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1.
Rev. psiquiatr. salud ment. (Barc., Ed. impr.) ; 11(3): 141-150, jul.-sept. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-176743

RESUMO

Introducción: La escala Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS-LD) fue creada para evaluar de forma breve el funcionamiento de las personas con trastorno de desarrollo intelectual y problemas de salud mental/trastornos de conducta. El objetivo del presente trabajo fue estudiar las evidencias sobre la validez de las puntuaciones obtenidas con la escala HoNOS-LD traducida al castellano. Material y método: La muestra estaba formada por 111 participantes que fueron evaluados con la HoNOS-LD traducida al castellano y otros cuestionarios relacionados. Para estudiar la fiabilidad entre examinadores y la fiabilidad test-retest, 33 participantes fueron evaluados por 2 examinadores y reevaluados al cabo de 7 días. Resultados: De acuerdo con criterios clínicos y conceptuales, y con el resultado del análisis paralelo, se seleccionó una solución factorial con único factor. La consistencia interna fue buena (coeficiente omega de 0,87). Las fiabilidades entre examinadores y test-retest fueron excelentes (coeficientes de correlación intraclase de 0,95 y 0,98, respectivamente). Las correlaciones entre secciones de la HoNOS-LD y los instrumentos relacionados fueron en el sentido esperado y altamente significativas (p<0,001), y la puntuación HoNOS-LD aumentaba con el nivel de apoyos necesario de los participantes, resultados que aportaron evidencia sobre la validez de asociación con otras variables externas. Conclusiones: La versión en castellano de la HoNOS-LD representa un instrumento breve, válido y fiable, que permitirá la evaluación rutinaria del funcionamiento con distintas finalidades, incluyendo el diagnóstico y la intervención


Introduction: The Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS-LD) is a brief instrument that assesses functioning in people with intellectual development disorder and mental health problems/behaviour disorders. The aim of the present study was to examine the evidence on the validity of the scores based on the Spanish version of the HoNOS-LD. Material and methods: The study included 111 participants that were assessed by the Spanish version of the HoNOS-LD and other questionnaires that measured different variables related to the scale. Thirty-three participants were assessed by 2 examiners, and retested 7 days later, in order to study inter-examiner reliability and test-retest reliabilities. Results: Based on clinical and conceptual criteria, and on the results of the parallel analysis, a factorial solution with one factor was selected. Internal consistency was good (Omega coefficient of 0.87). Inter-examiner and test-retest reliabilities were excellent (intraclass correlation coefficients of 0.95 and 0.98, respectively). Correlations between sections of the HoNOS-LD and the related instruments showed the expected direction, and were highly significant (P<.001), and the HoNOS-LD score increased with the intensity of the support required by the participants. These results showed evidence of the validity of association with other external variables. Conclusions: The Spanish version of the HoNOS-LD is a brief, valid and reliable instrument, which will enable a routine assessment of functioning for different uses, including diagnosis and intervention


Assuntos
Humanos , Masculino , Feminino , Adulto , Psicometria/instrumentação , Testes Psicológicos/normas , Transtornos de Aprendizagem/diagnóstico , Deficiência Intelectual/diagnóstico , Transtorno da Conduta/diagnóstico , Transtornos Mentais/diagnóstico , Traduções , Reprodutibilidade dos Testes , Reprodutibilidade dos Testes , Diagnóstico Diferencial , Testes Genéticos
2.
Behav Genet ; 48(4): 323-336, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29882083

RESUMO

A genetic analysis of unexplained mild-moderate intellectual disability and co-morbid psychiatric or behavioural disorders is not systematically conducted in adults. A cohort of 100 adult patients affected by both phenotypes were analysed in order to identify the presence of copy number variants (CNVs) responsible for their condition identifying a yield of 12.8% of pathogenic CNVs (19% when including clinically recognizable microdeletion syndromes). Moreover, there is a detailed clinical description of an additional 11% of the patients harbouring possible pathogenic CNVs-including a 7q31 deletion (IMMP2L) in two unrelated patients and duplications in 3q29, 9p24.2p24.1 and 15q14q15.1-providing new evidence of its contribution to the phenotype. This study adds further proof of including chromosomal microarray analysis (CMA) as a mandatory test to improve the diagnosis in the adult patients in psychiatric services.


