Cognitive Rehabilitation of Dementia in Adults with Down Syndrome: A Review of Non-Pharmacological Interventions

Abstract

Background: There is a close genetic relationship between Alzheimer's disease (AD) and Down syndrome (DS), AD being the most severe mental disorder affecting ageing individuals with DS. The objective of the present study was to evaluate the efficacy of cognitive rehabilitation interventions in DS patients with AD by means of a critical literature review. Summary: Because AD is progressive and irreversible, treatment is aimed at delaying and reducing the cognitive and functional decline in order to preserve or improve quality of life. The effects that pharmacological treatments and cognitive interventions have on elderly individuals with AD are well documented. Recent clinical trials have investigated the use of pharmacological treatment in DS patients with AD, generating preliminary results that have been unfavourable. Key Messages: There is a clear lack of studies addressing the efficacy of cognitive rehabilitation interventions in DS patients with AD, and there is an urgent need for studies providing evidence to inform decisions regarding the appropriate choice of treatment strategies.

Frontal Lobe Degeneration in Adults with Down Syndrome and Alzheimer's Disease: A Review

“…Despite the proven link between DS and AD, pharmacological and nonpharmacological interventions are still under investigation [15], and diagnosing dementia in individuals with intellectual disabilities continues to be a challenge. That is because the vast majority of instruments used for the detection of dementia were developed from studies of individuals with normal intellectual development, being intended for application in the general population.…”

Premature aging in adults with Down syndrome: genetic, cognitive and functional aspects

“…Nichols 20 preventively proposes therapeutic measures such as the protection of mitochondrial decline from oxidative stress with antioxidants, sleep regulation, dietary monitoring and vitamin supplementation, among others. Fonseca et al 10 , considering the occurrence of AD in this syndrome, emphasize the importance of treatments, pharmacological or not, in reducing cognitive and functional losses, attenuating clinical signs. Health care for adults and elderly people with DS is a matter of priority and should be aimed at maintaining a healthy lifestyle (diet, sleep hygiene and exercise) and developing autonomy for activities of daily living, highlighting measures of self-care, socialization, social and economic inclusion¹.…”

Book of Abstracts

“…People with learning disabilities are at an increased risk of developing dementia as compared to the general population, with a significantly higher risk for people with Down's syndrome, and at a much earlier age. Despite the increased prevalence, specific evidence-based non-pharmacological interventions are lacking (Fonseca et al, 2015). Cognitive Stimulation Therapy (CST) is a NICE recommended brief group intervention for individuals with mild-moderate dementia (Spector et al, 2003).…”