Down syndrome.<\/jats:p>\n <\/jats:list-item>\n \n CAMCOG\u2010DS\u2010II shows increased sensitivity to Alzheimer's disease\u2013related decline in Down syndrome.<\/jats:p>\n <\/jats:list-item>\n \n Improved applicability across an international and culturally diverse population.<\/jats:p>\n <\/jats:list-item>\n \n Differentiates Alzheimer's disease status: cognitively stable, prodromal, and clinical.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n 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