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10 - Dementia and mental ill-health in older people with intellectual disabilities

from Part II - Psychopathology and special topics

Published online by Cambridge University Press:  15 December 2009

By
Sally-Ann Cooper  and
Anthony J. Holland
Edited by
Nick Bouras  and
Geraldine Holt
Sally-Ann Cooper
Affiliation:
Professor of Learning Disabilities, University of Glasgow
Anthony J. Holland
Affiliation:
Professor of Learning Disabilities, University of Cambridge
Nick Bouras
Affiliation:
King's College London
Geraldine Holt
Affiliation:
King's College London
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Summary

Introduction

People with intellectual disabilities (ID) form a small proportion of the whole population but, because of special needs, require suitable services and supports. Older persons form only a small proportion of all people with ID. However, the needs of older compared with younger adults with ID do have some differences and, in many developed countries, services are only starting to recognize and adapt to meet such needs. Additionally, the number of people with ID who will reach old age is increasing.

Demography

The proportion of older people within the population is increasing. This is in part caused by changing birth rates — for example, the post-war baby boom cohort of the 1940s which affects people with ID as well as people of average ability. Additionally, life expectancy for the whole population is increasing, and although life expectancy for people with ID is still shorter than for the general population (McGuigan et al., 1995; Durvasula et al., 2002), it is increasing at a faster velocity. This is owing to more person-centred and improved quality of care and support, improved access to medical treatments such as for respiratory infections and congenital heart disease, changing attitudes and improved lifestyle opportunities, and reduced spread of infectious diseases. These factors have contributed to the increased life expectancy of people with ID at all ages and all ability levels.

Type
Chapter
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Psychiatric and Behavioural Disorders in Intellectual and Developmental Disabilities , pp. 154 - 172
Publisher: Cambridge University Press
Print publication year: 2007

