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Vaughan RM, O'Dwyer M, Tyrrell J, Kennelly SP, McCarron M. Drug burden index of people ageing with intellectual disability and cognitive complaints attending a specialist memory service. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:1386-1395. [PMID: 39187934 DOI: 10.1111/jir.13180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/05/2024] [Accepted: 07/29/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Medications with sedative or anticholinergic properties should be prescribed with caution in those with cognitive complaints. This is particularly relevant in people ageing with an intellectual disability (ID). Higher drug burden index (DBI) scores are associated with increased frailty and falls and reduced quality of life in older people and increased risk of adverse effects (daytime somnolence, constipation) in those with ID. While previous studies have shown that the ID population has higher rates of drug burden and a higher propensity to be prescribed an antipsychotic than the general population, the degree of burden has not been assessed specifically in those with ID and cognitive complaints. METHODS We assessed drug burden in a cohort of sequential referrals to a national memory service for people with ID. All patients were referred for assessment of cognitive complaints (self-reported or caregiver-reported problems with memory or cognition). DBI was calculated individually for each participant, and the impact of aetiology of ID, level of ID, age, psychiatric/neurological comorbidities and diagnostic outcome on DBI scores was assessed. RESULTS The study population was 58.6% female with a median age of 55 years and aetiology of ID was Down syndrome (DS) in 71.3%. Consensus diagnosis was Alzheimer's dementia in 40.2%, mild cognitive impairment in 29.9% and cognitively unimpaired from baseline in 25.3%. Medication use was high with 95.4% taking medications, with a median number of medications of 4 (interquartile range 4) and a rate of polypharmacy (≥5 medications) of 51.7%. Overall, 65.5% were exposed to sedative or anticholinergic medications with 39.1% exposed to a clinically significant DBI score >1. Those with psychiatric comorbidities, non-DS aetiology or epilepsy were significantly more likely to have a DBI score >1. CONCLUSIONS People with ID and incipient cognitive complaints have a high level of drug burden, which concerningly exceeds that of the general population.
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Affiliation(s)
- R M Vaughan
- National Intellectual Disability Memory Service, Tallaght University Hospital, Dublin, Ireland
| | - M O'Dwyer
- Trinity Centre for Ageing and Intellectual Disability, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | - J Tyrrell
- National Intellectual Disability Memory Service, Tallaght University Hospital, Dublin, Ireland
| | - S P Kennelly
- National Intellectual Disability Memory Service, Tallaght University Hospital, Dublin, Ireland
| | - M McCarron
- National Intellectual Disability Memory Service, Tallaght University Hospital, Dublin, Ireland
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
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MacHale R, NíNeill E, Wyer C, Corley E, McGuire BE. Preliminary feasibility study of a cognitive stimulation therapy programme for older adults with an intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13291. [PMID: 39143653 DOI: 10.1111/jar.13291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 06/21/2024] [Accepted: 07/31/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Despite the increased risk for people with an intellectual disability developing dementia, post-diagnostic psychosocial supports such as cognitive stimulation therapy (CST) are not routinely offered and there is limited research examining this intervention with people with intellectual disabilities. The aim of this study was to explore the feasibility of CST for older adults with intellectual disability to support active ageing. METHODS Five client participants attended a 14-session CST group and four staff attended a focus group. Reflexive thematic analysis was used to investigate the client and staff narratives. RESULTS Three key themes were generated: (1) Brain Health, (2) Connecting with others, and (3) Barriers and Enablers. CONCLUSION Findings indicated the suitability of CST as a way of supporting active ageing for older adults with intellectual disability. This study adds to the growing knowledge about service provision for older adults and their changing needs as they age and identifies clinical implications such as staff training to support intervention adherence.
