Dementia diagnostic criteria in Down syndrome. (3rd November 2014)

• Record Type: Journal Article
• Authors: Sheehan, Rory; Sinai, Amanda; Bass, Nick; Blatchford, Pippa; Bohnen, Ingrid; Bonell, Simon; Courtenay, Ken; Hassiotis, Angela; Markar, Therese; McCarthy, Jane; Mukherji, Kamalika; Naeem, Asim; Paschos, Dimitrios; Perez‐Achiaga, Natalia; Sharma, Vijaya; Thomas, David; Walker, Zuzana; Strydom, Andre
• Is Part Of: International journal of geriatric psychiatry. Volume 30:Number 8(2015:Aug.)
• Page Start: 857
• Page End: 863
• Publication Date: 2014-11-03
• Subjects: Geriatric psychiatry -- Periodicals; Geriatric Psychiatry -- Periodicals; 618.97689
• DOI: 10.1002/gps.4228
• Languages: English
• ISSNs: 0885-6230

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="gps4228-sec-0001" sec-type="section"> <title>Objective</title> <p>Dementia is a common clinical presentation among older adults with Down syndrome. The presentation of dementia in Down syndrome differs compared with typical Alzheimer's disease. The performance of manualised dementia criteria in the International Classification of Diseases (ICD)‐10 and Diagnostic and Statistical Manual of Mental Disorders‐IV‐Text Revision (DSM‐IV‐TR) is uncertain in this population.We aimed to determine the concurrent validity and reliability of clinicians' diagnoses of dementia against ICD‐10 and DSM‐IV‐TR diagnoses. Validity of clinical diagnoses were also explored by establishing the stability of diagnoses over time.</p> </sec> <sec id="gps4228-sec-0002" sec-type="section"> <title>Methods</title> <p>We used clinical data from memory assessments of 85 people with Down syndrome, of whom 64 (75.3%) had a diagnosis of dementia. The cases of dementia were presented to expert raters who rated the case as dementia or no dementia using ICD‐10 and DSM‐IV‐TR criteria and their own clinical judgement.</p> </sec> <sec id="gps4228-sec-0003" sec-type="section"> <title>Results</title> <p>We found that clinician's judgement corresponded best with clinically diagnosed cases of dementia, identifying 84.4% cases of clinically diagnosed dementia at the time of diagnosis. ICD‐10 criteria identified 70.3% cases, and DSM‐IV‐TR criteria identified 56.3% cases at the time of clinically diagnosed dementia. Over time, the proportion of cases meeting ICD‐10 or DSM‐IV‐TR diagnoses increased, suggesting that experienced clinicians used their clinical knowledge of dementia presentation in Down syndrome to diagnose the disorder at an earlier stage than would have been possible had they relied on the classic description contained in the diagnostic systems.</p> </sec> <sec id="gps4228-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Clinical diagnosis of dementia in Down syndrome is valid and reliable and can be used as the standard against which new criteria such as the DSM‐5 are measured. Copyright © 2014 John Wiley & Sons, Ltd.</p> </sec> </abstract>