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The relationship of dementia prevalence in older adults with intellectual disability (ID) to age and severity of ID

Published online by Cambridge University Press:  15 April 2008

A. Strydom ,
A. Hassiotis ,
M. King  and
G. Livingston
A. Strydom*
Affiliation:
Department of Mental Health Sciences, Royal Free and University College Medical School, UCL, London, UK
A. Hassiotis
Affiliation:
Department of Mental Health Sciences, Royal Free and University College Medical School, UCL, London, UK Camden and Islington NHS Foundation Trust, London, UK
M. King
Affiliation:
Department of Mental Health Sciences, Royal Free and University College Medical School, UCL, London, UK Camden and Islington NHS Foundation Trust, London, UK
G. Livingston
Affiliation:
Department of Mental Health Sciences, Royal Free and University College Medical School, UCL, London, UK Camden and Islington NHS Foundation Trust, London, UK
*
*Address for correspondence: Dr A. Strydom, Department of Mental Health Sciences, Royal Free and University College Medical School, UCL Hampstead Campus, Rowland Hill Street, London NW3 2PF, UK. (Email: [email protected])
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Abstract

Background

Previous research has shown that adults with intellectual disability (ID) may be more at risk of developing dementia in old age than expected. However, the effect of age and ID severity on dementia prevalence rates has never been reported. We investigated the predictions that older adults with ID should have high prevalence rates of dementia that differ between ID severity groups and that the age-associated risk should be shifted to a younger age relative to the general population.

Method

A two-staged epidemiological survey of 281 adults with ID without Down syndrome (DS) aged ⩾60 years; participants who screened positive with a memory task, informant-reported change in function or with the Dementia Questionnaire for Persons with Mental Retardation (DMR) underwent a detailed assessment. Diagnoses were made by psychiatrists according to international criteria. Prevalence rates were compared with UK prevalence and European consensus rates using standardized morbidity ratios (SMRs).

Results

Dementia was more common in this population (prevalence of 18.3%, SMR 2.77 in those aged ⩾65 years). Prevalence rates did not differ between mild, moderate and severe ID groups. Age was a strong risk factor and was not influenced by sex or ID severity. As predicted, SMRs were higher for younger age groups compared to older age groups, indicating a relative shift in age-associated risk.

Conclusions

Criteria-defined dementia is 2–3 times more common in the ID population, with a shift in risk to younger age groups compared to the general population.

Keywords

Alzheimer's diseasebrain reservedementiaintellectual disabilitymental retardation
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 1 , January 2009 , pp. 13 - 21
Copyright
Copyright © 2008 Cambridge University Press