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Affiliation(s)
| | - Emma NíNeill
- Psychology Department, Cope Foundation, Cork, Ireland
| | - Cathy Wyer
- Occupational Therapy Department, Cope Foundation, Cork, Ireland
| | - Emma Corley
- School of Psychology, University of Galway, Galway, Ireland
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Ptomey LT, Barton K, Swinford E, Bodde A, George A, Gorczyca AM, Niedens CM, Sprague SC, Yeager A, Helsel B, Teri L, Vidoni ED, Perales-Puchalt J. Preliminary translation of 'Reducing Disability in Alzheimer's Disease' among individuals with intellectual disabilities and caregiver dyads. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13239. [PMID: 38621995 PMCID: PMC11067498 DOI: 10.1111/jar.13239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 01/30/2024] [Accepted: 04/02/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND The Reducing Disability in Alzheimer's Disease in Kansas City (RDAD-KC) intervention has been shown to improve the health of individuals with dementia and caregiver dyads. This manuscript reports the results of implementing the RDAD among individuals with intellectual disabilities and caregiver dyads. METHODS Nine community agencies deployed the 12-week intervention. We assessed changes in individuals with intellectual disabilities' behavioural symptom related severity and physical activity, and caregivers' behavioural symptom-related distress, unmet needs, and caregiver strain. RESULTS Forty-four dyads enrolled, and 23 (~60 years, 48% female) completed ≥75% of the intervention. We observed decreases in behavioural symptom related severity (p = .07) and increases in physical activity (p = .20) among individuals with intellectual disabilities. We also observed decreases in behavioural symptom related distress (p = .14), unmet needs (p = .50), and caregiver strain (p = .50) among caregivers. CONCLUSIONS The RDAD-KC intervention showed promising, although statistically non-significant, benefits among individuals with intellectual disabilities and their caregivers.
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Affiliation(s)
- Lauren T Ptomey
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kelli Barton
- Health and Aging Department, University of Missouri-Kansas City Institute for Human Development, Kansas City, Missouri, USA
| | - Emma Swinford
- Health and Aging Department, University of Missouri-Kansas City Institute for Human Development, Kansas City, Missouri, USA
| | - Amy Bodde
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | | | - Anna M Gorczyca
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - C Michelle Niedens
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas, USA
| | | | - Amy Yeager
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas, USA
| | - Brian Helsel
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas, USA
| | - Linda Teri
- School of Nursing, University of Washington, Seattle, Washington, USA
| | - Eric D Vidoni
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas, USA
| | - Jaime Perales-Puchalt
- Department of Neurology, University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas, USA
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Pendl D, Glatz M, Gasteiger-Klicpera B. Intellectual disabilities and dementia: New tasks and experiences of Austrian formal caregivers. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13165. [PMID: 37849394 DOI: 10.1111/jar.13165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 07/18/2023] [Accepted: 09/28/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND In Austria, due to its history, only relatively little research on the topic of intellectual disabilities and dementia has been conducted to date. The present study thus aims to explore the challenges and tasks currently facing formal caregivers, together with assessing their wishes for further development. METHODS Ten semi-structured interviews were held with formal caregivers. Interviews were transcribed and analysed by means of structured qualitative content analysis. RESULTS Caregivers must deal with conflicts between residents, and with increasing demands for care and emotional support. Education and training on dementia and intellectual disability are mostly of high quality, but still remain insufficient. Caregivers would like to see suitable adaptation of care premises, smaller groups, more staff and better training on dementia and intellectual disability. CONCLUSION To ensure quality care and 'ageing in place', caregivers and providers need to pay greater attention to dementia-related changes when planning and adapting services.
