Sinai, AD; (2014) Assessing specific cognitive deficits associated with dementia in older adults with Down's syndrome: a London based study. Doctoral thesis , UCL (University College London).

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Abstract

Background: Dementia in older adults with Down’s syndrome is common. People with Down’s syndrome often have specific cognitive deficits, affecting prefrontal, hippocampal and cerebellar regions. A cognitive assessment battery has been developed (called the Arizona Cognitive Test Battery, ACTB), which assesses cognitive function in these areas. These tests have not yet been validated in older adults with Down’s syndrome. Methods: This study aimed to assess the use of the ACTB in older adults with Down’s syndrome and establish its validity in testing for dementia. Participants with Down’s syndrome aged 45 and over were assessed. Participants took part in a 2-3 hour assessment which included tests on a touchscreen computer tablet as well as standard table-top tests. Results: 50 participants with Down’s syndrome were recruited. Of these, 19 had a diagnosis of dementia or possible dementia. Most participants were able to attempt most of the tasks, although some tasks had a large number of participants at floor. There were significant differences between the dementia and no dementia groups on CANTAB Simple Reaction Time, Verbal Fluency and Object Memory tasks. Conclusions: In general, most of the tasks in the ACTB can be used in older adults with Down’s syndrome and have mild to moderate concurrent validity when compared to tabletop tests and carer ratings, although this varies on a test by test basis. Although the ACTB can be used in older adults with Down’s syndrome, it has not been shown to clearly detect differences between people with Down’s syndrome who have early stage dementia and those who do not have dementia. Suggestions are made regarding which of the tests assessed in this study are most useful when assessing cognitive skills in older people with Down’s syndrome. It is hoped that this research will help in the development of appropriate cognitive tests for older adults with Down’s syndrome.

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