Use of Part I of the Adaptive Behavior Scale in the assessment of dementia: Detection of suspected Alzheimer-like brain changes in persons with Down syndrome through adaptive behavior measurement

It is known that persons with Down syndrome progressively develop Alzheimer-like brain changes with age. As Alzheimer disease is recognized by the presence of dementia, the reliable assessment of dementia is important to providing appropriate services and to conducting research with persons with trisomy 21. Reliable diagnostic methods, suited to the task of dementia assessment in the mentally retarded, have yet to be established but may be expected to include, as they do with the normal population, clinical assessment of daily life functioning. The intent of this retrospective study is to determine what contributions the assessment of adaptive behavior, using Part I of the Adaptive Behavior Scale (ABS), might make to differentiating between the highly at risk older population of persons with trisomy 21 and other groups of mentally retarded persons (with and without Down syndrome).;Four groups, older and younger persons with Down syndrome and two control groups, matched on age, IQ and IQ test, were compared on their Part I scores with results that strongly suggest that Part I of the ABS does have the capacity to distinguish significant differences in adaptive behavior between older persons in whom Alzheimer-like brain changes are suspected and other groups of persons with mental retardation. The older Down syndrome (ODS) group was found to have significantly lower performance on eight of ten Part I adaptive behavior domains and all but one of sixteen significant between group differences were located in the relationships between the ODS group and one or more of the other three groups. The domain of Socialization (X) was found to discriminate most between the ODS and other groups, suggesting that this area of behavior may be somewhat more sensitive than other areas to decline in older persons with Down syndrome. Performance of the younger subjects versus the older subjects on a triad of domains also suggests effects of improved educational opportunities for younger persons with mental retardation, perhaps attributable to opportunities brought about by PL 94-142 may have been observed in this study.