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Affiliation(s)
- Dominik Pendl
- Inclusive Education Unit, University of Graz, Institute of Education Research and Teacher Education, Graz, Austria
| | - Mathieu Glatz
- Inclusive Education Unit, University of Graz, Institute of Education Research and Teacher Education, Graz, Austria
| | - Barbara Gasteiger-Klicpera
- Inclusive Education Unit, University of Graz, Institute of Education Research and Teacher Education, Graz, Austria
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Pavković S. Enhancing post-diagnostic care in Australian memory clinics: Health professionals' insights into current practices, barriers and facilitators, and desirable support. DEMENTIA 2024; 23:109-131. [PMID: 38116661 PMCID: PMC10797845 DOI: 10.1177/14713012231213419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Providing integrated and evidence-based support to individuals and families following a diagnosis of dementia is essential in order to optimise their quality of life and assist them to live well. Memory clinics provide multidisciplinary services specialising in the assessment and post-diagnostic treatment of people with dementia. This study sought to identify current practices, barriers and facilitators to provision of postdiagnostic support and to obtain health professionals' opinion of ideal post-diagnostic support to be offered in Australian memory clinics. METHODOLOGY This was a cross-sectional qualitative exploratory study. Data was collected from health professionals familiar with the process of diagnosis and post-diagnostic support through two expert panel meetings (n = 22). In addition, 5 focus groups (n = 22) were conducted including health professionals who are employed in Australian memory clinics. Data was collected between October 2020 and November 2021. Reflexive thematic analysis was undertaken. RESULTS Seven themes and three subthemes were identified under the three topics: Current Practices, Barriers and Facilitators, and Desirable Support. Themes relating to Current Practices were: Tailored Communication and feedback about diagnosis; Prescription of medications and follow-up; and Referrals to health and community services. Themes relating to Barriers and Facilitators were: The structure of the current system; Lack of funding; Lack of resources; Call for government investment. Themes relating to Desirable support were: A key/single point of support; Cognitive interventions; and Counselling and education. CONCLUSION Post-diagnostic support in Australian memory clinics focused primarily on ensuring people understood their diagnosis, information about postdiagnostic support was provided, and dementia medications were prescribed. There were notable differences in practices in metropolitan compared to regional areas. A key concern was the need for increased funding, particularly to support the establishment of a single point of contact to facilitate continuity of care.
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Affiliation(s)
- Slađana Pavković
- Wicking Dementia Research and Education Centre, University of Tasmania, College of Health and Medicine, Australia
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Dennehy H, Allen AP, McGlinchey E, Buttery N, García-Domínguez L, Chansler R, Corr C, Dunne P, Kennelly S, Daly L, McCallion P, McCarron M. A scoping review of post-diagnostic dementia supports for people with intellectual disability. Aging Ment Health 2022:1-10. [PMID: 36218056 DOI: 10.1080/13607863.2022.2130171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objectives: People with intellectual disability, particularly people with Down syndrome, are at an increased risk for early-onset dementia, in comparison to people without an intellectual disability. The aim of this review was to scope the current landscape of post-diagnostic dementia supports for people with intellectual disability.Method: A systematic search of five electronic databases (CINAHL, Medline, PsycArticles, PsycInfo and Web of Science) was conducted for this scoping review. Results were screened independently by two reviewers, with a third reviewer for arbitration where necessary.Results: Forty-two studies met the inclusion criteria, and relevant information was extracted. The articles included focussed on the experiences of people with intellectual disability and dementia, as well as the role of carers, family members and staff. Key themes included ageing in place, environmental supports for people with intellectual disability and dementia, dementia-specific interventions and therapies, as well as the feasibility of these interventions. Besides the studies that focussed on these themes, other studies focussed on staff training and family supports.Conclusion: This review highlights the importance of implementing timely and appropriate post-diagnostic supports for people living with intellectual disability and dementia. More controlled trials are required on post-diagnostic dementia supports for people with intellectual disability.
