Epilepsy, dementia and adaptive behaviour in Down's syndrome

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Abstract
Widespread inquiry identified 378 adults with Down's syndrome resident in Leicestershire, England. The immediate carer of 351 of these (92.8%) was interviewed for the purpose of establishing a past history of seizures, including the age at which the seizures began. The immediate carer was also invited to provide information to enable the completion of an Adaptive Behaviour Scale (A.B.S.) rating. Individuals with a history of seizures were divided into two groups on the basis of whether or not seizures commenced prior to or after age 35 years. Two control groups of individuals with Down's syndrome, but without a history of seizures were selected. Adaptive Behaviour Scale scores for those in whom seizures commenced at a younger age were similar to those who had no recorded history of seizures. However, in those in whom seizures began in later life, scores on all domains of the A.B.S. were significantly reduced compared to both young epileptic patients and their controls. Adaptive Behaviour Scale scores for the older control group held an intermediate position, suggesting that late-onset epilepsy may be a late manifestation of a dementing process. A clinical diagnosis of dementia recorded in the case records was significantly associated with the presence of late-onset epilepsy. This is supportive of the hypothesis that late-onset epilepsy in individuals with Down's syndrome is associated with Alzheimer's disease.

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