Blood-based biomarkers for Alzheimer's disease in Down syndrome: A systematic review and meta-analysis.

Individuals with Down syndrome (DS) are at high risk of Alzheimer's disease (AD), displaying AD pathology similar to the general population. This study evaluated AD-related blood biomarkers in DS within the AT(N) framework through a systematic review and meta-analysis of studies published between 2017 and October 2024. The meta-analysis focused on plasma amyloid beta (Aβ)42, Aβ40, total tau (t-tau), phosphorylated tau (p-tau)181, neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) levels, comparing 2109 DS individuals and 1006 euploid controls.

Type 2 diabetes mellitus in people with intellectual disabilities: Examining incidence, risk factors, quality of care and related complications. A population-based matched cohort study.

Aims: People with intellectual disabilities are at higher risk of type 2 diabetes mellitus (T2DM) but there are currently gaps in our understanding related to risk of new onset, care of T2DM and complications.

Methods: We examined electronic health-record data from Jan 2010 to May 2022 in 189,172 people with intellectual disabilities and 306,697 age, sex and family practice matched controls. We estimated incidence rates per 1,000-person-years, incidence rate ratios (IRRs), risk factors for T2DM (odds ratio, OR), indicators of quality of care and complications (hazard ratio, HR).

Pregnancy and postnatal outcomes for women with intellectual disability and their infants: A systematic review.

Background: While the perinatal period is a vulnerable time for women and their infants, it is also a window to promote adjustment and support. Women with intellectual disability might be a uniquely vulnerable group owing to pre-existing health and care inequalities. The aim of this paper is to explore the pregnancy and postnatal outcomes of women with intellectual disability and the health and development of their infants.

A UK-wide survey of community forensic services for adults with intellectual disability and/or autism.

Background: Specialist forensic community teams for people with intellectual disability and/or autism have been developed, but little is known about their extent and delivery.

Aims: To describe specialist forensic community teams for people with intellectual disability and/or autism across the UK.

Method: An online survey was sent to representatives of each UK Trust/Health Board providing adult mental health and/or intellectual disability services.

Specialist intellectual disability liaison nurses in general hospitals in England: cohort study using a large mortality dataset.

Objective: Intellectual disability liaison nurses in general hospitals could enhance access to high-quality, adapted healthcare and improve outcomes. We aimed to explore associations between the input of intellectual disability liaison nurses and the quality of care in people with intellectual disability who are admitted to hospital.

Design: Retrospective analysis of a national dataset of mortality reviews.

Constipation prevalence and risk from prescribed medications in people with intellectual disability: Findings from an English mortality programme.

Constipation is common in people with intellectual disability, with case reports of associated deaths. Risk factors include lifestyle factors, health conditions, and certain medications. We aimed to explore constipation in a sample of people with intellectual disability who died in 2021.

Diagnosis and pharmacological management of attention deficit hyperactivity disorder in adults with and without intellectual disability: cohort study using electronic health records.

Background: Attention deficit hyperactivity disorder (ADHD) is increasingly diagnosed in adults. People with intellectual disability have higher rates of ADHD yet there is little evidence on the presentation and pharmacological treatment of ADHD in this population or how this differs from the general population.

Methods: Retrospective cohort study using data from electronic health records.

The relationship between clinical presentation and the nature of care in adults with intellectual disability and epilepsy - national comparative cohort study.

Background: A quarter of People with Intellectual Disabilities (PwID) have epilepsy compared with 1% of the general population. Epilepsy in PwID is a bellwether for premature mortality, multimorbidity and polypharmacy. This group depends on their care provider to give relevant information for management, especially epilepsy.

Identifying individuals with intellectual disability who access mental health support and are at high risk for adverse clinical outcomes: cohort study.

Background: People with intellectual disability often experience aggressive challenging behaviour and mental health issues. It can be difficult to identify those who are at higher risk of adverse clinical outcomes when in clinical care.

Aims: To characterise potential subgroups in adults with intellectual disability referred to mental health services in those presenting with aggressive behaviour or common mental disorders (CMDs).

Recording of intellectual disability in general hospitals in England 2006-2019: Cohort study using linked datasets.

Background: Accurate recognition and recording of intellectual disability in those who are admitted to general hospitals is necessary for making reasonable adjustments, ensuring equitable access, and monitoring quality of care. In this study, we determined the rate of recording of intellectual disability in those with the condition who were admitted to hospital and factors associated with the condition being unrecorded.

Methods And Findings: Retrospective cohort study using 2 linked datasets of routinely collected clinical data in England.

Aggressive challenging behavior in adults with intellectual disability: An electronic register-based cohort study of clinical outcome and service use.

Background: Aggressive challenging behavior in people with intellectual disability is a frequent reason for referral to secondary care services and is associated with direct harm, social exclusion, and criminal sanctions. Understanding the factors underlying aggressive challenging behavior and predictors of adverse clinical outcome is important in providing services and developing effective interventions.

