Pharmacological interventions for cognitive decline in people with Down syndrome

Livingstone, Nuala; Hanratty, Jennifer; McShane, Rupert; Macdonald, Geraldine

doi:10.1002/14651858.cd011546.pub2

Cited by 28 publications

(28 citation statements)

References 70 publications

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“…A 2015 Cochrane review of medication for dementia in people with Down syndrome (Livingstone, Hanratty, McShane, & Macdonald, 2015) concluded that overall, the quality of evidence is low which prevents firm conclusions to be made and the authors argued for further trials. However, it is probably unlikely to conduct trials based on withholding treatments (in a placebo arm) from individuals with dementia if those treatments are accepted practice and recommended by current guidance.…”

Section: Pharmacological Interventionsmentioning

confidence: 99%

Consensus statement of the international summit on intellectual disability and Dementia related to post-diagnostic support

Dodd

Watchman

Janicki

et al. 2017

Aging & Mental Health

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Objectives: Post diagnostic support (PDS) has varied definitions within mainstream dementia services and different health and social care organizations, encompassing a range of supports that are offered to adults once diagnosed with dementia until death. Method: An international summit on intellectual disability and dementia held in Glasgow, Scotland in 2016 identified how PDS applies to adults with an intellectual disability and dementia. The Summit proposed a model that encompassed seven focal areas: post-diagnostic counseling; psychological and medical surveillance; periodic reviews and adjustments to the dementia care plan; early identification of behaviour and psychological symptoms; reviews of care practices and supports for advanced dementia and end of life; supports to carers/ support staff; and evaluation of quality of life. It also explored current practices in providing PDS in intellectual disability services. Results: The Summit concluded that although there is limited research evidence for pharmacological or non-pharmacological interventions for people with intellectual disability and dementia, viable resources and guidelines describe practical approaches drawn from clinical practice. Post diagnostic support is essential, and the model components in place for the general population, and proposed here for use within the intellectual disability field, need to be individualized and adapted to the person's needs as dementia progresses. Conclusions: Recommendations for future research include examining the prevalence and nature of behavioral and psychological symptoms (BPSD) in adults with an intellectual disability who develop dementia, the effectiveness of different non-pharmacological interventions, the interaction between pharmacological and non-pharmacological interventions, and the utility of different models of support.

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Section: Pharmacological Interventionsmentioning

confidence: 99%

Consensus statement of the international summit on intellectual disability and Dementia related to post-diagnostic support

Dodd

Watchman

Janicki

et al. 2017

Aging & Mental Health

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“…Furthermore, it would enable specific therapeutic interventions. Currently, treatment options are limited: in the few randomized controlled trials in the DS population, effectiveness of donepezil and memantine was not proven [13]. Alternatively, contemporary intellectual disability care focuses on timely (non-)pharmacologic therapy to reduce behavioral and psychological symptoms of dementia—the major cause of referral [14]—to improve quality of life and reduce caregiver burden [10], [15].…”

Section: Introduction: Down Syndrome At High Risk For Alzheimer's Dismentioning

confidence: 99%

Cerebrospinal fluid biomarkers for Alzheimer's disease in Down syndrome

Dekker

Fortea

Blesa

et al. 2017

Alz & Dem Diag Ass & Dis Mo

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Down syndrome (DS), present in nearly six million people, is associated with an extremely high risk to develop Alzheimer's disease (AD). Amyloid-β and tau pathology are omnipresent from age 40 years onward, but clinical symptoms do not appear in all DS individuals. Dementia diagnostics is complex in this population, illustrating the great need for predictive biomarkers. Although blood biomarkers have not yet proven useful, cerebrospinal fluid (CSF) biomarkers (low amyloid-β42, high t-tau, and high p-tau) effectively contribute to AD diagnoses in the general population and are increasingly used in clinical practice. Surprisingly, CSF biomarkers have been barely evaluated in DS. Breaking the taboo on CSF analyses would finally allow for the elucidation of its utility in (differential) diagnoses and staging of disease severity. A sensitive and specific biomarker profile for AD in DS would be of paramount importance to daily care, adaptive caregiving, and specific therapeutic interventions.

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“…Dessa forma, novas abordagens são necessárias (BALLARD et al, 2016). Ainda existem poucos estudos experimentais controlados e desenhados de forma adequada nesta área (LIVINGSTONE et al, 2015). Assim, novas pesquisas que avaliem estratégias nutricionais potencialmente capazes de amenizar os sintomas relacionados ao Alzheimer e à prevenção da demência relacionadas à SD fazem-se necessárias.…”

Section: Discussionunclassified

Aspectos nutricionais associados ao envelhecimento de indivíduos com síndrome de Down: uma revisão integrativa

Torres

2017

RBCEH

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Este trabalho apresenta uma análise da literatura acerca das pesquisas mais recentes envolvendo a alimentação e suplementação durante o envelhecimento de indivíduos com síndrome de Down. Em decorrência da alta incidência de Alzheimer, torna-se relevante o estudo de fatores que possam contribuir para uma melhor qualidade de vida nesta população. Os custos financeiros, emocionais e familiares na doença de Alzheimer são grandes e aumentam na ausência de uma terapêutica que retarde a progressão dessa. Dessa forma, foi realizada uma busca bibliográfica, referentes aos últimos 10 anos, nas bases de dados Scielo e Bireme. O objetivo foi levantar estudos que relacionassem a alimentação e a suplementação de compostos específicos ao processo de envelhecimento em indivíduos com SD. A análise dos documentos extraídos levou à leitura de 38 artigos. Parte das pesquisas na área de nutrição focaram na importância da neutralização dos radicais livres e na redução da inflamação cerebral como estratégia remediativa para as complicações mais comuns encontradas nessa população. Outros aspectos do envelhecimento de indivíduos com síndrome de Down foram abordados.

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Pharmacological interventions for cognitive decline in people with Down syndrome

Abstract: Due to the low quality of the body of evidence in this review, it is difficult to draw conclusions about the effectiveness of any pharmacological intervention for cognitive decline in people with Down syndrome.

Cited by 28 publications

References 70 publications

Consensus statement of the international summit on intellectual disability and Dementia related to post-diagnostic support

Consensus statement of the international summit on intellectual disability and Dementia related to post-diagnostic support

Cerebrospinal fluid biomarkers for Alzheimer's disease in Down syndrome

Aspectos nutricionais associados ao envelhecimento de indivíduos com síndrome de Down: uma revisão integrativa

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