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Biomedical subjects

V P Prasher

Publications and source records attributed to V P Prasher.

At least 19 recordsLinked to original sources
PubMed2004

Review of donepezil, rivastigmine, galantamine and memantine for the treatment of dementia in Alzheimer's disease in adults with Down syndrome: implications for the intellectual disability population.

The management of dementia in Alzheimer's disease has dramatically changed since the development of anti-dementia drugs. However, there is limited information available regarding the bio-medical aspects of the differing drugs; particularly relating to adults with intellectual disability. Indeed the information available for the intellectual disabled population is limited to adults with Down syndrome. This review highlights the important pharmacological and clinical aspects of donepezil, rivastigmine, galantamine and memantine and supports the view that such drugs play an important part in the management of dementia in adults with intellectual disability. Future clinical and research issues are discussed.

Alzheimer Disease↗
PubMed1999

Down syndrome and thyroid disorders: a review.

Thyroid disorders are common in the Down syndrome population but many specific areas of importance remain to be resolved. A detailed review of previously published case reports and research studies highlighting the clinical association between Down syndrome and thyroid disorders was undertaken. Historical, epidemiological, immunological, diagnostic and treatment issues are addressed. Recommendations for future management and research are considered.

Adolescent↗
PubMed1998

Molecular mapping of Alzheimer-type dementia in Down's syndrome.

Previous research has hypothesized an association between Alzheimer's disease and the amyloid precursor protein (APP) gene found on chromosome 21. We report the case of a 78-year-old woman with Down's syndrome with partial trisomy 21 [46,XX,rec(21)dup q, inv(21) (p12q22.1)]. No evidence of Alzheimer's disease was found on neuropsychological, magnetic resonance imaging, and neuropathological assessment. The gene sequence for APP was present in only two copies. This case further supports the hypothesis that Alzheimer's disease is associated with trisomy for proximal chromosome 21q, including the APP gene.

Aged↗
PubMed1998

Maladaptive behaviours and symptoms of dementia in adults with Down's syndrome compared with adults with intellectual disability of other aetiologies.

Dementia commonly occurs in elderly people with intellectual disability, especially those with Down's syndrome. The non-cognitive symptoms of dementia can be of greater significance to individuals and carers than the cognitive changes caused by this condition. It is not known whether there are differences between people with Down's syndrome and those with intellectual disability of other causes with regard to the prevalence of such symptoms. The present study was undertaken to draw a comparison between a group with Down's syndrome and dementia (n = 19), and a group with intellectual disability of other causes and dementia (n = 26). Maladaptive behaviours and psychiatric symptomatology were assessed in both groups. The group with Down's syndrome had a higher prevalence of low mood, restlessness/excessive overactivity, disturbed sleep, being excessively uncooperative and auditory hallucinations. Aggression occurred with greater frequency in those subjects with intellectual disability of other causes. These findings are of epidemiological importance in terms of service planning and understanding psychiatric presentation.

Adult↗
PubMed1998

Longitudinal changes in adaptive behavior in adults with Down syndrome: interim findings from a longitudinal study.

Age-related changes in adaptive behavior have been established in adults with Down syndrome. However, most studies have been cross-sectional, without controls for cohort and survival effects. We examined underlying factors for age-related decline in adaptive behavior in 128 adults with trisomy 21 over a 3-year period. Presence of dementia was the only determining factor, although the difference in trend over time as compared to subjects without dementia was not significant. No association between gender, sensory loss, severity of mental retardation, or place of residence was found. For subjects with no significant medical disorder (physical or psychological), no decline was seen. This longitudinal study confirms previously reported findings.

Activities of Daily Living↗
PubMed1997

ApoE genotype and Alzheimer's disease in adults with Down syndrome: meta-analysis.

The apoE gene polymorphism was examined in 100 adults with Down syndrome (with and without dementia) compared to 346 control subjects without mental retardation. Meta-analysis of available data (480 subjects) revealed that apolipoprotein E genotype distribution for people with Down syndrome was similar to that of the nonretarded population. Although no significant association between possession of the apoE epsilon 4 allele and onset of Alzheimer's disease was found, subjects with the allele had a tendency towards lower age of onset of dementia. Subjects with apoE epsilon 2 allele may not develop dementia and may have increased longevity.

Adult↗
PubMed1996

The role of magnetic resonance imaging in the diagnosis of Alzheimer disease in adults with Down syndrome.

OBJECTIVE: To correlate findings from magnetic resonance imaging (MRI) with neuropathological analysis and clinical assessment of Alzheimer disease in patients with Down syndrome. DESIGN AND METHODS: Case study of 1 elderly man with trisomy 21 and Alzheimer disease who had been followed up prospectively over a 5-year period. The patient was a resident in a supervised community unit and died with end-stage dementia. The MRI changes were correlated with the results of clinical psychopathological analysis and neuropathological brain tissue findings. To our knowledge, this is the first case in which clinical, MRI, and neuropathological data were available in a case involving an elderly patient with Down syndrome and Alzheimer disease. RESULTS: The MRI findings correlated with the clinical deterioration and neuropathological features of Alzheimer disease. Marked changes in temporal and hippocampal regions were found. CONCLUSION: Magnetic resonance imaging is potentially a valuable tool in the diagnosis of Alzheimer disease in adults with Down syndrome, particularly in individuals for whom standard intellectual assessments are not possible.

Aged↗
PubMed1996

Short-term prognosis of depression in adults with Down's syndrome: association with thyroid status and effects on adaptive behaviour.

Findings for Down's syndrome adults with depression were compared to those for non-depressed Down's syndrome controls. Mean age of onset of depression was 30.1 years, the majority of subjects were female and biological more so than psychotic symptoms were presenting features. No statistically significant association between depression and thyroid dysfunction was found. For the depressed group, scores for level of adaptive functioning were significantly lower and those for maladaptive behaviour significantly higher. At one-year follow-up, although some improvement was found, the majority of depressed subjects were still symptomatic. The short-term prognosis for depression in adults with Down's syndrome appears to be poor but possibly better the earlier the age of onset.

Adolescent↗
PubMed1996

Causes of age-related decline in adaptive behavior of adults with Down syndrome: differential diagnoses of dementia.

Although a decline in adaptive behavior with age in adults with Down syndrome has been established, the underlying causes of the decline remain unresolved. Differential causes of the decline in 201 adults with Down syndrome were investigated. Aging, dementia, and severity of mental retardation were found to be significant factors. Absence of a medical illness was a factor that predicted a higher level of adaptive behavior. No significant difference in age-related maladaptive behaviors was found. However, a clinical diagnosis of dementia was a predictive factor for increased maladaptive behavior. Clinical implications of these findings were discussed.

Adolescent↗