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References

Albert, M, Cohen, C (1992). The test for severe impairment: an instrument for the assessment of patients with severe cognitive dysfunction. Journal of the American Geriatrics Society 40, 449–453.CrossRefGoogle ScholarPubMed
APA (2000). Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (Text Revision). American Psychiatric Association: Washington, DC.Google Scholar
Ball, SL, Holland, AJ, Huppert, FA, Treppner, P, Watson, P, Hon, J (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, 611–620.CrossRefGoogle ScholarPubMed
Burt, DB, Aylward, EH (2000). Test battery for the diagnosis of dementia in individuals with intellectual disability. Journal of Intellectual Disability Research 44, 175–180.CrossRefGoogle ScholarPubMed
Cooper, SA (1997). High prevalence of dementia among people with learning disabilities not attributable to Down's syndrome. Psychological Medicine 27, 609–616.CrossRefGoogle Scholar
Del Ser, T, Hachinski, V, Merskey, H, Munoz, DG (1999). An autopsy-verified study of the effect of education on degenerative dementia. Brain 122, 2309–2319.CrossRefGoogle ScholarPubMed
Dunn, LM, Dunn, LM, Whetton, C, Burley, J (1997). British Picture Vocabulary Scale, 2nd edn. NFER-Nelson: Windsor.Google Scholar
Emerson, E, Hatton, C (2004). Estimating the Current Need/Demand for Supports for People with Learning Disabilities in England. Institute for Health Research, Lancaster University: Lancaster.Google Scholar
Evenhuis, HM (1996). Further evaluation of the Dementia Questionnaire for Persons with Mental Retardation (DMR). Journal of Intellectual Disability Research 40, 369–373.CrossRefGoogle ScholarPubMed
Ferri, CP, Prince, M, Brayne, C, Brodaty, H, Fratiglioni, L, Ganguli, M, Hall, K, Hasegawa, K, Hendrie, H, Huang, YQ, Jorm, A, Mathers, C, Menezes, PR, Rimmer, E, Scazufca, M (2005). Global prevalence of dementia: a Delphi consensus study. Lancet 366, 2112–2117.CrossRefGoogle ScholarPubMed
Geerlings, MI, Deeg, DJH, Penninx, BWJH, Schmand, B, Jonker, C, Bouter, LM, van Tilburg, W (1999). Cognitive reserve and mortality in dementia: the role of cognition, functional ability and depression. Psychological Medicine 29, 1219–1226.CrossRefGoogle ScholarPubMed
Gustavson, KH, Umb-Carlsson, O, Sonnander, K (2005). A follow-up study of mortality, health conditions and associated disabilities of people with intellectual disabilities in a Swedish county. Journal of Intellectual Disability Research 49, 905–914.CrossRefGoogle Scholar
Hassiotis, A, Strydom, A, Allen, K, Walker, Z (2003). A memory clinic for older people with intellectual disabilities. Aging and Mental Health 7, 418–423.CrossRefGoogle ScholarPubMed
Haveman, MJ (2004). Disease epidemiology and ageing people with intellectual disabilities. Journal of Policy and Practice in Intellectual Disabilities 1, 16–23.CrossRefGoogle Scholar
Lawton, MP, Brody, EM (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist 9, 179–186.CrossRefGoogle ScholarPubMed
McKeith, IG, Galasko, D, Kosaka, K, Perry, EK, Dickson, DW, Hansen, LA, Salmon, DP, Lowe, J, Mirra, SS, Byrne, EJ, Lennox, G, Quinn, NP, Edwardson, JA, Ince, PG, Bergeron, C, Burns, A, Miller, BL, Lovestone, S, Collerton, D, Jansen, ENH, Ballard, C, Devos, RAI, Wilcock, GK, Jellinger, KA, Perry, RH (1996). Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology 47, 1113–1124.CrossRefGoogle Scholar
McKhann, GM, Albert, MS, Grossman, M, Miller, B, Dickson, D, Trojanowski, JQ (2001). Clinical and pathological diagnosis of frontotemporal dementia: report of the work group on frontotemporal dementia and Pick's disease. Archives of Neurology 58, 1803–1809.CrossRefGoogle Scholar
Moss, S (2002). The Mini-PASADD Interview Pack. Pavilion: Brighton.Google Scholar
Nihira, K, Leland, L, Lambert, N (1992). Adaptive Behaviour Scale: Residential and Community, 2nd edn. Pro-ed: Austin, TX.Google Scholar
Page, RM, Cole, GE, Timmreck, TC (1995). Basic Epidemiological Methods and Biostatistics: A Practical Guidebook. Jones and Bartlett: Boston.Google Scholar
Patel, P, Goldberg, D, Moss, S (1993). Psychiatric morbidity in older people with moderate and severe learning disability. 2. The Prevalence Study. British Journal of Psychiatry 163, 481–491.CrossRefGoogle Scholar