Assuntos
Variações do Número de Cópias de DNA , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/genética , Transtornos Mentais/epidemiologia , Transtornos Mentais/genética , Adolescente , Adulto , Comorbidade , Feminino , Genótipo , Humanos , Incidência , Deficiência Intelectual/diagnóstico , Masculino , Transtornos Mentais/diagnóstico , Pessoa de Meia-Idade , Análise de Sequência com Séries de Oligonucleotídeos , Fenótipo , Estudos Prospectivos , Espanha , Estatísticas não Paramétricas , Adulto Jovem
3.
Neuroimage Clin ; 18: 160-166, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29868444

RESUMO

Background: We longitudinally assessed Down syndrome individuals at the age of risk of developing dementia to measure changes in brain anatomy and their relationship to cognitive impairment progression. Methods: Forty-two Down syndrome individuals were initially included, of whom 27 (mean age 46.8 years) were evaluable on the basis of completing the 2-year follow-up and success in obtaining good quality MRI exams. Voxel-based morphometry was used to estimate regional brain volumes at baseline and follow-up on 3D anatomical images. Longitudinal volume changes for the group and their relationship with change in general cognitive status and specific cognitive domains were mapped. Results: As a group, significant volume reduction was identified in the substantia innominata region of the basal forebrain, hippocampus, lateral temporal cortex and left arcuate fasciculus. Volume reduction in the substantia innominata and hippocampus was more prominent in individuals whose clinical status changed from cognitively stable to mild cognitive impairment or dementia during the follow-up. Relevantly, longitudinal memory score change was specifically associated with volume change in the hippocampus, prospective memory with prefrontal lobe and verbal comprehension with language-related brain areas. Conclusions: Results are notably concordant with the well-established anatomical changes signaling the progression to dementia in Alzheimer's disease, despite the dense baseline pathology that developmentally accumulates in Down syndrome. This commonality supports the potential value of Down syndrome as a genetic model of Alzheimer's neurodegeneration and may serve to further support the view that Down syndrome patients are best candidates to benefit from treatment research in Alzheimer's disease.


Assuntos
Encéfalo/diagnóstico por imagem , Demência/diagnóstico por imagem , Síndrome de Down/diagnóstico por imagem , Adulto , Envelhecimento , Encéfalo/patologia , Demência/etiologia , Demência/patologia , Progressão da Doença , Síndrome de Down/complicações , Síndrome de Down/patologia , Feminino , Humanos , Estudos Longitudinais , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos
4.
Br J Psychiatry ; 212(5): 287-294, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29693535

RESUMO

BACKGROUND: Copy number variants (CNVs) are established risk factors for neurodevelopmental disorders. To date the study of CNVs in psychiatric illness has focused on single disorder populations. The role of CNVs in individuals with intellectual disabilities and psychiatric comorbidities are less well characterised.AimsTo determine the type and frequency of CNVs in adults with intellectual disabilities and comorbid psychiatric disorders. METHOD: A chromosomal microarray analysis of 599 adults recruited from intellectual disabilities psychiatry services at three European sites. RESULTS: The yield of pathogenic CNVs was high - 13%. Focusing on established neurodevelopmental disorder risk loci we find a significantly higher frequency in individuals with intellectual disabilities and comorbid psychiatric disorder (10%) compared with healthy controls (1.2%, P<0.0001), schizophrenia (3.1%, P<0.0001) and intellectual disability/autism spectrum disorder (6.5%, P < 0.00084) populations. CONCLUSIONS: In the largest sample of adults with intellectual disabilities and comorbid psychiatric disorders to date, we find a high rate of pathogenic CNVs. This has clinical implications for the use of genetic investigations in intellectual disability psychiatry.Declaration of interestNone.


Assuntos
Transtornos Globais do Desenvolvimento Infantil/genética , Variações do Número de Cópias de DNA/genética , Deficiência Intelectual/genética , Transtornos Mentais/genética , Esquizofrenia/genética , Adulto , Transtornos Globais do Desenvolvimento Infantil/epidemiologia , Comorbidade , Europa (Continente)/epidemiologia , Feminino , Humanos , Deficiência Intelectual/epidemiologia , Masculino , Transtornos Mentais/epidemiologia , Análise em Microsséries , Pessoa de Meia-Idade , Esquizofrenia/epidemiologia
5.
Rev Psiquiatr Salud Ment ; 11(3): 141-150, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28017467