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Affiliation(s)
- Holly Dennehy
- Trinity Centre for Ageing & Intellectual Disability, Trinity College Dublin, Ireland
| | - Andrew P Allen
- Trinity Centre for Ageing & Intellectual Disability, Trinity College Dublin, Ireland.,School of Nursing & Midwifery, Trinity College Dublin, Ireland
| | - Eimear McGlinchey
- Trinity Centre for Ageing & Intellectual Disability, Trinity College Dublin, Ireland.,School of Nursing & Midwifery, Trinity College Dublin, Ireland.,National Intellectual Disability Memory Service, Tallaght University Hospital, Dublin, Ireland
| | - Nadine Buttery
- Trinity Centre for Ageing & Intellectual Disability, Trinity College Dublin, Ireland
| | | | - Rachael Chansler
- School of Nursing, University of Pennsylvania, Philadelphia, USA
| | - Christina Corr
- Trinity Centre for Ageing & Intellectual Disability, Trinity College Dublin, Ireland
| | - Pamela Dunne
- National Intellectual Disability Memory Service, Tallaght University Hospital, Dublin, Ireland
| | - Seán Kennelly
- National Intellectual Disability Memory Service, Tallaght University Hospital, Dublin, Ireland.,Department of Medical Gerontology, Trinity College Dublin, Ireland
| | - Louise Daly
- School of Nursing & Midwifery, Trinity College Dublin, Ireland
| | - Philip McCallion
- Trinity Centre for Ageing & Intellectual Disability, Trinity College Dublin, Ireland.,School of Social Work, Temple University, Philadelphia, USA
| | - Mary McCarron
- Trinity Centre for Ageing & Intellectual Disability, Trinity College Dublin, Ireland.,School of Nursing & Midwifery, Trinity College Dublin, Ireland.,National Intellectual Disability Memory Service, Tallaght University Hospital, Dublin, Ireland
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The 2018 Japan Floods Increased Prescriptions of Antidementia Drugs among Disaster Victims. J Am Med Dir Assoc 2022; 23:1045-1051. [DOI: 10.1016/j.jamda.2021.12.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/01/2021] [Accepted: 12/19/2021] [Indexed: 11/18/2022]
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Dierssen M, Herault Y, Helguera P, Martínez de Lagran M, Vazquez A, Christian B, Carmona-Iragui M, Wiseman F, Mobley W, Fisher EMC, Brault V, Esbensen A, Jacola LM, Potier MC, Hamlett ED, Abbeduto L, Del Hoyo Soriano L, Busciglio J, Iulita MF, Crispino J, Malinge S, Barone E, Perluigi M, Costanzo F, Delabar JM, Bartesaghi R, Dekker AD, De Deyn P, Fortea Ormaechea J, Shaw PA, Haydar TF, Sherman SL, Strydom A, Bhattacharyya A. Building the Future Therapies for Down Syndrome: The Third International Conference of the T21 Research Society. Mol Syndromol 2021; 12:202-218. [PMID: 34421499 DOI: 10.1159/000514437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/13/2021] [Indexed: 11/19/2022] Open
Abstract
Research focused on Down syndrome has increased in the last several years to advance understanding of the consequences of trisomy 21 (T21) on molecular and cellular processes and, ultimately, on individuals with Down syndrome. The Trisomy 21 Research Society (T21RS) is the premier scientific organization for researchers and clinicians studying Down syndrome. The Third International Conference of T21RS, held June 6-9, 2019, in Barcelona, Spain, brought together 429 scientists, families, and industry representatives to share the latest discoveries on underlying cellular and molecular mechanisms of T21, define cognitive and behavioral challenges and better understand comorbidities associated with Down syndrome, including Alzheimer's disease and leukemia. Presentation of cutting-edge results in neuroscience, neurology, model systems, psychology, cancer, biomarkers and molecular and phar-ma-cological therapeutic approaches demonstrate the compelling interest and continuing advancement in all aspects of understanding and ameliorating conditions associated with T21.