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References

Albert, M. and Cohen, C. (1992). The Test for Severe Impairment: an instrument for assessment of people with severe cognitive dysfunction. Journal of the American Geriatric Society, 40, 449–53.Google Scholar
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Psychiatric Disorders, 3rd edn, revised. Washington, DC: American Psychiatric Association.
Balakrishnan, T. R. and Wolf, L. C. (1976). Life expectancy of mentally retarded persons in Canadian institutions. American Journal on Mental Deficiency, 80, 650–62.Google Scholar
Ball, S. (2005). The Course of Alzheimer's Disease in Adults with Down's Syndrome: Evidence for the Early Compromise of Frontal Lobe Function. Thesis submitted to the University of Cambridge.
Ball, S. L., Holland, A. J., Huppert, F. A.et al. (2004). The modified CAMDEX informant interview is a valid and reliable tool for use in the diagnosis of dementia in adults with Down's Syndrome. Journal of Intellectual Disability Research, 48, 611–20.Google Scholar
Bittles, A. H., Petterson, B. A., Sullivan, S. G.et al. (2002). The influence of intellectual disability on life expectancy. Journal of Gerontology Series A – Biological Sciences and Medical Sciences, 57, 470–2.Google Scholar
Bleuler, E. (1916). Lehrbuch der Psychiatrie. Translated as Textbook of Psychiatry (1924) by Brill, A. A. New York: Dover Publications.
Boer, H., Holland, A. J., Whittington, J.et al. (2002). Psychotic illness in people with Prader–Willi syndrome due to chromosome 15 maternal uniparental disomy. Lancet, 359, 135–6.Google Scholar
Böhmer, C. J., Klinkenberg-Knol, E. C., Niczen-de Boer, R. C. and Meuwissen, S. G. (1997). The age-related incidences of oesophageal carcinoma in intellectually disabled individuals in institutes in the Netherlands. European Journal of Gastroenterology & Hepatology, 9, 589–92.Google Scholar
Breteler, M. M. B., Claus, J. J., Duijn, C. M., Launer, L. T. and Hofman, A. (1992). Epidemiology of Alzheimer's disease. Epidemiology Review, 14, 59–82.Google Scholar
Burt, D. B., Loveland, K. A. and Lewis, K. R. (1992). Depression and the onset of dementia in adults with mental retardation. American Journal on Mental Retardation, 96, 502–11.Google Scholar
Casson, I. R., Sham, R., Campbell, E. A., Tarlau, M. and di Domenico, A. (1982). Neurological and CT evaluation of knocked-out boxers. Journal of Neurology, Neurosurgery and Psychiatry, 45, 170–4.Google Scholar
Casson, I. R., Siegel, O., Sham, R.et al. (1984). Brain damage in modern boxers. Journal of the American Medical Association, 251, 2663–7.Google Scholar
Center, J., Beange, H. and McElduff, A. (1998). People with mental retardation have an increased prevalence of osteoporosis: A population study. American Journal on Mental Retardation, 103, 19–28.Google Scholar
Cooke, L. B. (1997). Cancer and learning disability. Journal of Intellectual Disability Research, 41, 312–16.Google Scholar
Cooper, S.-A. (1997a). High prevalence of dementia amongst people with learning disabilities not attributed to Down's syndrome. Psychological Medicine, 27, 609–16.Google Scholar
Cooper, S.-A. (1997b). Epidemiology of psychiatric disorders in elderly compared with younger people with learning disabilities. British Journal of Psychiatry, 170, 375–80.Google Scholar
Cooper, S.-A. (1997c). Psychiatric symptoms of dementia amongst elderly people with learning disabilities. International Journal of Geriatric Psychiatry, 12, 662–6.Google Scholar
Cooper, S.-A. (1998a). Clinical study of the effects of age on the physical health of adults with mental retardation. American Journal on Mental Retardation, 102, 582–9.Google Scholar
Cooper, S.-A. (1998b). A population-based cross-sectional study of social networks and demography in older compared with younger adults with learning disabilities. Journal of Learning Disabilities for Nursing, Health and Social Care, 2, 212–20.Google Scholar
Cooper, S.-A., Melville, C. A. and Einfeld, S. L. (2003). Psychiatric diagnosis, intellectual disabilities and Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD). Journal of Intellectual Disability Research, 47, 3–15.Google Scholar
