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Wellbeing for life: getting a timely diagnosis
- Author:
- MACINTYRE
- Publisher:
- MacIntyre
- Publication year:
- 2018
- Pagination:
- 32
- Place of publication:
- Milton Keynes
A short publication providing information on getting a timely diagnosis of dementia for people with learning disabilities. It covers understanding what Timely Diagnosis means, knowing how to prepare for the assessment process; being familiar with the dementia diagnosis pathway and your role in supporting the person; advocating for the person when the outcome of assessment(s) is known; and understanding the importance of baseline screening and monitoring to facilitate Timely Diagnosis in the future. It is part of the Wellbeing for Life toolkit created for the MacIntyre Dementia project in order to promote understanding about getting older with a learning disability and living well with dementia. (Edited publisher abstract)
Prevalence of dementia in intellectual disability using different diagnostic criteria
- Authors:
- STRYDOM A., et al
- Journal article citation:
- British Journal of Psychiatry, 191(8), August 2007, pp.150-157.
- Publisher:
- Cambridge University Press
Diagnosis of dementia is complex in adults with intellectual disability owing to their pre-existing deficits and different presentation. The aim was to describe the clinical features and prevalence of dementia and its subtypes, and to compare the concurrent validity of dementia criteria in older adults with intellectual disability. The Becoming Older with Learning Disability (BOLD) memory study is a two-stage epidemiological survey of adults with intellectual disability without Down syndrome aged 60 years and older, with comprehensive assessment of people who screen positive. Dementia was diagnosed according to ICD–10, DSM–IV and DC–LD criteria. The DSM–IV dementia criteria were more inclusive. Diagnosis using ICD–10 excluded people with even moderate dementia. Clinical subtypes of dementia can be recognised in adults with intellectual disability. Alzheimer’s dementia was the most common, with a prevalence of 8.6% (95% CI 5.2–13.0), almost three times greater than expected. Dementia is common in older adults with intellectual disability, but prevalence differs according to the diagnostic criteria used. This has implications for clinical practice.
Dementia and learning disabilities: bridging the gap
- Author:
- KILLICK Emma
- Journal article citation:
- Journal of Dementia Care, 25(3), 2017, pp.20-21.
- Publisher:
- Hawker
People with learning disabilities can be at particular risk of developing dementia, but special challenges can arise in trying to support them. This article describes 'The Dementia Project' from learning disability charity MacIntyre and updates on its progress to date. The project is creating a range of learning and multi-media resources to help improve practice and care for people with learning disabilities living with dementia. The resources will be available when the project finishes in 2019. (Edited publisher abstract)
Difficulties of dealing with dementia in individuals with intellectual disabilities: the healthcare perspective
- Authors:
- JETHWA Hannah, CASSIDY Geraldine
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 4(4), December 2010, pp.48-52.
- Publisher:
- Emerald
Dementia is a condition that involves inevitably progressive deficits in numerous cognitive domains, including thought, language, memory, understanding and judgement. It is more than 4 times as prevalent in people with intellectual disabilities as in the general population. This paper explains the main difficulties in dealing with dementia in people with intellectual disabilities, including late diagnosis, assessment and management issues. Diagnosis of the condition in people with intellectual disabilities is often difficult due to lack of baseline skill assessment, high staff turnover in supported accommodation and low expectations of capabilities. Current National Institute for Health and Clinical Excellence (NICE) guidelines on anti-dementia medication state that treatment should not be initiated until the condition has reached moderate severity. Determining whether symptoms are at this stage in people with intellectual disabilities is difficult because their skill level is already impaired. An accurate and extensive record of baseline skill levels in people with intellectual disabilities is therefore crucial, and regular comparison with baseline is key to early diagnosis of dementia.
Assessment of dementia in people with learning disabilities
- Author:
- TORR Jennifer
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 3(3), September 2009, pp.3-9.
- Publisher:
- Emerald
Alzheimer’s disease and other dementias are at least as prevalent in older people with learning disabilities as in the general population. In addition, people with Down’s syndrome have high rates of early onset Alzheimer’s disease. Assessment of dementia in people with learning disabilities is made difficult by pre-existing cognitive and functional impairments and high rates of comorbid disorders. This paper discusses the assessment of dementia in people with learning disabilities. The assessment procedure needs to include a comprehensive description of baseline functioning and pattern of decline, rigorous medical work-up and treatment of identified conditions, serial cognitive assessments, and functional and risk assessments to guide care planning.
