Strydom, A;
(2007)
The prevalence and subtypes of dementia in older adults with intellectual disabilities.
Doctoral thesis , UCL (University College London).
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Abstract
Adults with intellectual disability (ID) (excluding those with Down Syndrome, DS) are now living to old age and might be more likely than other adults to develop dementia due to genetic influences, cardiovascular factors and reduced cognitive reserve but could also have reduced prevalence due to a healthy cohort effect. This study aimed to detennine in the non-DS ID population the prevalence of dementia and its subtypes, compare it to the general population rates explore specific aetiological hypotheses, describe clinical features, and compare the main diagnostic criteria for dementia in this population. A representative cohort of 222 adults with non-DS ID aged 60 and older from 5 London boroughs was established. Participants who screened positive using the Dementia questionnaire for persons with Mental Retardation (DMR) or who had unexpectedly poor memorv performance, or were reported to have had deterioration in function underwent detailed assessment. Dementia diagnoses were made according to ICD-10, DSM-IV or DC-LD criteria. Dementia was common (18 b in those aged 65 and older), and the Standardised Morbidity Ratio was 2.77 (compared to general population rates). Prevalence did not differ significantly between ID severity groups. Age was a strong risk factor with a relative shift in age associated risk. Cardiovascular disorders were associated with vascular dementia but not Alzheimer's disease (AD). Functional decline, rather than memory problems, was reported to be an early symptom in those diagnosed with dementia. DSM-IV dementia criteria were more inclusive than ICD-10 criteria. In conclusion, dementia is more common in the non-DS ID population than in the general population, with a shift in risk to younger age groups, consistent with cognitive reserve theory. Prevalence differs according to criteria used. These findings have implications for clinical practice. Future research is needed to validate dementia diagnoses in ID, examine incidence and natural history.
| Type: | Thesis (Doctoral) |
|---|---|
| Title: | The prevalence and subtypes of dementia in older adults with intellectual disabilities |
| Identifier: | PQ ETD:593682 |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Thesis digitised by ProQuest. Third party copyright material has been removed from the ethesis. Images identifying individuals have been redacted or partially redacted to protect their identity. |
| UCL classification: | |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1446335 |
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