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Affiliation(s)
- Mara Dierssen
- Centre for Genomic Regulation, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Yann Herault
- Université de Strasbourg, CNRS, INSERM, Institut de Génétique et de Biologie Moléculaire et Cellulaire, Strasbourg, France
| | - Pablo Helguera
- Instituto Ferreyra, INIMEC-CONICET-UNC, Córdoba, Argentina
| | - Maria Martínez de Lagran
- Centre for Genomic Regulation, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Anna Vazquez
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Bradley Christian
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Maria Carmona-Iragui
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Barcelona Down Medical Center, Fundació Catalana de Síndrome de Down, Barcelona, Spain
| | - Frances Wiseman
- UK Dementia Research Institute, University College London, London, United Kingdom
| | - William Mobley
- University of California-San Diego, San Diego, California, USA
| | | | - Veronique Brault
- Université de Strasbourg, CNRS, INSERM, Institut de Génétique et de Biologie Moléculaire et Cellulaire, Strasbourg, France
| | - Anna Esbensen
- University of Cincinnati, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Lisa M Jacola
- St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Marie Claude Potier
- Brain & Spine Institute (ICM), CNRS UMR7225 - INSERM U1127 - UPMC Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Eric D Hamlett
- Medical University of South Carolina, Columbia, South Carolina, USA
| | | | | | | | | | | | - Sébastien Malinge
- Telethon Kids Institute - Cancer Centre, Nedlands, Washington, Australia
| | | | | | | | - Jean Maurice Delabar
- Brain & Spine Institute (ICM), CNRS UMR7225 - INSERM U1127 - UPMC Hôpital de la Pitié-Salpêtrière, Paris, France
| | | | - Alain D Dekker
- University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Peter De Deyn
- University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.,University of Antwerp, Antwerp, Belgium
| | - Juan Fortea Ormaechea
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Barcelona Down Medical Center, Fundació Catalana de Síndrome de Down, Barcelona, Spain
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Antonarakis SE, Skotko BG, Rafii MS, Strydom A, Pape SE, Bianchi DW, Sherman SL, Reeves RH. Down syndrome. Nat Rev Dis Primers 2020; 6:9. [PMID: 32029743 PMCID: PMC8428796 DOI: 10.1038/s41572-019-0143-7] [Citation(s) in RCA: 375] [Impact Index Per Article: 93.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/17/2019] [Indexed: 12/11/2022]
Abstract
Trisomy 21, the presence of a supernumerary chromosome 21, results in a collection of clinical features commonly known as Down syndrome (DS). DS is among the most genetically complex of the conditions that are compatible with human survival post-term, and the most frequent survivable autosomal aneuploidy. Mouse models of DS, involving trisomy of all or part of human chromosome 21 or orthologous mouse genomic regions, are providing valuable insights into the contribution of triplicated genes or groups of genes to the many clinical manifestations in DS. This endeavour is challenging, as there are >200 protein-coding genes on chromosome 21 and they can have direct and indirect effects on homeostasis in cells, tissues, organs and systems. Although this complexity poses formidable challenges to understanding the underlying molecular basis for each of the many clinical features of DS, it also provides opportunities for improving understanding of genetic mechanisms underlying the development and function of many cell types, tissues, organs and systems. Since the first description of trisomy 21, we have learned much about intellectual disability and genetic risk factors for congenital heart disease. The lower occurrence of solid tumours in individuals with DS supports the identification of chromosome 21 genes that protect against cancer when overexpressed. The universal occurrence of the histopathology of Alzheimer disease and the high prevalence of dementia in DS are providing insights into the pathology and treatment of Alzheimer disease. Clinical trials to ameliorate intellectual disability in DS signal a new era in which therapeutic interventions based on knowledge of the molecular pathophysiology of DS can now be explored; these efforts provide reasonable hope for the future.
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Affiliation(s)
- Stylianos E Antonarakis
- Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland.
| | - Brian G Skotko
- Down Syndrome Program, Division of Medical Genetics, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Michael S Rafii
- Keck School of Medicine of University of Southern California, California, CA, USA
| | - Andre Strydom
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sarah E Pape
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Diana W Bianchi
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Stephanie L Sherman
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Roger H Reeves
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Santos FH, Watchman K, Janicki MP. Highlights from the International Summit on Intellectual Disability and Dementia Implications for Brazil. Dement Neuropsychol 2018; 12:329-336. [PMID: 30546842 PMCID: PMC6289481 DOI: 10.1590/1980-57642018dn12-040001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 11/01/2018] [Indexed: 11/22/2022] Open
Abstract
In October of 2016, an interdisciplinary group representing North and South American and European countries met in Glasgow, Scotland, to scrutinize universal issues regarding adults with intellectual disability (ID) affected by dementia and to produce recommendations and guidelines for public policy, practice, and further research. The aim of this paper is to apprise relevant outcomes of the Summit targeting Brazilian researchers, clinicians, and nongovernmental organizations in the field of ageing and dementia that are committed to developing the Brazilian national dementia plan. Three core themes were covered by the Summit: i) human rights and personal resources, ii) personalized services and caregiver support, and iii) advocacy and public impact. The exploration of the themes highlighted variations across countries, and revealed consensual views on matters such as international networks, guidance for practices, and advocacy on behalf of both people with ID affected by dementia, and their families. The authors outline the challenges Brazil must confront regarding ageing and dementia and proffer recommendations to address the needs of adults with ID affected by dementia within this scenario; both of which would help in developing the Brazilian national dementia plan.