Corbett, J. A. (1979). Psychiatric morbidity and mental retardation. In James, F.-E. and Snaith, R. P. (eds.), Psychiatric Illness and Mental Handicap. London: Gaskell Press.
Day, K. (1985). Psychiatric disorder in the middle-aged and elderly mentally handicapped. British Journal of Psychiatry, 147, 660–7.Google Scholar
Day, K. A. (1987). The elderly mentally handicapped in hospital: a clinical study. Journal of Mental Deficiency Research, 31, 131–46.Google Scholar
Dayton, N. A., Doering, C. R., Hilferty, M. M., Maher, H. C. and Dolan, H. H. (1932). Mentality and life expectation in mental deficiency in Massachusetts: analysis of the fourteen-year period 1917–1930. New England Journal of Medicine, 206, 550–70.Google Scholar
Devenny, D. A., Hill, A. L., Paxtot, O., Silverman, W. P. and Wisniewski, K. E. (1992). Ageing in higher functioning adults with Down's syndrome: an interim report in a longitudinal study. Journal of Intellectual Disability Research, 36, 241–50.Google Scholar
Durvasula, S., Beange, H. and Baker, W. (2002). Mortality of people with intellectual disability in northern Sydney. Journal of Intellectual and Developmental Disability, 27, 255–64.Google Scholar
Evenhuis, H. M. (1992). Evaluation of a screening instrument for dementia in ageing mentally retarded persons. Journal of Intellectual Disability Research, 36, 337–47.Google Scholar
Evenhuis, H. M. (1995a). Medical aspects of ageing in a population with intellectual disability: I. Visual impairment. Journal of Intellectual Disability Research, 39, 19–25.Google Scholar
Evenhuis, H. M. (1995b). Medical aspects of ageing in a population with intellectual disability: II. Hearing impairment. Journal of Intellectual Disability Research, 39, 27–33.Google Scholar
Evenhuis, H. M. (1997). Medical aspects of ageing in a population with intellectual disability: II. Mobility, internal conditions and cancer. Journal of Intellectual Disability Research, 41, 8–18.Google Scholar
Eyman, R. K., Grossman, H. J., Chaney, R. H. and Call, T. L. (1990). The life expectancy of profoundly handicapped people with mental retardation. New England Journal of Medicine, 323, 584–9.Google Scholar
Fraser, J. and Mitchell, A. (1876). Kalmuc idiocy: report of a case with autopsy with notes on 62 cases. Journal of Mental Science, 22, 169–79.Google Scholar
Gedye, A. (1995). Dementia Scale for Down's Syndrome. Vancouver, BC: Gedye Research and Consulting.
General Register Office for Scotland (2002). Scotland's Population 2001. General Register Office for Scotland: Edinburgh.
Hand, J. E. (1994). Report of a national survey of older people with lifelong intellectual handicap in New Zealand. Journal of Intellectual Disability Research, 38, 275–87.Google Scholar
Heaton-Ward, W. A. (1967). Mental Subnormality, 3rd edn. Bristol: John Wright and Sons.
Hofman, A., Rocca, W. A., Brayne, C.et al. (1991). The prevalence of dementia in Europe: a collaborative study of 1980–1990 findings. International Journal of Epidemiology, 20, 736–48.Google Scholar
Holland, A. J., Hon, J., Huppert, F. A., Stevens, F. and Watson, P. (1998). A population-based study of the prevalence and presentation of dementia in adults with Down's Syndrome. British Journal of Psychiatry, 172, 493–8.Google Scholar
Holland, A. J., Hon, J., Huppert, F. A., Stevens, F. and Watson, P. (2000). Incidence and course of dementia in people with Down's Syndrome: findings from a population-based study. Journal of Intellectual Disability Research, 44, 138–46.Google Scholar
Holland, A. J. and Oliver, C. (1995). Down's syndrome and the links with Alzheimer's disease. Journal of Neurology, Neurosurgery and Psychiatry, 59, 111–15.Google Scholar
Hollins, S., Attard, M. T., Fraunhofer, N., McGuigan, S. and Sedgwick, P. (1998). Mortality in people with learning disability: risks, causes, and death certification findings in London. Developmental Medicine and Child Neurology, 40, 50–6.Google Scholar
Janicki, M. P., Dalton, A. J., Henderson, C. M. and Davidson, P. W. (1999). Mortality and morbidity among older adults with intellectual disability: health services considerations. Disability & Rehabilitation, 21, 284–94.Google Scholar
