Mental Health Sciences Unit, University College London, London, UK.
Curr Opin Psychiatry. 2012 Sep;25(5):359-64. doi: 10.1097/YCO.0b013e328355ab26.
Improvements in health and social care for people with intellectual disability have led to a dramatic increase in the life expectancy of this population, resulting in a large and growing number of older adults with intellectual disability. They are at risk of age-related mental disorders such as dementia and continue to present with high rates of mental illness.
Recent research with older adults with intellectual disability has included physical health issues that may affect mental well being, and biological and clinical features of dementia in people with Down syndrome. Two key clinical trials of memantine and antioxidants for dementia in Down syndrome showed that these treatment options were ineffective in the short term. Other research focussed on environmental and psychosocial issues (including carer issues) and end-of-life care.
Improved mental well being requires effective management of mental illness and co-morbid physical health problems as well as consideration of environmental and social issues. Biological research has identified potential treatments for age-related decline, which has led to the development of medication trials. Despite disappointing results, two recent medication trials showed that randomized controlled trials are feasible in older people with intellectual disabilities - a group who are often excluded from trials.
智力障碍患者的健康和社会关怀得到改善,导致其预期寿命显著延长,因此出现了大量且不断增加的老年智力障碍患者。他们面临与年龄相关的精神障碍(如痴呆症)的风险,并且继续表现出较高的精神疾病发病率。
最近对智力障碍老年人的研究包括可能影响心理健康的身体健康问题,以及唐氏综合征患者痴呆症的生物学和临床特征。两项关于美金刚和抗氧化剂治疗唐氏综合征痴呆症的关键临床试验表明,这些治疗选择在短期内无效。其他研究侧重于环境和心理社会问题(包括照顾者问题)和临终关怀。
改善心理健康需要有效管理精神疾病和合并的身体健康问题,同时考虑环境和社会问题。生物学研究已经确定了针对与年龄相关的衰退的潜在治疗方法,这导致了药物试验的发展。尽管结果令人失望,但最近的两项药物试验表明,随机对照试验在智力障碍老年人中是可行的,而这些老年人通常被排除在试验之外。