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Affiliation(s)
- Flavia H Santos
- São Paulo State University, Bauru, SP, Brazil
- University College Dublin, Ireland
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Appetite, Metabolism and Hormonal Regulation in Normal Ageing and Dementia. Diseases 2018; 6:diseases6030066. [PMID: 30036957 PMCID: PMC6164971 DOI: 10.3390/diseases6030066] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 07/17/2018] [Accepted: 07/19/2018] [Indexed: 12/12/2022] Open
Abstract
Feeding and nutrition follow the growth trajectory of the course of life. The profound physiological changes that human body experiences during ageing affect separate aspects of food intake, from tastant perception to satiety. Concurrent morbidities, such as neurodegeneration, as seen in dementia, and metabolic syndrome, may further shape nutritional behaviours, status and adequacy. In an effort to fill the gap between the exhausting basic research and the actual needs of professionals caring for the exponentially expanding ageing population, the current review addresses major factors relevant to appetite and eating disturbances. Does age alter the perception of food modalities? Is food generally still perceived as alluring and delicious with age? Is there an interplay between ageing, cognitive decline, and malnutrition? What tools can we adopt for proper and timely monitoring? Finally, what anatomical and pathophysiological evidence exists to support a hypothesis of central regulation of metabolic perturbations in normal and accelerated cognitive impairment, and how can we benefit from it in health practice?
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Jokinen N, Gomiero T, Watchman K, Janicki MP, Hogan M, Larsen F, Beránková A, Heloísa Santos F, Service K, Crowe J. Perspectives on family caregiving of people aging with intellectual disability affected by dementia: Commentary from the International Summit on Intellectual Disability and Dementia. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2018; 61:411-431. [PMID: 29583104 DOI: 10.1080/01634372.2018.1454563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This article, an output of the 2016 International Summit on Intellectual Disability and Dementia, examines familial caregiving situations within the context of a support-staging model for adults with intellectual disability (ID) affected by dementia. Seven narratives offer context to this support-staging model to interpret situations experienced by caregivers. The multidimensional model has two fundamental aspects: identifying the role and nature of caregiving as either primary (direct) or secondary (supportive); and defining how caregiving is influenced by stage of dementia. We propose staging can affect caregiving via different expressions: (1) the "diagnostic phase," (2) the "explorative phase," (3) the "adaptive phase," and (4) the "closure phase." The international narratives illustrate direct and indirect caregiving with commonality being extent of caregiver involvement and attention to the needs of an adult with ID. We conclude that the model is the first to empirically formalize the variability of caregiving within families of people with ID that is distinct from other caregiving groups, and that many of these caregivers have idiosyncratic needs. A support-staging model that recognizes the changing roles and demands of carers of people with ID and dementia can be useful in constructing research, defining family-based support services, and setting public policy.
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Affiliation(s)
- Nancy Jokinen
- a School of Social Work, University of Northern British Columbia , Prince George , Canada
| | | | - Karen Watchman
- c Faculty of Health Sciences and Sport, University of Stirling , Scotland
| | - Matthew P Janicki
- d Department of Disability and Human Development, University of Illinois at Chicago , USA
| | - Mary Hogan
- e National Task Group in Intellectual Disabilities and Dementia Practices , Eliot , ME , USA
| | - Frode Larsen
- f Norwegian National Advisory Unit on Ageing and Health , Oslo , Norway
| | - Anna Beránková
- g Centre of Expertise in Longevity and Long-term Care, Charles University , Prague , Czech Republic
| | - Flávia Heloísa Santos
- h Department of Psychology, SãoPaulo State University , Bauru , Brazil
- i Department of Basic Psychology, University of Minho , Braga , Portugal
| | - Kathy Service
- j Nurse Practitioner Consultant, Northampton , MA , USA
| | - Jim Crowe
- k European Association of Service providers for Persons with Disabilities (EASPD) , Brussels , Belgium
- l Learning Disability Wales , Cardiff , Wales
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