RESUMO

INTRODUCTION: The Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS-LD) is a brief instrument that assesses functioning in people with intellectual development disorder and mental health problems/behaviour disorders. The aim of the present study was to examine the evidence on the validity of the scores based on the Spanish version of the HoNOS-LD. MATERIAL AND METHODS: The study included 111 participants that were assessed by the Spanish version of the HoNOS-LD and other questionnaires that measured different variables related to the scale. Thirty-three participants were assessed by 2 examiners, and retested 7 days later, in order to study inter-examiner reliability and test-retest reliabilities. RESULTS: Based on clinical and conceptual criteria, and on the results of the parallel analysis, a factorial solution with one factor was selected. Internal consistency was good (Omega coefficient of 0.87). Inter-examiner and test-retest reliabilities were excellent (intraclass correlation coefficients of 0.95 and 0.98, respectively). Correlations between sections of the HoNOS-LD and the related instruments showed the expected direction, and were highly significant (P<.001), and the HoNOS-LD score increased with the intensity of the support required by the participants. These results showed evidence of the validity of association with other external variables. CONCLUSIONS: The Spanish version of the HoNOS-LD is a brief, valid and reliable instrument, which will enable a routine assessment of functioning for different uses, including diagnosis and intervention.


Assuntos
/diagnóstico , Escalas de Graduação Psiquiátrica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Psicometria , Espanha , Traduções , Adulto Jovem
6.
Span J Psychol ; 20: E32, 2017 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-28726593

RESUMO

Despite how important it is to assess executive functioning in persons with Intellectual Disability (ID), instruments adapted and validated for this population are scarce. This study's primary goal was to find evidence for the validity of the ID version of the Tower of London (TOLDXtm) test in persons with mild (IDMi) and moderate (IDMo) levels of ID with Down Syndrome (DS). A multicenter study was carried out. Subjects (n = 63, ≥ 39 years old) had DS with mild (n = 39) or moderate ID (n = 24) with no minor neurocognitive disorder or Alzheimer's disease. Assessment protocol: TOLDXtm for ID, Kaufman Brief Intelligence Test Second Edition (K-BIT II), Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and Others with Intellectual Disabilities (CAMDEX-DS), Weigl's Color-Form Sorting Test (WCFST), Barcelona Test for Intellectual Disability (BT-ID), and the Behavior Rating Inventory of Executive Function (BRIEF-P). The internal consistency (IDMi and IDMo), factor structure of the different subscales, and relationship between TOLDXtm subscales and other cognitive measures (BT-ID, WCFST, and BRIEF-P) were analyzed. A normative data table with ID population quartiles is provided. TOLDXtm for ID showed a robust one factor structure and coherentassociations with other, related neuropsychological instruments. Significant differences between IDMi and IDMo on movement-related variables like Correct (Corr; p = .002) and Moves (Mov; p = .042) were observed, along with good internal consistency values, Corr (α = .75), Mov (α = .52). Regarding internal consistency, no between-groups differences were observed (all p-value > 0.05). The TOLDXtm for ID is thus an instrument, supported by good validity evidence, to evaluate problem-solving and planning in ID. It distinguishes between individuals with mild and moderate ID, and is highly associated with other measures of executive functioning.


Assuntos
Função Executiva/fisiologia , Deficiência Intelectual/diagnóstico , Testes Neuropsicológicos/normas , Psicometria/instrumentação , Adulto , Síndrome de Down/diagnóstico , Síndrome de Down/fisiopatologia , Feminino , Humanos , Deficiência Intelectual/fisiopatologia , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
7.
J Alzheimers Dis ; 57(1): 61-70, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28222523

RESUMO

BACKGROUND: Neural tissue alterations in Down syndrome are fully expressed at relatively late developmental stages. In addition, there is an early presence of neurodegenerative changes in the late life stages. OBJECTIVE: The aims of this study were both to characterize white matter abnormalities in the brain of adult Down syndrome patients using diffusion tensor imaging (DTI) and to investigate whether degenerative alterations in white matter structure are detectable before dementia is clinically evident. METHODS: Forty-five adult non-demented Down syndrome patients showing a wide age range (18-52 years) and a matched 45-subject control group were assessed. DTI fractional anisotropy (FA) brain maps were generated and selected cognitive tests were administered. RESULTS: Compared with healthy controls, non-demented Down syndrome patients showed lower DTI FA in white matter involving the major pathways, but with more severe alterations in the frontal-subcortical circuits. White matter FA decreased with age at a similar rate in both DS and control groups. CONCLUSIONS: Our results contribute to characterizing the expression of white matter structural alterations in adult Down syndrome. However, an accelerated aging effect was not demonstrated, which may suggest that the FA measurements used are not sufficiently sensitive or, alternatively, age-related white matter neurodegeneration is not obvious prior to overt clinical dementia.


