Search results for ‘Subject term:"learning disabilities"’ Sort:
Results 1 - 9 of 9
Quality outcomes in group home dementia care for adults with intellectual disabilities
- Author:
- JANICKI M.P.
- Journal article citation:
- Journal of Intellectual Disability Research, 55(8), August 2011, pp.763-776.
- Publisher:
- Wiley
As more individuals with intellectual disabilities are surviving to an older age, the number who present with cognitive decline and are diagnosed with dementia can be expected to grow. As new needs become apparent residential support agencies may need to adapt their current methods of care to meet different applicable standards. This is particularly true for small group homes. Relevant policy and practice organisational guidelines and the applied research literature addressing components of care and service provision were reviewed with the aim of identifying quality care factors. The intention being to propose components of quality outcomes for specialist dementia care that are universally applicable and could serve as a framework for adapting existing residential environments and make them ‘dementia-capable’. It is concluded that efforts to evaluate dementia-related care provision with respect to quality need to consider quality of care provision components such as: clinically relevant early and periodic assessment; functional modifications in the living setting; constructive staff education and functionality for stage-adapted care; and flexible long-term services provision that recognises and plans for progression of decline and loss of function.
Impact of depressive symptoms on the rate of progression to dementia of patients affected by mild cognitive impairment: the Italian Longitudinal Study on Aging
- Authors:
- PANZA Francisco, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(7), July 2008, pp.726-734.
- Publisher:
- Wiley
Mild cognitive impairment (MCI) is often a prodromal of dementia and depressive symptoms have been suggested as risk factor for dementing disorders. The authors evaluated the possible impact of depressive symptoms on the rate of progression to dementia in MCI patients after a 3.5-year follow-up; and the interaction between depressive symptoms and vascular risk factors for conversion to dementia. A total of 2,963 individuals from a sample of 5,632 65-84 year old subjects were evaluated at the first (1992-93), and second (1995-96) surveys of the Italian Longitudinal Study on Aging, a prospective cohort study. MCI and dementia were classified using current clinical criteria. Depressive symptoms were measured with the Geriatric Depression Scale. Among the 2,963 participants, 139 prevalent MCI patients were diagnosed at the first survey. During the 3.5-year follow-up, 14 MCI patients progressed to dementia, and no significant relationship between depressive symptoms and rate of progression to dementia was found. No socio-demographic variables or vascular risk factors modified the association between depressive symptoms and conversion to dementia. It was concluded that in the population studied depressive symptoms were not associated with the rate of progression to dementia in MCI patients. The findings did not support a role of socio-demographic variables or vascular risk factors in the association of depressive symptoms and conversion to dementia.
Dementia and memory: a handbook for students and professionals
- Author:
- THOMPSON Simon B.N.
- Publisher:
- Ashgate
- Publication year:
- 2006
- Pagination:
- 235p., bibliog.
- Place of publication:
- Aldershot
Intended for students and trained healthcare and medical professionals, this book focuses on treatment of people suffering from dementia and memory problems. It looks at ageing and ageism, definition of dementia, different types of dementia, memory disorders, learning disability and dementia, and coping with memory problems and dementia. It includes information about how to treat memory problems, advanced memory strategies, assessing dementia, treating and managing dementia, and future directions for people with dementia. Case studies on memory, dementia, and dementia and learning disability, and a memory test are included.
A systematic review of cognitive decline in the general elderly population
- Authors:
- PARK Helen L., O'CONNELL Janice O., THOMSON Richard G.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(12), December 2003, pp.1121-1134.
- Publisher:
- Wiley
The aim was to establish the rate of age-related cognitive decline in the general elderly population. Systematic review of studies of cognitive decline in the general elderly population. Medline, Embase and PsycINFO databases were searched using an adapted version of McMaster's aetiology, causation and harm strategies and the Cochrane Dementia and Cognitive Impairment Group strategy. Grey literature was explored and experts contacted. A second observer was involved at all stages and quality appraisal of included studies was performed. Included studies were representative, community-based, cohort studies of people aged over 60, incorporating individuals with dementia. Identification of 5990 abstracts and retrieval of 163 full texts led to inclusion of 19 papers. Heterogeneity made narrative review the appropriate method of data synthesis. Some degree of cognitive impairment with increasing age was found in all studies, although the extent varied. The prevalence of cognitive impairment and the rate of decline increased with age. Studies were of variable quality. Cognitive decline is almost universal in the general elderly population and increases with age. Improved communication between researchers and between clinicians to identify a core minimum data set of neuropsychological tests that could be used in different populations would support consistent study design and meta-analysis, helping to quantify the true rate of cognitive decline in the elderly and assisting diagnosis in clinical practice.
Cognitive decline in high-functioning older adults: reserve or ascertainment bias?
- Authors:
- TUOKKO H., et al
- Journal article citation:
- Aging and Mental Health, 7(4), July 2003, pp.259-270.