Patja, K, Iivanainen, M, Vesala, H, Oksanen, H, Ruoppila, I (2000). Life expectancy of people with intellectual disability: a 35-year follow-up study. Journal of Intellectual Disability Research 44, 591–599.CrossRefGoogle ScholarPubMed
Randall, Smith (2005). Human Rights, Anti-Discrimination and Disability in Britain. School for Policy Studies, University of Bristol: Bristol, UK.Google Scholar
Saunders, PA, Copeland, JRM, Dewey, ME, Gilmore, C, Larkin, BA, Phaterpekar, H, Scott, A (1993). The prevalence of dementia, depression and neurosis in later life: the Liverpool MRC-Alpha study. International Journal of Epidemiology 22, 838–847.CrossRefGoogle ScholarPubMed
Saxton, J, Swihart, AA (1989). Neuropsychological assessment of the severely impaired elderly patient. Clinics in Geriatric Medicine 5, 531–543.CrossRefGoogle ScholarPubMed
Scarmeas, N, Albert, SM, Manly, JJ, Stern, Y (2006). Education and rates of cognitive decline in incident Alzheimer's disease. Journal of Neurology, Neurosurgery and Psychiatry 77, 308–316.CrossRefGoogle ScholarPubMed
Schmand, B, Smit, JH, Geerlings, MI, Lindeboom, J (1997). The effects of intelligence and education on the development of dementia. A test of the brain reserve hypothesis. Psychological Medicine 27, 1337–1344.CrossRefGoogle ScholarPubMed
Schofield, PW, Mosesson, RE, Stern, Y, Mayeux, R (1995). The age at onset of Alzheimer's disease and an intracranial area measurement. A relationship. Archives of Neurology 52, 95–98.CrossRefGoogle Scholar
Shallice, T (1982). Specific impairments of planning. Philosophical Transactions of the Royal Society of London, Series B. Biological Sciences 298, 199–209.Google ScholarPubMed
Staff, RT, Murray, AD, Deary, IJ, Whalley, LJ (2004). What provides cerebral reserve? Brain 127, 1191–1199.CrossRefGoogle ScholarPubMed
Stern, Y (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society 8, 448–460.CrossRefGoogle ScholarPubMed
Stern, Y (2003). The concept of cognitive reserve: a catalyst for research. Journal of Clinical and Experimental Neuropsychology 25, 589–593.CrossRefGoogle ScholarPubMed
Strydom, A, Livingston, G, King, M, Hassiotis, A (2007). Prevalence of dementia in intellectual disability using different diagnostic criteria. British Journal of Psychiatry 191, 150–157.CrossRefGoogle ScholarPubMed
Thompson, CW (1951). Decline in limit of performance among adult morons. American Journal of Psychology 64, 203–215.CrossRefGoogle ScholarPubMed
Torr, J (2005). Dementia and intellectual disability. In Dementia (ed. Burns, A., O'Brien, J. T. and Ames, D.), pp. 745–749. Hodder Arnold: London.Google Scholar
Tredgold, AF (1952). Amentia with other forms of mental disease. In Mental Deficiency (ed. Tredgold, A. F.), pp. 394–395. Bailliere, Tindall and Cox: London.Google Scholar
Troyer, AK (2000). Normative data for clustering and switching on verbal fluency tasks. Journal of Clinical and Experimental Neuropsychology 22, 370–378.CrossRefGoogle ScholarPubMed
Valenzuela, MJ, Sachdev, P (2006). Brain reserve and dementia: a systematic review. Psychological Medicine 36, 441–454.CrossRefGoogle ScholarPubMed
Verghese, J, Lipton, RB, Katz, MJ, Hall, CB, Derby, CA, Kuslansky, G, Ambrose, AF, Sliwinski, M, Buschke, H (2003). Leisure activities and the risk of dementia in the elderly. New England Journal of Medicine 348, 2508–2516.CrossRefGoogle ScholarPubMed
Whalley, LJ, Deary, IJ, Appleton, CL, Starr, JM (2004). Cognitive reserve and the neurobiology of cognitive aging. Ageing Research Reviews 3, 369–382.CrossRefGoogle ScholarPubMed
Whalley, LJ, Starr, JM, Athawes, R, Hunter, D, Pattie, A, Deary, IJ (2000). Childhood mental ability and dementia. Neurology 55, 1455–1459.CrossRefGoogle ScholarPubMed
WHO (1993). The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. World Health Organization: Geneva.Google Scholar
Zigman, WB, Schupf, N, Devenny, DA, Miezejeski, C, Ryan, R, Urv, TK, Schubert, R, Silverman, W (2004). Incidence and prevalence of dementia in elderly adults with mental retardation without Down syndrome. American Journal on Mental Retardation 109, 126–141.2.0.CO;2>CrossRefGoogle ScholarPubMed