Assuntos
Envelhecimento/patologia , Encéfalo/diagnóstico por imagem , Síndrome de Down/diagnóstico por imagem , Substância Branca/diagnóstico por imagem , Adolescente , Adulto , Imagem de Tensor de Difusão , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Vias Neurais/diagnóstico por imagem , Adulto Jovem
8.
Span. j. psychol ; 20(1): e32.1-e32.14, 2017. tab, ilus, graf
Artigo em Inglês | IBECS | ID: ibc-164986

RESUMO

Despite how important it is to assess executive functioning in persons with Intellectual Disability (ID), instruments adapted and validated for this population are scarce. This study’s primary goal was to find evidence for the validity of the ID version of the Tower of London (TOLDXtm) test in persons with mild (IDMi) and moderate (IDMo) levels of ID with Down Syndrome (DS). A multicenter study was carried out. Subjects (n = 63, ≥ 39 years old) had DS with mild (n = 39) or moderate ID (n = 24) with no minor neurocognitive disorder or Alzheimer’s disease. Assessment protocol: TOLDXtm for ID, Kaufman Brief Intelligence Test Second Edition (K-BIT II), Cambridge Examination for Mental Disorders of Older People with Down’s Syndrome and Others with Intellectual Disabilities (CAMDEX-DS), Weigl’s Color-Form Sorting Test (WCFST), Barcelona Test for Intellectual Disability (BT-ID), and the Behavior Rating Inventory of Executive Function (BRIEF-P). The internal consistency (IDMi and IDMo), factor structure of the different subscales, and relationship between TOLDXtm subscales and other cognitive measures (BT-ID, WCFST, and BRIEF-P) were analyzed. A normative data table with ID population quartiles is provided. TOLDXtm for ID showed a robust one factor structure and coherentassociations with other, related neuropsychological instruments. Significant differences between IDMi and IDMo on movement-related variables like Correct (Corr; p = .002) and Moves (Mov; p = .042) were observed, along with good internal consistency values, Corr (α = .75), Mov (α = .52). Regarding internal consistency, no between-groups differences were observed (all p-value > 0.05). The TOLDXtm for ID is thus an instrument, supported by good validity evidence, to evaluate problemsolving and planning in ID. It distinguishes between individuals with mild and moderate ID, and is highly associated with other measures of executive functioning (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/psicologia , Síndrome de Down/diagnóstico , Síndrome de Down/psicologia , Doença de Alzheimer/complicações , Testes de Inteligência , Inventário de Personalidade/normas , Dissonância Cognitiva , Terapia Cognitivo-Comportamental/métodos , Neuropsicologia/métodos
9.
Mol Genet Genomic Med ; 2(6): 512-21, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25614873

RESUMO

Deletions in the 2p16.3 region that includes the neurexin (NRXN1) gene are associated with intellectual disability and various psychiatric disorders, in particular, autism and schizophrenia. We present three unrelated patients, two adults and one child, in whom we identified an intragenic 2p16.3 deletion within the NRXN1 gene using an oligonucleotide comparative genomic hybridization array. The three patients presented dual diagnosis that consisted of mild intellectual disability and autism and bipolar disorder. Also, they all shared a dysmorphic phenotype characterized by a long face, deep set eyes, and prominent premaxilla. Genetic analysis of family members showed two inherited deletions. A comprehensive neuropsychological examination of the 2p16.3 deletion carriers revealed the same phenotype, characterized by anxiety disorder, borderline intelligence, and dysexecutive syndrome. The cognitive pattern of dysexecutive syndrome with poor working memory and reduced attention switching, mental flexibility, and verbal fluency was the same than those of the adult probands. We suggest that in addition to intellectual disability and psychiatric disease, NRXN1 deletion is a risk factor for a characteristic cognitive and dysmorphic profile. The new cognitive phenotype found in the 2p16.3 deletion carriers suggests that 2p16.3 deletions might have a wide variable expressivity instead of incomplete penetrance.

