The present study examined the validity of the Severe Impairment Battery (SIB) as a tool for measuring cognitive decline in clients with Down syndrome. Two groups participated: 10 clients who showed behavioural decline over at least a 2 year period as measured by the Vineland Adaptive Behaviour Scales, and 14 clients who showed no decline on this measure over the same period. No differences were found between the two groups in relation to health or life factors which may have impacted on functional and cognitive decline. The deteriorating group were found to be significantly older than the non-deteriorating group. The comparison of the SIB scores indicated that the deteriorating group showed a significant decline between baseline and 12 months and baseline and 24 months on the orientation factor. By contrast, for the non-deteriorating group, significant increases were found for praxis, orientating to name and total scores.

The present study examines two methods of using the Vineland Adaptive Behaviour Scales as a measure of behavioural change in people with Down syndrome who are at risk of developing Alzheimer's disease. The first method uses the Vineland scales as the basis of a semi-structured interview and notes all areas of behavioural change identified by staff; the second method scores the Vineland scales using the basal rule outlined in the manual. The comparison of these two methods illustrated that using the second method highlighted a significant decline in scores for the group meeting the criteria for 'probable Alzheimer's disease' on a number of domains between baseline and 12-24 months. However, this scoring method also appeared to miss more subtle changes in behaviour, which may be important early indicators of Alzheimer's disease, which were picked up by the first method. The implications of the study are discussed.

Patients over the age of 64 and those under 65 referred to a Psychology Department in the Scottish Borders were compared in terms of referral rates, differences in attendance behaviour and service received. Routinely collected departmental data and NHS demographic data were utilised. Results showed that older adults were proportionally less likely to be referred to psychological services than those under 65. The older group also generally had less time to wait for an initial appointment, and were more reliable attendees. However, they were more likely to decline contact before their initial appointment. Implications of these findings are discussed in the light of recent recommendations by the Scottish Executive concerning services for older people in the NHS.

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