Assessment of dementia in a clinical sample of persons with intellectual disability

Abstract

Background Assessment of age‐associated disorders has become increasingly important. Methods In a clinical setting, people with intellectual disability with and without dementia were assessed retrospectively using the Neuropsychological Test Battery (NTB) and the Dementia Questionnaire for People with Learning Disabilities (DLD) at two different times to analyse neuropsychological changes and diagnostic validity. One group (n = 44) was assessed with both instruments, while the DLD was applied in 71 patients. Results In the NTB (n = 44), only patients with dementia (n = 26) showed a decline in the NTB total score and three subscales. Receiver operating characteristic analysis revealed a diagnostic sensitivity of .67, a specificity of .81, and an area under the curve (AUC) of .767. In the DLD group (n = 71), only those with dementia displayed a decrease in the cognitive and social scale; diagnostic sensitivity and specificity values were low (.61/.63) and the AUC was .704. Conclusions Neuropsychological assessment was sensitive to detect cognitive changes over time. Sensitivity values of both instruments suggest a reassessment at a later time point.

Screening and diagnosing dementia in people with Down’s syndrome: implications of using the DLD questionnaire

“…Specificity was 60% for DLD SCS and 73% for DLD SOS. The results are comparable to those of Ro ¨sner et al (2021), who used the same cut-off scores in 71 patients, and found that the sensitivity values ranged from 58.3% to 72.2%, and the specificity values from 62.9% to 71.4% (Ro ¨sner et al, 2021). Previous literature reports the sensitivity and specificity separately for both SCS and SOS scores to have varied considerably (Evenhuis, 1992(Evenhuis, , 1996.…”

“…There are eight sub-scales (short-term memory, long-term memory, spatial and temporal orientation, speech, practical skills, mood, activity and interest and behavioural disturbance). Even though Evenhuis (1992) reported that the DMR has a sensitivity of 100% (Evenhuis, 2018), other studies have shown that DLD has lower sensitivity and specificity (0.61/ 0.63) despite its wide usage (Ro ¨sner et al, 2021;Evenhuis, 1992). Studies have shown how individual carers' perceptions of decline in function can influence the outcome of the DLD assessment.…”

The Use of F-18 FDG PET-Based Cognitive Reserve to Evaluate Cognitive Decline in Alzheimer’s Disease, Independent of Educational Influence

“…Questionnaire-based neuropsychological assessments may be difficult to obtain, particularly for individuals with intellectual disabilities. Indeed, the low sensitivity of questionnaire-type cognitive assessments has been previously reported [ 18 ]. The evaluation of cognitive function using neuropsychological assessments, including the MMSE, remains controversial [ 19 , 20 ].…”

The Global Deterioration Scale for Down Syndrome Population (GDS-DS): A Rating Scale to Assess the Progression of Alzheimer’s Disease

“…There are several cases in daily clinical practice in which neuroimaging and biomarker findings suggest a certain diagnosis but without being supported by a neuropsychological examination, as in cases of biomarker positivity for AD without associated or progressive cognitive impairment [ 18 ]. Because biomarkers may fail in the diagnosis of AD, a neuropsychological examination can provide crucial cognitive information in the diagnostic and follow-up processes of the ID population [ 23 ]. In this sense, the aspects that should be explored in any longitudinal assessment for the entire continuum of AD-DS are dysexecutive cognitive or behavioral features, episodic memory, orientation, and general global cognitive decline [ 24 , 25 , 26 , 27 ].…”