Mental health problems in elderly people with and without Down's syndrome.
Mental health changes in elderly Down syndrome are tied to dementia, not just age.
01Research in Context
What this study did
The team ran a survey. They compared elderly people with Down syndrome to elderly people with other intellectual disabilities.
They asked about mental health, dementia, and challenging behavior. The goal was to see how aging affects each group.
What they found
Down syndrome plus age brought more mood and sleep problems. These problems rose alongside signs of dementia.
The other ID group showed more classic psychiatric labels, but less acting-out behavior as they aged.
How this fits with other research
Farrant et al. (1998) later used case notes and saw the same split. Down syndrome plus dementia showed low mood, restlessness, and hearing voices. The other-ID group showed more open aggression.
Smith et al. (2014) seems to disagree. They found no rise in behavior problems with age in Down syndrome adults. The key difference is dementia. T excluded it; J included it. Once dementia enters, behavior changes spike.
McLennan et al. (2008) also push back. Their big follow-up says Down syndrome adults have half the mental-ill-health rate of other-ID adults. Again, age range matters. J looked at the very old; D looked across the whole adult span.
Why it matters
You can’t use age alone to predict behavior in Down syndrome. Ask about dementia signs first. If they appear, expect mood swings, sleep loss, and withdrawal, not aggression. Track restlessness, incontinence, and lost speech as early red flags. Share this with staff and families so everyone shifts from “behavior plan” to “medical work-up” at the right time.
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02At a glance
03Original abstract
This article reports on age-specific findings of mental health problems among residents with Down's syndrome (DS) (n = 307) and without (non-DS) (n = 1274 in dutch group homes and institutes for people with mental retardation. Whereas a proportional increase of psychological problems was found for elderly DS persons with severe mental retardation, non-DS residents did not show such age-specific differences. High ratings of psychological problems for the elderly DS residents corresponded very well with the diagnosis of 'dementia' made by the physicians. Only for non-DS persons with severe mental retardation was a proportional decrease of challenging behaviour found with advanced age. Whereas psychological problems in elderly DS persons could be explained for the greater part of the diagnosis 'dementia', challenging behaviour--although also common in elderly DS--was shown to be a more independent phenomenon. With regard to psychiatric diagnosis, non-DS residents with mild retardation had six times as much a mental disorder, and non-DS residents with severe or profound mental retardation had up to 15 times as much, compared with their DS peers.
Journal of intellectual disability research : JIDR, 1994 · doi:10.1111/j.1365-2788.1994.tb00400.x