Janicki, M. P., Davidson, P. W., Henderson, C. M.et al. (2002). Health characteristics and health services utilization in older adults with intellectual disability living in community residences. Journal of Intellectual Disability Research, 46, 287–98.Google Scholar
Jervis, G. A. (1948). Early senile dementiath mongoloid idiocy. American Journal of Psychiatry, 105, 102–6.Google Scholar
Kapell, D., Nightingale, B., Rodriguez, A.et al. (1998). Prevalence of chronic medical conditions in adults with mental retardation: comparison with the general population. Mental Retardation, 36, 269–79.Google Scholar
Katzman, R. (1993). Education and the prevalence of dementia and Alzheimer disease. Neurology, 43, 13–20.Google Scholar
Lai, F. and Williams, R. S. (1989). A prospective study of Alzheimer's disease in Down's syndrome. Archives Neurology, 46, 849–53.Google Scholar
Lund, J. (1985). The prevalence of psychiatric morbidity in mentally retarded adults. Acta Psychiatrica Scandinavica, 72, 563–70.Google Scholar
Mann, D. M. A. (1988). Alzheimer's disease and Down's syndrome. Histopathology, 13, 125–37.Google Scholar
Mann, D. M. A. (1994). Association between Alzheimer Disease and Down's Syndrome: neuropathological observations. In Berg, J. M., Karlinsky, H., Holland, A. J. (eds.), Alzheimer's Disease, Down Syndrome and their Relationship. Oxford: Oxford Medical Publication, Oxford University Press, pp. 71–92.
McCurley, R., Mackay, D. N. and Scally, B. G. (1972). The life expectation of the mentally subnormal under community and hospital care. Journal of Mental Deficiency Research, 16, 57–66.Google Scholar
McGrother, C., Thorp, C., Taub, N. and Machado, O. (2001). Prevalence, disability and need in adults with severe learning disability. Tizard Learning Disability Review, 6, 4–13.Google Scholar
McGuigan, S. M., Hollins, S. and Attard, M. (1995). Age-specific standardized mortality rates in people with learning disability. Journal of Intellectual Disability Research, 39, 527–31.Google Scholar
Miller, C. and Eyman, R. (1978). Hospital and community mortality rates among the retarded. Journal of Mental Deficiency Research, 22, 137–45.Google Scholar
Moss, S. and Patel, P. (1993). The prevalence of mental illness in people with intellectual disability over 50 years of age, and the diagnostic importance of information from carers. The Irish Journal of Psychology, 14, 110–29.Google Scholar
Moss, S. and Patel, P. (1995). Psychiatric symptoms associated with dementia in older people with learning disability. British Journal of Psychiatry, 167, 663–7.Google Scholar
Murphy, K. C. and Owen, M. J. (2001). Velo-cardio-facial syndrome: a model for understanding the genetics and pathogenesis of schizophrenia. British Journal of Psychiatry, 179, 397–402.Google Scholar
Oliver, C. and Holland, A. J. (1986). Down's syndrome and Alzheimer's disease: a review. Psychological Medicine, 16, 307–22.Google Scholar
Patel, P., Goldberg, D. and Moss, S. (1993). Psychiatric morbidity in older people with moderate and severe learning disabilities II: The prevalence study. British Journal of Psychiatry, 163, 481–91.Google Scholar
Patja, K. (2000). Life expectancy of people with intellectual disability: A 35-year follow-up study. Journal of Intellectual Disability Research, 44, 590–9.Google Scholar
Patja, K., Eero, P. and Iivanainen, M. (2001b). Cancer incidence among people with intellectual disability. Journal of Intellectual Disability Research, 45, 300–7.Google Scholar
Patja, K., Molsa, P. and Iivanainen, M. (2001a). Cause-specific mortality of people with intellectual disability in a population-based, 35-year follow-up. Journal of Intellectual Disability Research, 45, 30–40.Google Scholar
Penrose, L. S. (1949). The incidence of mongolism in the general population. Journal of Mental Science, 9, 10.Google Scholar
Prasher, V. P. (1994). Temporal association between clinical and neuropathological dementia in people with Down syndrome. British Journal of Clinical and Social Psychiatry, 9, 24–5.Google Scholar
Prasher, V. P. (1995). Age specific prevalence, thyroid dysfunction and depressive symptomatology in adults with Down syndrome and dementia. International Journal of Geriatric Psychiatry, 10, 25–31.Google Scholar
