Functional loss in older adults with intellectual disabilities and dementia
Intended for healthcare professionals
Evidence and practice    

Functional loss in older adults with intellectual disabilities and dementia

Rachel Kirwan Staff nurse, Nursing Stewarts Care Ltd, Dublin, Ireland
Fintan Sheerin Associate professor in intellectual disability nursing and head of the School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
Eimear McGlinchey Assistant professor in intellectual disability, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
Philip McCallion Professor and director, School of Social Work, College of Public Health, Temple University, Philadelphia, Pennsylvania, US
Mary McCarron Professor and dean, Faculty of Health Sciences, School of Nursing and Midwifery, Trinity Centre for Ageing and Intellectual Disability, Trinity College Dublin, Dublin, Ireland

Why you should read this article:
  • To be aware of secondary analysis of data from waves 1 and 3 of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA)

  • To appreciate that dementia is highly prevalent in older adults with intellectual disabilities, particularly in those with Down’s syndrome

  • To recognise the need for routine assessment of cognition and adaptive functioning in older adults with intellectual disabilities to increase recognition, identify early symptoms of dementia and plan care accordingly

Background Diagnosing dementia in people with intellectual disabilities can be challenging due to pre-existing cognitive impairment. In this population, functional loss could be an early indicator of dementia, but the relationship between functional loss and dementia is not well understood. This means there is a risk of delayed diagnosis and therefore a delay in care planning.

Aim To identify and compare the prevalence and age distribution of dementia in people with intellectual disabilities, differentiating between those with Down’s syndrome and those with an intellectual disability not attributable to Down’s syndrome, and to identify and compare functional loss in people with intellectual disabilities who have developed dementia, differentiating between those with Down’s syndrome and those with an intellectual disability not attributable to Down’s syndrome.

Method This was a secondary analysis of data from waves 1 and 3 of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA), a nationally representative study in Ireland of older adults with intellectual disabilities as they age. Functional loss was determined by participants’ level of difficulty with activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

Results The prevalence of dementia was higher among participants with Down’s syndrome than among those with an intellectual disability not attributable to Down’s syndrome, and the age distribution of dementia differed markedly between the two groups. Both groups experienced similar patterns of difficulty with ADLs and IADLs. IADLs posed more difficulty than ADLs, and among ADLs self-care activities posed the most difficulty.

Conclusion It is important to continue to investigate functional loss in older adults with intellectual disability who have developed dementia, as this should lead to earlier assessment and care planning.

Learning Disability Practice. doi: 10.7748/ldp.2022.e2184

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software

Correspondence

kirwanra@tcd.ie

Conflict of interest

None declared

Kirwan R, Sheerin F, McGlinchey E et al (2022) Functional loss in older adults with intellectual disabilities and dementia. Learning Disability Practice. doi: 10.7748/ldp.2022.e2184

Acknowledgement

Rachel Kirwan wishes to thank the Health Research Board for granting her a Summer Student Scholarship in the summer of 2019. The scholarship supports undergraduate students in healthcare-related disciplines to complete a research project to give them an opportunity to develop their research techniques

Published online: 30 June 2022

Want to read more?

Already subscribed? Log in

OR

Unlock full access to RCNi Plus today

Save over 50% on your first 3 months

Your subscription package includes:
  • Unlimited online access to all 10 RCNi Journals and their archives
  • Customisable dashboard featuring 200+ topics
  • RCNi Learning featuring 180+ RCN accredited learning modules
  • RCNi Portfolio to build evidence for revalidation
  • Personalised newsletters tailored to your interests
Subscribe
RCN student member? Try Nursing Standard Student

Alternatively, you can purchase access to this article for the next seven days. Buy now

Or