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Service use and cost of mental disorder in older adults with intellectual disability
- Authors:
- STRYDOM Andre, et al
- Journal article citation:
- British Journal of Psychiatry, 196(2), February 2010, pp.133-138.
- Publisher:
- Cambridge University Press
The cost of caring for people with intellectual disability, which is already high, may rise as more people with intellectual disability live to old age. In addition the rates of mental illness and dementia are thought to be higher in this group than in the general population. This study reports service use patterns and costs for people (n=212) with intellectual disability (excluding Down syndrome) over 60 years of age living in London. It covered costs of accommodation, health and personal care, physical as well as mental illness, dementia, sensory impairment and disability and aimed to explore the influence of sociodemographic and illness-related determinants. The average weekly cost per older person was £790 (£41080 per year); accommodation accounted for 74%. Overall costs were highest for those living in congregate settings, such as nursing or residential homes. Gender, intellectual disability severity, hearing impairment, physical disorder and mental illness had significant independent relationships with costs. Mental health problems were associated with an additional weekly cost of £202. The authors note that older adults with intellectual disability comprise 0.15–0.25% of the population of England but consume up to 5% of the total personal care budget. They suggest interventions that meet needs and might prove to be cost-effective should be sought.
Dementia in older adults with intellectual disabilities: epidemiology, presentation and diagnosis
- Authors:
- STRYDOM Andre, et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 7(2), June 2010, pp.96-110.
- Publisher:
- Wiley
The authors conducted a literature review on the epidemiology, presentation and diagnosis of dementia in older adults with intellectual or learning disabilities (ID) and specific genetic syndromes, such as Downs syndrome (DS) using Medline, EMBASE and PsycINFO for original papers in English, German or Dutch, between 1997 and 2008. Articles from the United Kingdom, Canada, Australia, United States, Netherlands, Ireland; Japan, South Africa, Scandinavia and Italy had varied methodologies and differences in diagnoses resulting in a wide range of prevalence rates of dementia. Rates of dementia in those with ID, not because of DS, were comparable or higher than those in the general population. The onset of Alzheimers disease in DS appears earlier and the prevalence increases from less than 10% in the 40’s, to more than 30% in the 50’s with varying prevalence reported in those over 60 years. Incidence rates increased with age. Presentation differs in the ID population compared with the general population, with those with DS presenting with behavioural changes believed to be due to frontal lobe deficits. Few studies of dementia in other genetic syndromes such as Rett syndrome, an autistic spectrum disorder, and Sanfilippo syndrome were located in the literature, but these are discussed and tabulated along with others found.
Mental health and social care needs of older people with intellectual disabilities
- Authors:
- STRYDOM Andre, HASSIOTIS Angela, LIVINGSTON Gill
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 18(3), September 2005, pp.229-235.
- Publisher:
- Wiley
In this study all adults with intellectual disabilities (ID) without Down syndrome (DS) aged 65+ living in the London boroughs of Camden and Islington were identified. The Psychiatric Assessment Schedule for Adults with a Developmental Disability (PASADD) checklist was used to detect psychiatric disorder, the Vineland behaviour scale (maladaptive domain) for problem behaviours and the Dementia Questionnaire for persons with Mental Retardation (DMR) to screen for dementia. Carers reported health problems and disability. Needs were measured with the Camberwell Assessment of Need for adults with Intellectual Disabilities (CANDID-S). A total of 23 older people with ID (13 had mild ID and nine more severe ID) and their carers participated in the survey. In which, 74% had one or more psychiatric symptoms; 30% were previously known with a diagnosis of mental illness. One-third of the older people screened positive for dementia. Three quarters of the group had physical health problems, 74% had poor sight, 22% had hearing loss and 30% had mobility problems. Carers rated unmet needs for accommodation (22%), day activities, and eyesight and hearing. The people with ID rated unmet needs to be social relationships (44%), information and physical health. The authors conclude that older people with ID without DS have considerable prevalence of health problems and psychiatric disorders, including symptoms of functional decline and dementia. Such symptoms are often not recognised and further research into their needs is a priority.
Caregiving and adults with intellectual disabilities affected by dementia
- Authors:
- COURTENAY Ken, JOKINEN Nancy S., STRYDOM Andre
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 7(1), March 2010, pp.26-33.
- Publisher:
- Wiley
This article describes a systematic review of the available Dutch, English, and German language literature on the current knowledge on social-psychological and pharmacological care given to older adults with intellectual disabilities (ID) and dementia. The authors note that the lack of robust evidence to meet the needs of older people with ID and dementia means that services often have to extrapolate from the evidence base of dementia care practices in the general population. The article outlines concerns over staff burden, behavioural interventions, and staff training, and notes that applications of care were emerging, but were not systematically studied – pharmacological agents and non-pharmacological, psychosocial techniques were being used to assist carers manage behaviour, but the evidence base of both non-pharmacological and pharmacological interventions that can help people and their carers is insufficient. In conclusion, with more adults projected to be affected by dementia, the authors note a need for an international research agenda that begins to address gaps in knowledge.
Dementia in older adults with intellectual disabilities: a report on the state of science on dementia in older adults with intellectual disabilities by the IASSID Special Interest Research Group on Ageing and Intellectual Disabilities
- Authors:
- STRYDOM Andre, et al
- Publisher:
- International Association for the Scientific Study of Intellectual Disabilities
- Publication year:
- 2009
- Pagination:
- 49p., bibliog.
- Place of publication:
- Canterbury
This systematic review summarises current knowledge on dementia in older people with learning disabilities. The review included papers published from 1997 to 2008. Findings are discussed in the areas of: epidemiology; presentation and symptoms; screening, assessment and diagnosis; non-pharmacological and pharmacological interventions and issues for carers.