Prasher, V. P. (2004). Review of donepezil, rivastigmine, galantamine and memantine for the treatment of dementia in adults with Down Syndrome: implications for the intellectual disability population. International Journal of Geriatric Psychiatry, 19, 509–15.Google Scholar
Prasher, V. P., Adams, C., Holder, R. and the Down Syndrome Research Group (2003). Long-term safety and efficacy of donepezil in the treatment of dementia in Alzheimer Disease in adults with Down's Syndrome: open label study. International Journal of Geriatric Psychiatry, 18, 549–51.Google Scholar
Prasher, V. P. and Filer, A. (1995). Behavioural disturbance in people with Down's syndrome and dementia. Journal of Intellectual Disability Research, 39, 432–6.Google Scholar
Puri, B. K., Lekh, S. K., Langa, A., Zamas, R. and Singh, I. (1995). Mortality in a hospitalised mentally handicapped population: a 10-year old survey. Journal of Intellectual Disability Research, 39, 442–6.Google Scholar
Reid, A. H. and Aungle, P. G. (1974). Dementia in ageing mental defectives: a clinical psychiatric study. Journal of Mental Deficiency Research, 18, 15–23.Google Scholar
Roberts, A. H. (1969). Brain Damage in Boxers. Pitman: London.
Royal College of Psychiatrists (2001). [DC-LD] Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation. London: Gaskell Press.
Rubinzstein, D., Hon, J., Stevens, F.et al. (1999). ApoE genotype and risk of dementia in Down's Syndrome. Neuropsychiatric Genetics, 88, 344–7.Google Scholar
Rumble, B., Retallack, R., Hilbich, C.et al. (1989). Amyloid A4 protein and its precursor in Down's syndrome and Alzheimer's disease. New England Journal of Medicine, 320, 1446–52.Google Scholar
Sansom, D. T., Singh, I., Jawed, S. H. and Mukherjee, T. (1994). Elderly people with learning disabilities in hospital: a psychiatric study. Journal of Intellectual Disability Research, 38, 45–52.Google Scholar
Sparrow, S. S., Balla, D. A. and Cicchetti, D. V. (1984). Vineland Adaptive Behaviour Scales. A Revision of the Vineland Social Maturity Scale by Edgar A. Doll. Circle Pines, MN: American Guidance Service Inc.
Stern, Y., Gurland, B., Taternichi, T. K.et al. (1994). Influence of education and occupation on the incidence of Alzheimer's disease. Journal of the American Medical Association, 271, 1004–10.Google Scholar
Strauss, D. and Eyman, R. K. (1996). Mortality of people with mental retardation in California with and without Down Syndrome, 1986–1991. American Journal on Mental Retardation, 100, 643–53.Google Scholar
Strüwe, F. (1929). Histopathologische untersuchungen uber entstehung und wesen der senilen plaques. Zeitshrift für die Gesamte Neurologie und Psychiatrie, 122, 291.Google Scholar
Tait, D. (1983). Mortality and dementia among ageing defectives. Journal of Mental Deficiency Research, 27, 133–42.Google Scholar
Tanzi, R. E., Gusella, J. F., Watkins, P. C.et al. (1987). Amyloid β – protein gene: cDNA, mRNA distribution and genetic linkage near the Alzheimer locus. Science, 234, 880–4.Google Scholar
Thase, M. E., Tigner, R., Smeltzer, D. J. and Liss, L. (1984). Age-related neuropsychological deficits in Down's Syndrome. Biological Psychiatry, 19, 571–85.Google Scholar
Schrojenstein Lantman-de Valk, H. M., Akker, M., Maaskant, M. A.et al. (1997). Prevalence and incidence of health problems in people with intellectual disability. Journal of Intellectual Disability Research, 41, 42–51.Google Scholar
Wolf, L. C. and Wright, R. E. (1987). Changes in life expectancy of mentally retarded persons in Canadian institutions: a 12-year comparison. Journal of Mental Deficiency Research, 31, 41–59.Google Scholar
World Health Organization (1968). Eighth Revision of the International Classification of Diseases: Glossary of Psychiatric Disorders. Geneva: World Health Organization.
World Health Organization (1993). The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Geneva: World Health Organisation.
Zigman, W. B., Schupf, N., Lubin, R. A. and Silverman, W. P. (1987). Premature regression of adults with Down's syndrome. American Journal on Mental Deficiency, 92, 161–8.Google Scholar

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