Context: The ageing of the population has relevance not just for the general community but also for those with intellectual disability. Improved life expectancy in this group brings with it an increased likelihood of age-related neurodegenerative conditions. In addition, Down syndrome is associated with increased risk of Alzheimer's disease characterised by an earlier onset of dementia compared with the general population. The treatment of individuals with both intellectual disability and dementia is an area which has been relatively neglected by clinicians and researchers alike.
Objectives: This talk will review the literature on drug and non-drug treatment of dementia in intellectual disability. A particular focus will be the status of the evidence for use of cholinesterase inhibitors in this population. In addition, there will be a focus on the methodological limitations of published studies, the safety profile and potential future treatment options.
Key messages: Preliminary studies suggest the utility of cholinesterase inhibitors in the management of dementia in individuals with Down syndrome, but this literature is limited by significant methodological shortcomings and paucity of safety data. Studies have not been performed in other groups with intellectual disability. The pharmacological management of the behavioural and psychological symptoms (BPSD) associated with dementia in this group awaits study.
Conclusion: There is a limited literature base supporting the use of pharmacological agents in the treatment of dementia in intellectual disability. This is an area of emerging clinical importance that requires further study.
