Psych CASC / OSCE · Intellectual disability psychiatry — Down syndrome
Explain depression versus dementia risk to carers of an adult with Down syndrome — CASC communication station
MRCPsych/FRANZCP-style communication station: explain probabilistic Alzheimer risk without fatalism, outline depression and medical mimics, and negotiate a clear assessment and support plan.
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Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
Parents of a 48-year-old woman with Down syndrome and moderate intellectual disability are distressed after an online article said 'everyone with Down syndrome gets Alzheimer disease by 50'. Their daughter has been quieter for 6 weeks after a friend moved away. They want to know if she already has dementia, whether anything can be treated, and what you will do next.
Station brief
Format. Communication station, approximately 7–10 minutes. You are the psychiatry registrar in the adult intellectual disability clinic. [1]
Candidate instructions. Explain Alzheimer risk in Down syndrome without catastrophic fatalism; discuss depression and medical causes of recent change; outline assessment (bloods, sensory, sleep, structured tools); negotiate a collaborative plan; check understanding with empathy. The examiner plays both parents. [2][4]
References6ShowHide
- [1]Antonarakis SE, Skotko BG, Rafii MS, et al. Down syndrome Nat Rev Dis Primers, 2020.PMID 32029743
- [2]Zigman WB, Lott IT Alzheimer's disease in Down syndrome: neurobiology and risk Ment Retard Dev Disabil Res Rev, 2007.PMID 17910085
- [3]Holland AJ, Hon J, Huppert FA, et al. Population-based study of the prevalence and presentation of dementia in adults with Down's syndrome Br J Psychiatry, 1998.PMID 9828989
- [4]Walker JC, Dosen A, Buitelaar JK, Janzing JG Depression in Down syndrome: a review of the literature Res Dev Disabil, 2011.PMID 21392935
- [5]Deb S, Hare M, Prior L, Bhaumik S Dementia screening questionnaire for individuals with intellectual disabilities Br J Psychiatry, 2007.PMID 17470960
- [6]Ball SL, Holland AJ, Huppert FA, et al. The modified CAMDEX informant interview is a valid and reliable tool for use in the diagnosis of dementia in adults with Down's syndrome J Intellect Disabil Res, 2004.PMID 15312062