Challenges faced in managing dementia in Alzheimer’s disease in patients with Down syndrome

Abstract

Dementia in Alzheimer’s disease (DAD) is more common in adults with Down syndrome (DS), with characteristically an earlier onset. The treatment of DAD is not too dissimilar in the general population and in people with intellectual disabilities. However, the underlying intellectual disability can make the management of DAD more challenging in older adults with DS. This literature review aimed to look at the management of DAD in people with DS. The management of dementia is holistic. This includes treating reversible factors, aiming to slow the cognitive decline, psychological therapies, ensuring that the environment is appropriate, and use of psychotropic medication when necessary to manage behavioral problems, psychotic symptoms, depressive symptoms, and sleep difficulty. Antidementia medications have a role to play but remain limited. The management of DAD in the DS population can be at times challenging, but good clinical practice should involve accurate diagnosis of dementia, treating any reversible additional factors, consideration of psychological and behavioral management, use of antidementia medication, and a multidisciplinary team approach.

Tiny Toes to Tau Tangles: Down's Syndrome and Its Association With Alzheimer's Disease

“…Management mainly aims to delay and reduce cognitive decline, thus improving the quality of life [ 38 ]. But the management of AD in DS patients can be challenging due to underlying ID [ 39 ].…”

Caregivers’ Perceptions of Family Quality of Life of Individuals with Developmental Disabilities Comorbid with Dementia: A Pilot Study

“…Secondary infections, such as pneumonia, are common contributors to premature death in individuals with dementia (Manabe et al, 2019). People with Down syndrome and dementia can have additional comorbidities such as weight loss, hypothyroidism, as well as hearing and vision impairments (Esbensen, 2010;Prasher et al, 2016). People with dementia gradually lose their ability to complete activities of daily living and in end stages often cannot recognise their own family members.…”