- Publisher:
- Taylor and Francis
The detection of mild cognitive impairment and dementia in high-functioning older adults can be difficult. It has also been observed that high-functioning persons show a lower prevalence of dementia than low-functioning persons. Three alternative explanations for this observation have been proposed in the literature: brain reserve capacity (BRC), cognitive reserve, and ascertainment bias. With data from a prospective, population-based study of incident dementia, the Canadian Study of Health and Aging (CSHA), we classified participants as being high- (HF) or low-functioning (LF) in three ways: educational and occupational attainment, and estimated premorbid IQ. We observed that fewer HF older adults were diagnosed with dementia after five years, which is in accordance with both the BRC and cognitive reserve models. Contrary to expectations, no difference on rate of memory deterioration was observed between those HF and LF persons who exhibited mild cognitive impairment at CSHA-1. However, HF persons who subsequently were diagnosed with dementia (CSHA-2) showed more rapid decline on five of the six memory measures over time than did LF persons diagnosed with dementia at CSHA-2. When performance on measures of memory functioning at CSHA-1 was examined for highly educated older adults, significantly more of those with dementia at CSHA-2 (n¼59) had scores falling within or below the average range in comparison to normative standards than those who continued to show no cognitive impairment (n¼145). Our findings suggest that the lower incidence of dementia for HF persons may be primarily the result of ascertainment bias, not underlying differences in brain or cognitive reserve.
The detection of mild cognitive impairment in the general practice setting
- Authors:
- ATERO S, RITCHIE K.
- Journal article citation:
- Aging and Mental Health, 7(4), July 2003, pp.251-258.
- Publisher:
- Taylor and Francis
Results from a general practice study of cognitive impairment are used to construct guidelines for the detection of mild cognitive impairment (MCI) in general practice. The role of the general practitioner in the diagnosis of MCI is discussed and the potential feasibility of general practice screening is evaluated with data from a two-year prospective study conducted in the Montpellier region of France. Neuropsychological tests with the highest predictive value for dementia conversion and suitable for use in general practice, were determined by logistic regression modelling. An examination comprising three tests (delayed auditory verbal recall, verbal fluency and visuospatial construction), were found to give a specificity of 99% and sensitivity of 73%. Reports from other research centres suggest that MCI detection should not be limited to cognitive performance alone. It is suggested that proxy observations of behavioural change and information relating to loss of ability to perform activities of daily living should also be used to improve sensitivity and also to provide information needed in patient management. It may be potentially feasible for the family practitioner to verify cognitive complaints and to screen for MCI with a high degree of accuracy using a brief test battery derived from empirical observations in population studies.
Mild cognitive impairment in the oldest old: a comparison of two approaches
- Authors:
- HONG T. B., JOHANSSON B., ZARIT S. H.
- Journal article citation:
- Aging and Mental Health, 7(4), July 2003, pp.271-276.
- Publisher:
- Taylor and Francis
The main purpose of the current investigation was to examine the predictive utility of two sets of criteria for mild cognitive impairment (MCI). A second purpose was to determine the incidence of MCI in a longitudinal, population-based sample of the oldest old in Sweden. The participants were from the larger ‘Origins of Variance in the Old-Old: Octogenarian Twins’ (OCTO-Twin) study, identified through the Swedish Twin Registry. Participants were initially aged 80 or above with a mean age of 83 and were re-examined after two, three, six and eight years. The sample for this study consisted of 263 elders that were randomly selected singletons from twin pairs. Mild cognitive impairment was rated at baseline using both Petersen’s and Ritchie’s criteria. Petersen’s criteria emphasize memory and memory complaint whereas Ritchie’s criteria use a broader set of cognitive indicators. The incidence rate was comparable to that of other studies, however, neither set of criteria predicted subsequent dementia. The failure to confirm subsequent dementia suggests that there may be many sources of MCI in very late life besides incipient dementia. The presence of a key informant, as well as the weighting of performance across domains by an experienced clinician, both of which are hard to quantify, may be the key elements that give predictive values to MCI in prior studies.
The role of volumetric MRI in understanding mild cognitive impairment and similar classifications
- Authors:
- ANSTEY K. J., MALLER J. J.
- Journal article citation:
- Aging and Mental Health, 7(4), July 2003, pp.238-250.
- Publisher:
- Taylor and Francis
The authors review nineteen empirical studies of mild cognitive impairment (MCI), age-associated memory impairment (AAMI) and related classifications reportingvolumetric data on the hippocampus, entorhinal cortex and amygdala. Studies varied considerably in terms of the selection of participants, sample characteristics, the definitions of regions of interest and normalization techniques. Effect sizes for differences in left hippocampal volume and right hippocampal volumes of AAMI, MCI and pre-clinical dementia groups compared with controls ranged from 0.47 to 1.34. Effect sizes for left and right hippocampal volumes for Alzheimer’s disease (AD) versus control were 1.88 and 1.75 respectively. Longitudinal results confirm that initial hippocampal volume is predictive of conversion to AD. Greater standardisation in methodology and the development of normative age-referenced databases of regional brain volumes is required.
A memory clinic for older people with intellectual disabilities
- Authors:
- HASSIOTIS A., et al
- Journal article citation:
- Aging and Mental Health, 7(6), November 2003, pp.418-423.
- Publisher:
- Taylor and Francis
Cognitive decline in older people with intellectual disabilities (ID) is often under-recognized. Following the publication of the National Service Framework for Older People and the white paper Valuing People, older people with intellectual disabilities of all aetiologies should have access to a systematic assessment of their cognitive function in order to detect decline in cognition and adaptive skills and implement appropriate treatments as early as possible. The development of a memory clinic for older people with ID is described, including instruments used and characteristics of attendees. Such projects are in line with current UK government policies and can contribute to the improvement of standards of care and support research in this vulnerable group of people.