Executive dysfunction and its association with personality and behaviour changes in the development of Alzheimer's disease in adults with Down syndrome and mild to moderate learning disabilities

Abstract

These findings provide further evidence for a specific impairment in frontal-lobe functioning in the preclinical stages of AD in DS. Implications for the assessment, diagnosis, and management of dementia in DS are discussed.

Guidelines for Dementia-Related Health Advocacy for Adults With Intellectual Disability and Dementia: National Task Group on Intellectual Disabilities and Dementia Practices

“…For example, symptoms may be perceived as stereotypic or inappropriate (i. e., ''challenging'') behaviors rather than symptoms of an underlying health-related or cognitive pathology. Symptoms among adults with ID with more severe impairment levels may pose a different challenge: these cases are often difficult to discern because of the low rate of verbal communication and general functioning (Ball et al, 2008;Bishop et al, 2013;Evenhuis et al, 2001;Perkins, 2007;Service, Tyler, & Janicki, 2006).…”

“…With advanced age, many adults were also found to be at risk or susceptible to age-related physical and mental health problems, including neuropathologies, such as Alzheimer's disease and related dementias (Cooper, 1997;Evenhuis, Henderson, Beange, Lennox, & Chicoine, 2001;Haveman et al, 2010;Iacono & Sutherland, 2006;Moran et al, 2013;Torr & Davis, 2007;WHO, 2012). Adults with ID who have Down syndrome have been found to have a greater risk for Alzheimer's disease and demonstrate an earlier onset of symptoms when affected (Ball et al, 2006;Ball, Holland, Treppner, Watson, & Huppert, 2008;Evenhuis, 1997;Holland, 1999;McCarron, McCallion, Reilly, & Mulryan, 2014a;Oliver & Kalsy, 2005). Even though they have an increased chance of developing early-onset Alzheimer's disease, other age-related conditions may present with symptoms that may appear similar to those of dementia, such as depression and thyroid dysfunction, or that may result from overmedication or undernutrition, which are amenable to treatment (Ball et al, 2006;Ball et al, 2008;Bishop et al, 2013;Holland, 1999;Prasher, 2005).…”

“…Adults with ID who have Down syndrome have been found to have a greater risk for Alzheimer's disease and demonstrate an earlier onset of symptoms when affected (Ball et al, 2006;Ball, Holland, Treppner, Watson, & Huppert, 2008;Evenhuis, 1997;Holland, 1999;McCarron, McCallion, Reilly, & Mulryan, 2014a;Oliver & Kalsy, 2005). Even though they have an increased chance of developing early-onset Alzheimer's disease, other age-related conditions may present with symptoms that may appear similar to those of dementia, such as depression and thyroid dysfunction, or that may result from overmedication or undernutrition, which are amenable to treatment (Ball et al, 2006;Ball et al, 2008;Bishop et al, 2013;Holland, 1999;Prasher, 2005).…”

Down Syndrome and Dementia: Guide to Identification, Screening, and Management

“…17 Behavioral and personality changes may in fact precede a deterioration of memory as frontal lobe function may be first to be affected in DS patients with dementia. 20 Positive personality traits associated with DS include an engaging and pleasant manner that may shift to aggressive or withdrawn behavior with AD. 20 Adults with DS also experience loss and grief, a normal part of life.…”

“…20 Positive personality traits associated with DS include an engaging and pleasant manner that may shift to aggressive or withdrawn behavior with AD. 20 Adults with DS also experience loss and grief, a normal part of life. Loss of significant-others, parents, or friends, or conflict in their environment, can be difficult to cope with, and adults with AD may not have adequate coping skills and may undergo a cognitive decline.…”