Cognitive and Demographic Associations of Dementia-Related Behavioural Changes in Adults With an Intellectual Disability: Findings From the IDS-TILDA Study.
Marie-Joelle Beaudoin, Pavithra Pavithra, Mary McCarron and 5 others
Adults with Down syndrome had higher scores on a caregiver-reported dementia screening measure than those with other intellectual disabilities, and older age was linked to higher scores.
Verbal fluency performance was associated with these scores; memory and praxis tests were not.
Key findings
1Adults with Down syndrome were 55% more likely to obtain higher dementia-related behavioural change scores than those with non-Down-syndrome intellectual disability (p < 0.01).
2Each additional year of age was associated with a 3% increase in the dementia screening score across the full sample (p < 0.001), though this association was not significant within the Down syndrome subgroup (p = 0.06).
3Verbal fluency performance was significantly associated with higher dementia screening scores (5% increase per correct word, p = 0.01), while the Test for Severe Impairment and the Brief Praxis Test showed no significant association in any subgroup.
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What it does not show
Cross-sectional design: associations cannot be interpreted as causal, and the temporal order between cognitive change and behavioural change is unknown. The Down syndrome subgroup had only 55 participants, limiting statistical power for within-subgroup analyses (the age effect in DS was p = 0.06, just above the significance threshold). No baseline cognitive scores were available, so it is impossible to tell whether the cognitive tests captured a change or simply a static level of ability. Substantial missing data on the DSQIID (88 participants excluded) and on individual cognitive tests (up to 138 missing on the BPT) reduced the effective sample for each analysis. Mode-based imputation was applied to DSQIID items with up to 5% missing, which may introduce bias if missingness was not random.
Declared interests
Funded by the Health Research Board and the Department of Health, Ireland. The authors declare no conflicts of interest.
The easy way to misread this
Do not read the verbal fluency association as evidence that better verbal ability causes more dementia symptoms. The authors suggest it may simply mean caregivers can more easily notice and report changes in people who are more verbally able, while changes in less verbally able individuals go unrecognised. Also, the Down syndrome subgroup had only 55 participants, so the non-significant age finding within that group (p = 0.06) should not be taken as proof that age has no effect in DS.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →