Mental health needs

Psychiatric and behavioural disorders increase with age. Among people with Down syndrome the neuropathological changes of Alzheimer's dementia are universal after the age of 35 years, although clinical dementia is not inevitable. Dementia occurs more frequently among elderly people with mental retardation than among the general population, and with the increasing longevity of people with mental retardation the number with dementia is rising. (37) The distress that can result from dementia, both for the elderly people and for their carers, requires understanding and effective management.

When an individual manifests behavioural changes, it is essential that a full history and medical examination be carried out, because behavioural change may be a response to bereavement, abuse, or other life event, or to a physical illness or pain. The full range of behavioural, psychotherapeutic, or drug treatments should be used.

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