A Proactive Psychological Strategy for Determining the Presence of Dementia in Adults with Down Syndrome: Preliminary Description of Service Use and Evaluation

The authors describe and assess the experience of providing proactive screening for dementia in older adults with intellectual disabilities (ID) through a dedicated clinical psychology service within the National Health Service in England. Subjects were the first 18 participants who were referred to the clinical service or were identified as showing early signs of probable dementia in a proactive screening strategy. The screening process involved combining neuropsychological, behavioral, and health data with information from a clinical assessment of the presenting problem in a case series approach. The process of psychological assessment and formulation is illustrated together with an outline of the psychological interventions employed for early‐, mid‐, and late‐stage dementia. An appraisal of the service strategy showed that a dedicated psychology service for dementia assessment can be effective when offering a defined and workable psychological response to the increasing presentation of dementia‐associated behaviors among people with ID. Ancillary services included supporting carers in contributing to the assessment and intervention process so as to ensure appropriately responsive and respectful care management for the person with ID and dementia. The authors recommend that a multimodal stage model of intervention founded on direct performance and informant‐based assessments (within a framework of differential diagnosis) be employed in supporting people with ID and dementia.