Impact of Dementia-derived Nonpharmacological Intervention Procedures on Cognition and Behavior in Older Adults With Intellectual Disabilities: A 3-year Follow-up Study.

Dementia appears at a higher rate among some adults with intellectual disabilities (ID) and this potentially poses a greater risk of nursing home admission. Yet, to date, there is no evidence on the efficacy of general dementia-derived environment-, personnel-, and patient-oriented intervention strategies in delaying onset of dementia or in slowing down its rate of progression in this population. To investigate the feasibility and efficacy of a multicomponent nonpharmacological approach, the authors studied a sample of 14 adults with worsening cognition and everyday functioning who were no longer manageable by their family or staff in day centers or group homes, and who were relocated in a model special care unit (SCU) designed to proactively accommodate the needs of people with ID and dementia. Baseline level and rate of decline across a 3-year period were assessed by means of the Dementia Questionnaire for Persons with Intellectual Disabilities and compared to two control groups not in dementia-capable programs matched for age, sex, and severity of ID. After 3 years, the authors found some improvement in cognition and stabilization in everyday functioning and behaviors in the SCU residents and a worsening in the control groups. The authors noted that enrollment in a dementia-capable program facilitated daily practice of residents' residual skills and abilities, enhancing their memory and verbal communication, that the prosthetic environment contributed to activity maintenance and appropriate intellectual challenges, and that the greater participation on an individual level added to the skill maintenance. Although the interpretation of these positive findings is not straightforward, they confirm the validity of this 'in-place progression' model and provide a platform for continuing progress in person-centered services and care for aging persons with ID. [ABSTRACT FROM AUTHOR]