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- Wael M. M. R. I. Foad, None (29 May 2007)
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An inteteresting paper but a misleading title!
- Sowmya Krishna, Frances Lindon, Emad Salib, Peasley Cross Hospital, St Helens (28 November 2007)
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Wael M. M. R. I. Foad, SHO in Learning Disabilities. MerseyCare NHS Trust, None
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wfoad{at}hotmail.co.uk Wael M. M. R. I. Foad, et al.
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Dear Editors, Shoumitro Deb and colleagues developed a dementia screening questionnaire, through an observer-rated questionnaire, based on behavioural rating scale of individuals with intellectual disabilities due to Down’s syndrome. As acknowledged in the article, dementia is hard to determine in people with intellectual disabilities. Diagnosis remains essentially a clinical one, based on individual loss of skills and deterioration in memory, and in the absence of mental illness or organic cause accounting for the psycho-pathology. DC-LD (Royal College of Psychiatrists, 2001) presents diagnostic criteria for dementia specifically designed for this population. In November 2006, and in their first collaboration, the National Institute for Health and Clinical Excellence (NICE) and the Social Care Institute for Excellence (SCIE) issued their first joint guidelines, and this was on dementia. They recommended the use of tools to assess the severity of dementia in people with Learning disabilities which should be sensitive to their level of competence. This obviously predates the publication of the questionnaire in hand, and the tools recommended are: • Cambridge Cognitive Examination. • Modified Cambridge Examination for for Mental disorders of the Elderly. • DMR (Dementia Questionnaire for persons with Mental Retardation- Evenhuis, 1992). • Dementia Scale for Down Syndrome (DSDS). Reference: 1- NICE-SCIE guidelines on Dementia- November 2006. 2- College Seminars in the psychiatry of learning disabilities- second edition. Declaration of interest-none Dr Wael Foad. MB ChB, MRCPsych part 1. Senior House Officer, Learning Disabilities. 20 Crosby Road North, Liverpool L22 4QF. Telephone: 01519284107. Fax: 0151 928 6590. |
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Sowmya Krishna, ST3 in Learning Disabilities Willis House, 5 Boroughs Partnership NHS Trust, St Helens, Frances Lindon, Emad Salib, Peasley Cross Hospital, St Helens
Send letter to journal:
sowmya.krishna{at}nhs.net Sowmya Krishna, et al.
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We read with interest the paper by Deb et al (2007)on dementia screening in patients with learning disabilities. However, we have found the title of the article rather misleading!. Whilst the paper refers to a dementia Screening questionnaire for Individuals with Intellectual Disabilities, the sample consisted only of patients with Down’s syndrome. It is rather difficult to understand as to why the authors did not simply use a more descriptive title such as ' A dementia for individuals with Down's syndrome' which would have been more appropriate and accurate. A previous study which compared presentation of dementia in people with Down’s syndrome and learning disabilities of other aetiologies. The findings of this study suggest that dementia presentation differs in those with and without this syndrome Cooper & Prasher 1998). It would be indeed interesting to see whether the screening tool used in the study will have the same sensitivity and specificity as reported in the Down's syndrome sample. Declaration of interest – none Reference: Cooper, S. A. & Prasher, V. P. (1998) Maladaptive behaviours and symptoms of dementia in adults with Down’s syndrome compared with adults with intellectual disability of other aetiologies. Journal of Intellectual Disability Research, 42, 293 –300. |
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