Determinants of aggression, and adaptive and maladaptive behaviour in older people with Down's syndrome with and without dementia

In a cross-sectional study of aggression, and adaptive and maladaptive beha viour in 128 subjects with Down's syndrome (DS), 29 of whom had dementia, t he current authors found that the presence of dementia was not predictive o f aggression or maladaptive behaviour. However, the level of adaptive behav iour was shown to be lower in subjects with dementia, and in those with low er levels of cognitive functioning, as measured on a rating instrument, the Test for Severe Impairment. Although the presence of aggressive behaviours is not higher in subjects with dementia and DS on cross-sectional review, it remains to be seen whether aggression will increase in individual cases with the onset or progression of dementia. The decline in adaptive behaviou r shown in the present study confirms the findings of previous studies and indicates a direction for service development for persons with the dual dia gnosis of dementia and DS.