Screening of Cognitive Changes in Adults With Intellectual Disabilities: A Systematic Review
Brain Sciences
Paiva, A. F., Nolan, A., et al. (2020).
Brain Sciences, 10(11), Article 848.
This systematic review investigates the screening tools available to detect cognitive changes in adults with intellectual disabilities. Although speech-language pathologists do not diagnose dementia, findings from this review may be useful for identifying screening tools to detect cognitive and behavioral changes in adults with intellectual disabilities.
Studies investigating the use of different screening tools for identifying dementia in individuals with Down syndrome (DS) found that the Dementia Questionnaire for Learning Disabilities (DLD) demonstrated good test-retest reliability for cognition, adequate inter-rater reliability, and good psychometric properties for identifying cognitive declines in adults with DS and dementia. The Cambridge Cognitive Examination—Down Syndrome (CAMCOG-DS) also showed the ability to identify cognitive and behavioral changes and demonstrates good internal reliability for measuring cognitive performance in adults with DS and dementia. The Test for Severe Impairment (TSI) showed good reliability, validity, and internal consistency for monitoring dementia progression in adults with DS. The Severe Impairment Battery (SIB) was found to be suitable for assessing cognition and cognitive decline in individuals with Down syndrome; however, the authors noted the tool is not intended to screen for dementia. The authors of this review conclude that the "evidence supports the DLD as a promising informant-based screening tool for the diagnosis of dementia... [and is] a good screening instrument for follow-up assessment which is reliable when used routinely in combination with other objective measures such as, for example, CAMCOG-DS" (p. 10).
Evidence was reported to support the use of specifically-designed instruments, such as the Dementia Questionnaire for Learning Disabilities (DLD) and the Cambridge Cognitive Examination—Down Syndrome (CAMCOG-DS), to identify cognitive and behavior changes related to Intellectual Disabilities and dementia. The use of measures for the general population was discouraged due to the lack of sensitivity in differentiating individuals with and without dementia. Evidence indicated the DLD as a promising informant-based screening tool since it addressed cognitive and behavioral symptoms.