Methods: This was a retrospective total-population cohort study using electronic records linked with Hospital Episode Statistics data.

COVID-19 pandemic impact on psychotropic prescribing for adults with intellectual disability: an observational study in English specialist community services.

Background: Coronavirus disease 2019 (COVID-19) has had a disproportionate impact on people with intellectual disability (PwID). PwID are at higher risk of mental illness and receive psychotropic prescribing 'off licence' also, to manage distress behaviour. The lockdown and reduction of multidisciplinary face-to-face appointments had an impact on care delivery, the recourse possibly being psychotropic prescribing.

The reliability and validity of DSM 5 diagnostic criteria for neurocognitive disorder and relationship with plasma neurofilament light in a down syndrome population.

The validity of dementia diagnostic criteria depends on their ability to distinguish dementia symptoms from pre-existing cognitive impairments. The study aimed to assess inter-rater reliability and concurrent validity of DSM-5 criteria for neurocognitive disorder in Down syndrome. The utility of mild neurocognitive disorder as a distinct diagnostic category, and the association between clinical symptoms and neurodegenerative changes represented by the plasma biomarker neurofilament light were also examined.

Effects of the COVID-19 pandemic on mental healthcare and services: results of a UK survey of front-line staff working with people with intellectual disability and/or autism.

Aims And Method: Mental health services have changed the way they operate during the COVID-19 pandemic. We investigated the challenges and innovations reported by staff working in services for people with intellectual disability and/or autism in National Health Service (NHS) and non-NHS sectors, and in in-patient and community settings.

Results: Data were drawn from 648 staff who participated in a UK-wide online survey.

Risk factors for in-patient admission among adults with intellectual disability and autism: investigation of electronic clinical records.

Adults with intellectual disability or autism are at risk of psychiatric admission which carries personal, social and economic costs. We identified 654 adults with intellectual disability or autism in the electronic clinical records of one mental health trust. We investigated the demographic and clinical factors associated with admission and readmission after discharge.

UK psychiatrists' experience of withdrawal of antipsychotics prescribed for challenging behaviours in adults with intellectual disabilities and/or autism.

Background: A high proportion of adults with intellectual disabilities are prescribed off-licence antipsychotics in the absence of a psychiatric illness. The National Health Service in England launched an initiative in 2016, 'Stopping over-medication of people with a learning disability [intellectual disability], autism or both' (STOMP), to address this major public health concern.

Aims: To gain understanding from UK psychiatrists working with adults with intellectual disabilities on the successes and challenges of withdrawing antipsychotics for challenging behaviours.

A structured medication review tool to promote psychotropic medication optimisation for adults with intellectual disability: feasibility study.

Objectives: To investigate the feasibility of delivering structured psychotropic medication review in community services for adults with intellectual disability (ID).

Design: Single-arm feasibility study conducted over a 6-month period.

Setting: Specialist community ID teams in England.

Experiences of psychotropic medication use and decision-making for adults with intellectual disability: a multistakeholder qualitative study in the UK.

Objectives: Understanding patient and carer perspectives is essential to improving the quality of medication prescribing. This study aimed to explore experiences of psychotropic medication use among people with intellectual disability (ID) and their carers, with a focus on how medication decisions are made.

Design: Thematic analysis of data collected in individual semistructured interviews.

A structured programme to withdraw antipsychotics among adults with intellectual disabilities: The Cornwall experience.

Background: Antipsychotic medications are used among 19%-58% of adults with intellectual disabilities to manage challenging behaviour against the NICE guideline recommendations. Studies show that it is possible to completely withdraw antipsychotics in about one third of adults with intellectual disabilities and a dose reduction of 50% or more in another third.

Method: In Cornwall, over three years the present authors developed a structured pathway to withdraw antipsychotics among adults with intellectual disabilities which involved people with intellectual disabilities and their carers, GPs, community learning disability team members and pharmacists.

Association of Focused Medication Review With Optimization of Psychotropic Drug Prescribing: A Systematic Review and Meta-analysis.

Importance: Medication review has been proposed to achieve improved use of psychotropic drugs, but benefits have not been confirmed.

Objective: To synthesize evidence for focused psychotropic medication review in medication optimization.

Data Sources: Medline, PsycINFO, EMBASE, and CINAHL Plus were searched from inception to February 2018 using the index terms "drug utilization review" and "psychotropic drugs" and synonyms.

Achieving better health for people with intellectual disability: the power of policy.

Unlabelled: People with intellectual disability have high mental and physical healthcare needs, which must be addressed on individual, local and national levels. Policy interventions informed by research and stakeholder views and extending beyond a focus on health are needed to reduce inequities in this group.

Declaration Of Interest: None.