Deb S, Hare M, Prior L
University of Birmingham, Birmingham, UK.
J Intellect Disabil Res. 2007 Sep;51(Pt 9):726-39. doi: 10.1111/j.1365-2788.2007.00956.x.
Dementia is common among adults with Down's syndrome (DS); yet the diagnosis of dementia, particularly in its early stage, can be difficult in this population. One possible reason for this may be the different clinical manifestation of dementia among people with intellectual disabilities.
The aim of this study was to map out the carers' perspective of symptoms of dementia among adults with DS in order to inform the development of an informant-rated screening questionnaire.
Unconstrained information from carers of people with DS and dementia regarding the symptoms, particularly the early symptoms of dementia, was gathered using a qualitative methodology. Carers of 24 adults with DS and dementia were interviewed. The interviews were recorded and fully transcribed. The transcripts were then analysed using qualitative software.
There appeared to be many similarities in the clinical presentation of dementia in adults with DS and the non-intellectually disabled general population. Like in the non-intellectually disabled general population, forgetfulness especially, impairment of recent memory combined with a relatively intact distant memory and confusion were common, and presented early in dementia among adults with DS. However, many 'frontal lobe'-related symptoms that are usually manifested later in the process of dementia among the general population were common at an early stage of dementia among adults with DS. A general slowness including slowness in activities and speech, other language problems, loss of interest in activities, social withdrawal, balance problems, sleep problems, loss of pre-existing skills along with the emergence of emotional and behaviour problems were common among adults with DS in our study.
This study highlights the similarities in the clinical presentation of dementia among the general population and people with DS with a particular emphasis on the earlier appearance of symptoms associated with the frontal lobe dysfunction among adults with DS.
痴呆症在唐氏综合征（DS）成年人中很常见；然而，在这一人群中，痴呆症的诊断，尤其是早期诊断可能很困难。造成这种情况的一个可能原因可能是智障人群中痴呆症的临床表现有所不同。
本研究的目的是梳理出护理人员对DS成年人痴呆症状的看法，以便为制定一份由 informant 评分的筛查问卷提供信息。
采用定性方法，收集了DS和痴呆症患者护理人员关于症状，特别是痴呆症早期症状的无限制信息。对24名患有DS和痴呆症的成年人的护理人员进行了访谈。访谈进行了录音并全文转录。然后使用定性软件对转录本进行分析。
DS成年人痴呆症的临床表现与非智障普通人群似乎有许多相似之处。与非智障普通人群一样，尤其是健忘、近期记忆受损而远期记忆相对完好以及意识模糊很常见，并且在DS成年人痴呆症早期就会出现。然而，许多通常在普通人群痴呆症后期才出现的与“额叶”相关的症状，在DS成年人痴呆症早期很常见。在我们的研究中，DS成年人普遍存在活动和言语迟缓、其他语言问题、对活动失去兴趣、社交退缩、平衡问题、睡眠问题、原有技能丧失以及出现情绪和行为问题。
本研究强调了普通人群和DS患者痴呆症临床表现的相似性，特别强调了DS成年人中与额叶功能障碍相关症状的早期出现。
