Dementia in intellectual disability

Sheehan, Rory; Ali, Afia; Hassiotis, Angela

doi:10.1097/yco.0000000000000032

Cited by 30 publications

(25 citation statements)

References 37 publications

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“…As life expectancy of PWID extends into older age, dementia is an increasing cause of morbidity and mortality. The prevalence of dementia in PWID is comparable with or even higher than in the general population [1][2][3][4]. Preexisting cognitive impairment may complicate the diagnosis of dementia in PWID possibly leading to underdiagnosis and consequently mismanagement [4].…”

Section: Introductionmentioning

confidence: 98%

Prevalence of dementia and organization of dementia care in Swiss disability care homes

Wicki

Riese

2016

Disability and Health Journal

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Section: Introductionmentioning

confidence: 98%

Prevalence of dementia and organization of dementia care in Swiss disability care homes

Wicki

Riese

2016

Disability and Health Journal

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“…An emerging public health concern is the increasing prevalence of adults with intellectual disability (ID) diagnosed with Alzheimer's disease and related conditions resulting in dementia Jokinen et al, 2013; National Task Group on Intellectual Disabilities and Dementia Practices [NTG], 2012a; Sheehan, Ali, & Hassiotis, 2014;Strydom, Hassiotis, King, & Livingston, 2009;Watchman, 2014;World Health Organization [WHO], 2012). Consequently, questions have been raised as to how formal (paid staff) and informal (family or friends) caregivers could best obtain help with accessing appropriate diagnostic and post-diagnostic supportive health services (Bishop & Lucchino, 2010;Bishop, Robinson, & Van Lare, 2013;Jokinen et al, 2013).…”

mentioning

confidence: 99%

Guidelines for Dementia-Related Health Advocacy for Adults With Intellectual Disability and Dementia: National Task Group on Intellectual Disabilities and Dementia Practices

Bishop

Hogan

Janicki³

et al. 2015

Intellectual and Developmental Disabilities

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Increasing numbers of adults with intellectual disabilities (ID) are living into old age. Though this indicates the positive effects of improved health care and quality of life, the end result is that more adults with ID are and will be experiencing age-related health problems and also exhibiting symptoms of cognitive impairment and decline, some attributable to dementia. Early symptoms of dementia can be subtle and in adults with ID are often masked by their lifelong cognitive impairment, combined with the benign effects of aging. A challenge for caregivers is to recognize and communicate symptoms, as well as find appropriate practitioners familiar with the medical issues presented by aging adults with lifelong disabilities. Noting changes in behavior and function and raising suspicions with a healthcare practitioner, during routine or ad hoc visits, can help focus the examination and potentially validate that the decline is the result of the onset or progression of dementia. It can also help in ruling out reversible conditions that may have similar presentation of symptoms typical for Alzheimer's disease and related dementias. To enable caregivers, whether family members or staff, to prepare for and advocate during health visits, the National Task Group on Intellectual Disabilities and Dementia Practices has developed guidelines and recommendations for dementia-related health advocacy preparation and assistance that can be undertaken by provider and advocacy organizations.

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“…Dementia is defined as a chronic, progressive mental disorder which adversely affects higher cortical functions including memory, language and orientation (31) and associated with increasing morbidity and mortality and imposes significant costs (32). It is therefore important that evidencebased treatments for dementia in ID are developed and evaluated.…”

Section: Dementia In Older Adults With Idmentioning

confidence: 99%

Pharmacological Management of Behavioral and Psychiatric Symptoms in Older Adults with Intellectual Disability

Eady

Courtenay²,

Strydom³

2015

Drugs Aging

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Abstract:Given medical and social advances, the life expectancy of individuals with intellectual disability (ID) has increased dramatically, leading to a generation of older individuals with such disabilities. This review focuses on the pharmacological treatment of behavioral and psychiatric symptoms and disorders in older persons with ID. Older adults with ID often present with medical co-morbidities and mental health issues. Medication management of behavioral and psychiatric problems is complicated by a higher risk for adverse events, lack of decision-making capacity, and complex care networks. Some studies have shown that persons with ID and co-morbid mental disorders are undertreated in comparison to individuals with similar disorders in the general population, resulting in poorer outcomes.However, older adults with ID are also at risk of polypharmacy and older age is a risk factor for development of side-effects. A general principle is that medication treatment for psychiatric disorders in older persons with ID should be started at low dosages and be increased cautiously while monitoring response and side-effects. The use of psychotropic drugs for older persons with ID and behavioral problems remains controversial, particularly in those with dementia. Key points:• The growing population of older persons with ID has an increased risk for aging related health issues such as dementia, on a background of lifelong disabilities and physical health and psychiatric co-morbidities. Management of psychiatric symptoms in older persons with ID• Medication management of behavioral and psychiatric problems may be complicated by a higher risk for adverse events, lack of decision-making capacity, and complex care networks.• Medication management of specific conditions is however beneficial, but in general, medication should be started at low doses, with careful titration against response, and regular monitoring for side-effects.

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Dementia in intellectual disability

Cited by 30 publications

References 37 publications

Prevalence of dementia and organization of dementia care in Swiss disability care homes

Prevalence of dementia and organization of dementia care in Swiss disability care homes

Guidelines for Dementia-Related Health Advocacy for Adults With Intellectual Disability and Dementia: National Task Group on Intellectual Disabilities and Dementia Practices

Pharmacological Management of Behavioral and Psychiatric Symptoms in Older Adults with Intellectual Disability

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