The existing evidence paints an unclear picture of whether an association exists between depression and memory impairment. The purpose of this investigation was to determine whether depression is associated with memory impairment, whether moderator variables determine the extent of this association, and whether any obtained association is unique to depression. Meta-analytic techniques were used to synthesize data from 99 studies on recall and 48 studies on recognition in clinically depressed and nondepressed samples. Associations between memory impairment and other psychiatric disorders (e.g., schizophrenia, dementia) were also examined. A significant, stable association between depression and memory impairment was revealed. Further analyses indicated, however, that it is likely that depression is linked to particular aspects of memory, the linkage is found in particular subsets of depressed individuals, and memory impairment is not unique to depression.

The foremost impediment to progress in the understanding and treatment of dementia in adults with intellectual disability is the lack of standardized criteria and diagnostic procedures. Standardized criteria for the diagnosis of dementia in individuals with intellectual disability are proposed, and their application is discussed. In addition, procedures for determining whether or not criteria are met in individual cases are outlined. It is the intention of the authors, who were participants of an International Colloquium on Alzheimer Disease and Mental Retardation, that these criteria be appropriate for use by both clinicians and researchers. Their use will improve communication among clinicians and researchers, and will allow researchers to test hypotheses concerning discrepancies in findings among research groups (e.g. dementia prevalence ranges and age of onset).

A working battery of tests for the diagnosis of dementia, which is applicable to most adults with intellectual disability, is proposed by an international Working Group. The battery, reflecting contemporary research and practice findings, includes scales for informant report of functioning and tests for direct assessment. The Working Group recommends the international use of the battery both as part of ongoing and new longitudinal research, and in clinical practice. The widespread use of a common battery will enhance communication and collaborative opportunities among researchers and clinicians at various sites, and will help to standardize diagnostic protocols and research findings. The collaborative evaluation of such a battery will address one of the greatest challenges in the field, that of differentiating change associated with ageing from that associated with dementia.

Two experiments were conducted to explore the switching of attention between perception and memory. In Experiment 1, college students performed a task that required them to cycle or switch attention between perceptual and memorial inputs. Switching times of 293 and 376 msec per switch were obtained on the basis of two formulas. In Experiment 2, the attentional load was manipulated by varying the number of perceptual and memorial inputs. Switching time increased as a function of list length, indicating that item load affects both the control processes that set attentional allocation policies and one's ability to perform memory and/or perceptual tasks. These results suggest that modularity, or encapsulation of item and control-process systems, does not hold. A model is presented that depicts the relation between item and control-process representation in rapidly alternating attention between perception and memory.Many common tasks, such as reading (Baddeley, 1982; Byrd & Gholson, 1984) and using a memorized shopping list, seem to involve a rapid cycling of attention or switching between information available in the environment and information stored in memory. The nature of switching between perception and memory is the concern of the present study.In the past, typical methods used to study attention switching involved either dichotic listening, in the classical tradition of Broadbent (1958), or the manipulation of expectancies as to the spatial location of critical events (Shulman, Remington, & McLean, 1978). In the dichotic listening task, each ear concurrently receives a different set of digits to be recalled. The pattern of recall does not typically follow the order of presentation, but is first by one ear and then the other, presumably because of the difficulty or time required to alternate attention between ears. In the expectancy manipulation approach, the probable location of a target is cued, and then the target is presented. In cases of agreement between cued and real target information, there is a savings in reaction time over a control condition with a noninformative cue. In cases of disagreement between cue and target location, there is a substantial increase in processing over a control condition. This latter difference could be interpreted as a switching time.However excellent the dichotic and expectancy methods may be for the study of certain aspects of attention, they may not be entirely appropriate for the study of rapid selfpaced switches between perception and memory. TheThe first author would like to acknowledge the support and use of facilities from the Department of Psychology and Social Relations, Harvard University, during his sabbatical leave. D. B. Burt is now at the

Although dementia associated with Down syndrome is often presumed to be progressive and irreversible, variations in disease course have been described. In addition, prevalence rates have varied widely among studies. This interim report is a description of the status of 70 adults with Down syndrome who are being followed for signs of dementia. Of the 70, 12 met all criteria for dementia, 40 met subsets of criteria, and 18 met no criteria. Information is provided on instruments used, rationale for choice and revision of instruments as well as criteria used to identify dementia and changes in the status of the participants. The results suggest that extreme care is needed when diagnosing dementia in adults with Down syndrome, for both clinical and research purposes.

Accurate detection of dementia in adults with intellectual disabilities is important for clinical care, program planning, and clinical research. This paper reports on a study that examined two major diagnostic methods that varied in the following ways: (1) the extent to which they relied on clinical judgment; (2) the statistical method used to detect declines; and (3) the sensitivity to declines in functioning. Two methods based on testing were compared with one based on clinical judgment. Data were drawn from annual sequential assessments of 168 adults with intellectual disabilities (78 with Down syndrome and 90 with other etiologies). Agreement between testing and clinical judgment methods was 72-75% depending on testing method used. Clinical judgment produced a higher rate of dementia diagnosis for adults with Down syndrome compared with testing methods, suggesting a possible bias. The authors found that diagnostic criteria were useful both for identifying dementia and for describing its characteristics. Our results suggest that clinical judgment could result in a higher number of adults with Down syndrome diagnosed with dementia than methods based on test batteries. Common results across research studies indicate that combinations of sources of information (interviews/direct testing) would be most useful for dementia diagnosis. Future collaboration across research sites is needed to promote rapid progress in this important area, with emphasis on differential diagnosis.

A cross-sequential design was used to examine changes related to aging in adults with and without Down syndrome (ns = 55 and 75, respectively). Adults received yearly neuropsychological and medical evaluations. Support for precocious aging in adults with Down syndrome was evident only on a test of verbal fluency, with weaker support obtained on a test of fine-motor skills. Cross-sectional age differences for all adults were obtained on tests of memory and community living skills. General intellectual level, gender, and psychiatric status were consistently related to performance, indicating the need to examine such mediating variables in studies on aging.

We compared groups with and without diagnosed dementia matched on IQ, age, and presence of Down syndrome. The Dementia Scale for Down Syndrome and Dementia Questionnaire for Mentally Retarded Persons were used to assess participants. We developed two performance tasks to determine whether they were useful in separating subjects with and without dementia and also used the Reiss Screen. Both dementia scales and both performance tasks discriminated between groups. The dementia scales were not related to premorbid IQ, age, or gender, whereas performance tasks were related to dementia and IQ but not age or gender. Various Reiss Screen subscales also discriminated between groups. Subscales of the screening instruments and performance tasks were significantly related, indicating congruent validity. Logistic regression was conducted to assess which combination of tests discriminated best between groups.