Deb, S., Hare, M. and Prior, L. (2007), Symptoms of dementia among adults with Down's syndrome: a qualitative study. Journal of Intellectual Disability Research, 51: 726-739. https://doi.org/10.1111/j.1365-2788.2007.00956.x

Symptoms of dementia among adults with Down's syndrome: a qualitative study

- Especially difficult in the early stage of  the disease
- Difficulty administering tests
  - Tests like the Mini Mental State Examination (MMSE)
    - Can't be used due to the floor effect
- Only professionals can administer tests
- Carers have the responsibility in detecting changes in behavior


The difficulty of Diagnosing Dementia in Individuals with Down Syndrome

- Mental deterioration
- Slowing
- Confusion
- Reduced output of speech
- Deterioration in gait
- Personality Change

Common Early Symptoms of Dementia in Individuals with Down Syndrome

Eady, N., Sheehan, R., Rantell, K., Sinai, A., Bernal, J., Bohnen, I., . . . Strydom, A. (2018). Impact of cholinesterase inhibitors or memantine on survival in adults with Down syndrome and dementia: Clinical cohort study. The British Journal of Psychiatry, 212(3), 155-160. doi:10.1192/bjp.2017.21

Impact of cholinesterase inhibitors or memantine on survival in adults with Down syndrome and dementia: clinical cohort study

Dementia is common in adults with Down Syndrome, but it is difficult to receive this diagnosis. It may be manifested in different ways depending on the individual. 

Cedarville University

Down syndrome is a developmental disorder that causes varying degrees of physical and cognitive disability. It is the most common genetic condition and is caused by a chromosomal abnormality in which there is an extra copy of chromosome 21. 

Down Syndrome

Dementia is characterized by memory loss and impairment of mental functioning that. Depression, paranoia, anxiety, confusion, and wandering are symptoms of the illness.

Dementia

According to the APA, dementia is a generalized, pervasive deterioration of memory and at least one other cognitive function, such as language and an executive function, due to a variety of causes. The loss of intellectual abilities is severe enough to interfere with an individual’s daily functioning and social and occupational activity.

As a result of atypical chromosomal composition, the characteristics of individuals with Down syndrome present in many aspects of their development, both physical and cognitive. Individuals with Down syndrome are characterized by…
 - Physical characteristics of Down syndrome
 - Cognitive characteristics of Down syndrome
- Developmental characteristics of Down syndrome
- Comorbidities of Down syndrome


Characteristics of Down syndrome

The science, research, and biological evaluation of Down syndrome allow us to understand it as we can today. Ways in which scientists have made progress in Down syndrome studies can be appreciated through
- the neurobiology of Down syndrome
- Genes affected by the triplication of chromosome 21 and their links to Down syndrome symptoms
- Mouse Model of Down syndrome: Ts65Dn
- Emerging treatments of Down syndrome


The Science of Down syndrome

Down syndrome is caused by the presence of an extra copy of the 23rd chromosome, resulting in an excessive number of chromosomes: 47, as opposed to 46. However, variations of this chromosomal abnormality exist. And though it is the most common chromosomal abnormality, births with Down syndrome are random and not linked to any health or socioeconomic patterns. We can best explore the variations of the occurrence of Down syndrome through:  
- Types of Down syndrome
- Trisomy 21
- Frequency 
- Inheritance 
- Factors that increase risk 

What causes Down syndrome?

Individuals with disabilities and their families and caretakers often identify with the umbrella term of the “Down syndrome community.” To understand this disability, it is important to understand the cultural and social characteristics of the community. We can understand the community by considering how the Down syndrome community prefers to be communicated with, the employment and education trends, disparities in outcomes, how individuals with Down syndrome see themselves and each other, and the experiences of caretakers. 

Culture of Down syndrome

The life expectancy for people with down syndrome has increased from 10 years of age in 1960 to 47 in 2007. It is still lower than people without it because of the additional health conditions and lower birth weight associated with this syndrome. Race has also been seen to impact how long one can live with this condition. One explanation for this increase in life expectancy is that people have stopped institutionalizing those with down syndrome.

Life expectancy for people with Down Syndrome

Such factors may include:
- chemotherapy;
- cigarette smoking;
- chemicals that disrupt hormone-releasing glands;
- hormones the person receives through treatment for example.

Environmental factors that can influence probability of Down Syndrome

Down Syndrome and Dementia

Early
  - Apathy 
  - Withdrawal

Late
 - Severe intellectual deterioration
 - Marked Changes in Personality and Mood
 - Loss of Sphincter Control
 - Onset of epileptic seizures 
 - Loss of mobility with increased muscle tone
 - Eventual complete loss of all self-help skills

Common Early and Late Symptoms of Dementia in individuals with IDD

Reference for Pseudodementia

Pseudodementia is a false neurocognitive disorder resulting from depression that mimics the symptoms of early Alzheimer's.

Pseudodementia

Alzheimer's disease is a specific type of dementia characterized as an irreversible, progressive brain disorder, which is understood to have a genetic basis. It gradually destroys memory and cognitive skills, eventually impairing the ability to perform simple tasks like walking, talking, and eating. This severe cognitive decline is associated with the formation of plaques in the brain resulting from cell death.

Alzheimer's Disease

An 80-year-old individual is brought to a clinic by their family. Which of the following sets of observations most clearly aligns with the defining characteristics of dementia?

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