10.
Rev Neurol ; 57(8): 337-46, 2013 Oct 16.
Artigo em Espanhol | MEDLINE | ID: mdl-24081888

RESUMO

INTRODUCTION: Dementia caused by Alzheimer's disease commonly affects the adult population with Down's syndrome. This population presents two characteristic clinical features: a semiologic pattern that differs from the typical Alzheimer's disease, and previous intellectual deficits that may confound the clinical diagnosis. There is a clear need to validate specific instruments adapted to Spanish population. AIM: To adapt and to validate CAMDEX-DS (Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and Others with Intellectual Disabilities) in Spanish population. PATIENTS AND METHODS: 146 patients with intellectual disability (mild to moderate) were recruited and assessed with CAMDEX-DS, K-BIT I and DMR tests. Test-retest reliability, inter-rater concordance and validity statistic were performed between CAMDEX-DS and clinical diagnosis. This is an observational, multicenter, cross-sectional and validation study. RESULTS: Test-retest and inter-rater reliability achieved kappa coefficient values of 0.92 and 0.91, respectively. Agreement (kappa index) for CAMDEX-DS on clinical diagnosis compared to other clinical criteria was high: CAMDEX-DS vs DSM-IV (kappa = 0.95; p < 0,001); CAMDEX-DS vs ICD-10 (kappa = 0.97; p < 0.001). All item-test correlations ranged between 0,31 and 0,69. Internal reliability-calculated using Chronbach's alpha scored 0.93. CONCLUSIONS: The Spanish version of CAMDEX-DS is a valid instrument with high applicability for people with intellectual disability. It shows good psychometric properties. The Cambridge Cognitive Examination for Older Adults with Down's Syndrome (CAMCOG-DS) can set two key points by the level of intellectual disability on the suspicion of cognitive impairment in people with Down's syndrome.


Assuntos
Idoso/psicologia , Síndrome de Down/psicologia , Deficiência Intelectual/psicologia , Índice de Gravidade de Doença , Adulto , Estudos Transversais , Feminino , Humanos , Testes de Inteligência , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Psicometria , Reprodutibilidade dos Testes , Espanha , Inquéritos e Questionários , Tradução
11.
Rev. neurol. (Ed. impr.) ; 57(8): 337-346, 16 oct., 2013. tab
Artigo em Espanhol | IBECS | ID: ibc-116331

RESUMO

síndrome de Down. Esta población presenta dos rasgos clínicos característicos: la presencia de demencia con semiología distinta a la enfermedad de Alzheimer típica y déficits intelectuales previos que pueden confundir el diagnóstico clínico. Existe una evidente necesidad de validar instrumentos específicos en castellano adaptados a esta población. Objetivo. Adaptar y validar el Cambridge Examination for Mental Disorders of Older People with Down’s Syndrome and Others with Intellectual Disabilities (CAMDEX-DS) en población española. Pacientes y métodos. Se consideraron 146 pacientes con discapacidad intelectual (leve-moderada). Se realizó un estudio de validación de tipo observacional, transversal y multicéntrico. Se administraron los siguientes tests: CAMDEX-DS, testbreve de inteligencia de Kaufman y Dementia Questionnaire for Persons with Mental Retardation. Se calculó la fiabilidad test-retest, la fiabilidad interjueces, la concordancia del CAMDEX-DS para el diagnóstico clínico y la validez. Resultados. La fiabilidad test-retest e interjueces obtuvo un coeficiente kappa de 0,92 y 0,91, respectivamente. El índice kappa del CAMDEX-DS para el diagnóstico clínico respecto al resto de los criterios clínicos utilizados fue alto: CAMDEX-DS frente a DSM-IV (kappa = 0,95; p < 0,001); CAMDEX-DS frente a Clasificación Internacional de Enfermedades, décima revisión (kappa = 0,97; p = 0,000). Todas las correlaciones ítem-test oscilaban entre 0,31 y 0,69. La fiabilidad interna calculada mediante el alfa de Cronbach fue de 0,93. Conclusiones. La versión española del CAMDEX-DS es un instrumento válido, de alta aplicabilidad a personas con discapacidad intelectual, que muestra buenas propiedades psicométricas. El Cambridge Cognitive Examination for Older Adults with Down’s Syndrome (CAMCOG-DS) permite establecer dos puntos de corte para la sospecha de deterioro cognitivo en el grupo de personas con síndrome de Down en función del nivel de discapacidad intelectual previo (AU)