The psychiatry of elderly people with mental handicaps
- Author:
- COOPER Sally-Ann
- Journal article citation:
- International Journal of Geriatric Psychiatry, 7(12), December 1992, pp.865-874.
- Publisher:
- Wiley
Argues that postmortem studies and attempts to link neuropathological findings with clinical findings, and presumptive diagnoses of Alzheimer's Disease following a decline in skills of the elderly with mental handicaps, have shed little light on the true extent of dementia in the elderly mentally handicapped.
"Forgetting familiar faces": staff perceptions of dementia in people with intellectual disabilities
- Authors:
- RYAN Christian, MacHALE Rosemary, HICKEY Emma
- Journal article citation:
- British Journal of Learning Disabilities, 46(3), 2018, pp.155-162.
- Publisher:
- Wiley
Background: Living with dementia is challenging, but poses unique difficulties for people with an intellectual disability. The process of dementia is also challenging for family, carers and friends. Materials and Methods: This study explores the impact of dementia on direct care staff using a focus group methodology. Thematic analysis was used to investigate the staff narratives. Results: Four key themes that emerged were as follows: (a) the difficulty of recognising symptoms of dementia in people with intellectual disabilities, (b) the process of diagnosis, (c) the challenge of dementia for the person, (d) the emotional impact of dementia for other people. Conclusion: The themes identify a number of important potential targets for supporting staff and peers in this challenging area of work. (Publisher abstract)
People with dementia and learning disabilities: reasonable adjustments
- Author:
- PUBLIC HEALTH ENGLAND
- Publisher:
- Public Health England
- Publication year:
- 2018
- Place of publication:
- London
This guide aims to help staff in public health, health services and social care to provide services that are accessible to people with learning disabilities that have or are at risk of developing dementia. It summarises current evidence and highlights policy and guidelines relating to people with learning disabilities and dementia. It includes links to a wide range of online resources, including those specifically about dementia in people with learning disabilities and to easy-read resources and apps related to dementia in general. The guide also includes case studies and examples of reasonable adjustments to services made in relation to people with learning disabilities and dementia. (Edited publisher abstract)
The assessment of executive functioning in people with intellectual disabilities: an exploratory analysis
- Authors:
- BEVINS Shelley, HURSE Emily
- Journal article citation:
- British Journal of Learning Disabilities, 44(2), 2016, pp.87-94.
- Publisher:
- Wiley
The following article details a piece of service development work undertaken as part of the Plymouth Down Syndrome Screening Programme. The work aimed to review the use of three measures assessing executive functioning skills used within the Programme as well as with people without Down syndrome. Three tasks assessing executive functioning (the Weigl, Cats and Dogs, and verbal fluency task) were evaluated. The Weigl task was removed from the Programme and analyses due to floor effects and difficulties in administration. Correlation analyses showed relationships between the Cats and Dogs task and two other measures, cognitive skills as reported by carers and object memory. No relationships were found between the verbal fluency task and other measures. A full consideration is given to these findings, and implications for future practice are considered. Further data are needed to make full conclusions about the value of the tasks in predicting dementia in people with intellectual disabilities and people with Down syndrome. Further recommendations concerning the development of the assessment of executive skills are also considered. (Publisher abstract)
Case report: an unusual case of post-stroke psychosis in a 71-year-old lady with a learning disability
- Authors:
- LEEDS Lesley, SRINIVASAN Janaki
- Journal article citation:
- British Journal of Learning Disabilities, 39(4), December 2011, pp.292-294.
- Publisher:
- Wiley
Stroke is a major health concern, and can lead to psychiatric problems, and people with a learning disability are just as likely as people in the general population to be at risk of cerebrovascular disease, due to the presence of undetected or undertreated vascular risk factors. However, it is often difficult to tell whether someone with a learning disability has had a stroke, especially if they seem well. When people with a learning disability are presenting with additional cognitive impairment, it is important to consider a range of conditions that may account for this. Stroke is a major cause of cognitive impairment in older people, affecting at least one-third of stroke survivors. However, post-stroke psychosis is rare following stroke, and, as can be seen from the case of ‘May’, a 71 year-old lady with a learning disability, individuals can make a good recovery with appropriate assessment and intervention. The article concludes that it is important that a diagnosis of dementia is given only after all other potentially treatable conditions have been excluded, and there is deterioration in condition that defies other explanations.