The British Journal of Psychiatry (2007) 191: 150-157. doi: 10.1192/bjp.bp.106.028845
© 2007 The Royal College of Psychiatrists
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Prevalence of dementia in intellectual disability using different diagnostic criteria

A. STRYDOM, MBChB, MRCPsych, MSc, G. LIVINGSTON, MBChB, FRCPsych, MD, M. KING, MBChB, FRCPsych, PhD and A. HASSIOTIS, MA, MRCPsych, PhD

Department of Mental Health Sciences, Royal Free and University College Medical School, London, UK

Correspondence: Dr A. Strydom, Department of Mental Health Sciences, Royal Free and University College Medical School, UCL Hampstead Campus, London NW3 2PF, UK. Tel: +44 (0)20 7794 0500, ext. 34120; fax: +44 (0)20 7830 2808; email: a.strydom{at}medsch.ucl.ac.uk

Declaration of interest None.

Background Diagnosis of dementia is complex in adults with intellectual disability owing to their pre-existing deficits and different presentation.

Aims To describe the clinical features and prevalence of dementia and its subtypes, and to compare the concurrent validity of dementia criteria in older adults with intellectual disability.

Method The Becoming Older with Learning Disability (BOLD) memory study is a two-stage epidemiological survey of adults with intellectual disability without Down syndrome aged 60 years and older, with comprehensive assessment of people who screen positive. Dementia was diagnosed according to ICD–10, DSM–IV and DC–LD criteria.

Results The DSM–IV dementia criteria were more inclusive. Diagnosis using ICD–10 excluded people with even moderate dementia. Clinical subtypes of dementia can be recognised in adults with intellectual disability. Alzheimer’s dementia was the most common, with a prevalence of 8.6% (95% CI 5.2–13.0), almost three times greater than expected.

Conclusions Dementia is common in older adults with intellectual disability, but prevalence differs according to the diagnostic criteria used. This has implications for clinical practice.


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