Introduction. Dementia caused by Alzheimer’s disease commonly affects the adult population with Down’s syndrome. This population presents two characteristic clinical features: a semiologic pattern that differs from the typical Alzheimer’s disease, and previous intellectual deficits that may confound the clinical diagnosis. There is a clear need to validate specific instruments adapted to Spanish population. Aim. To adapt and to validate CAMDEX-DS (Cambridge Examination for Mental Disorders of Older People with Down’s Syndrome and Others with Intellectual Disabilities) in Spanish population. Patients and methods. 146 patients with intellectual disability (mild to moderate) were recruited and assessed with CAMDEX-DS, K-BIT I and DMR tests. Test-retest reliability, inter-rater concordance and validity statistic were performed between CAMDEX-DS and clinical diagnosis. This is an observational, multicenter, cross-sectional and validation study. Results. Test-retest and inter-rater reliability achieved kappa coefficient values of 0.92 and 0.91, respectively. Agreement (kappa index) for CAMDEX-DS on clinical diagnosis compared to other clinical criteria was high: CAMDEX-DS vs DSM-IV (kappa = 0.95; p < 0,001); CAMDEX-DS vs ICD-10 (kappa = 0.97; p < 0.001). All item-test correlations ranged between 0,31 and 0,69. Internal reliability-calculated using Chronbach’s alpha scored 0.93.Conclusions. The Spanish version of CAMDEX-DS is a valid instrument with high applicability for people with intellectual disability. It shows good psychometric properties. The Cambridge Cognitive Examination for Older Adults with Down’s Syndrome (CAMCOG-DS) can set two key points by the level of intellectual disability on the suspicion of cognitive impairment in people with Down’s syndrome (AU)


Assuntos
Humanos , Síndrome de Down , Testes Neuropsicológicos , Doença de Alzheimer , Psicometria/instrumentação , Pessoas com Deficiência Mental/estatística & dados numéricos , Reprodutibilidade dos Testes
12.
Artigo em Espanhol | IBECS | ID: ibc-80589

RESUMO

La mayoría de las personas con síndrome de Down (SD) llegan a una edad en que, como ciudadanos seniors, tienen una serie de necesidades que deben ser consideradas y atendidas, obligando a unas intervenciones de anticipación y prevención. Esta realidad ya está generando dificultades en los servicios que tienen la responsabilidad de atenderlos, a sus propias familias y a los propios afectados. Cuando una persona con SD inicia un proceso de deterioro cognitivo o demencia, se hace evidente la inadecuada y escasa planificación de políticas y, al mismo tiempo, la falta de provisión de servicios. La Organización Mundial de la Salud (OMS) en colaboración con la Asociación Internacional para el Estudio Científico de Discapacidades Intelectuales (IASSID)y de Inclusión Internacional ha desarrollado un informe que recoge las necesidades sociales y sanitarias de las personas con discapacidad intelectual en proceso de envejecimiento, entre ellos las personas con SD. En el mismo documento de trabajo se señala como prioritaria la necesidad de que cada país de la Unión Europea desarrolle «Proyectos para el envejecimiento saludable» que conduzcan a la inclusión social de forma natural mejorando el soporte y la formación de los cuidadores formal ese informales. Se presenta a continuación una primera aproximación a la posible creación de programas para personas con SD y deterioro-cognitivo/demencia (AU)


Most individuals with Down syndrome (DS) reachan advanced age which gives rise to specific needs.These must be considered and addressed, through anticipationand prevention. Difficulties are already emergingin services responsible for this population, as wellas for the individuals concerned and their relatives. Theinadequacy and unsuitability of policy planning andlack of adequate services are made apparent whenevera person with DS begins to develop cognitive deteriorationor dementia.The World Health Organization (WHO) has drawnup, in conjunction with the International Associationfor the Scientific Study of Intellectual Disabilities(IASSID) and Inclusion International, a report on thesocial and health care needs of aging persons with intellectualdisabilities, including those with DS. This workingdocument highlights as a priority the need for eachcountry in the European Union to implement «Projectsfor Healthy Aging» that are naturally conducive to socialinclusion while improving support and training forboth formal and informal caregivers. The present articleprovides a rough outline for potential future programstargeting individuals with DS and cognitive deteriorationor dementia (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Síndrome de Down/epidemiologia , Demência/complicações , Demência/epidemiologia , Demência/psicologia , Cuidadores/organização & administração , Cuidadores/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Atenção Primária à Saúde/métodos , Idoso Fragilizado/psicologia , Síndrome de Down/psicologia , Atenção Primária à Saúde/tendências , Serviços de Saúde para Idosos/normas , Assistência a Idosos/legislação & jurisprudência , Assistência a Idosos/normas
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