Autism, Diagnostics, and Dementia: A Consensus Report From the 2nd International Summit on Intellectual Disabilities and Dementia

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry Pub Date : 2025-06-06 DOI:10.1002/gps.70110

Matthew P. Janicki, Philip McCallion, Nancy Jokinen, Frode Kibsgaard Larsen, Kathyrn P. Service, Dawna T. Mughal, Karen Watchman, Tiziano Gomiero, Seth M. Keller

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引用次数: 0

Abstract

Objectives

The second International Summit on Intellectual Disability and Dementia, held in 2023, highlighted the unique challenges of diagnosing dementia in older autistic adults, particularly those with intellectual disabilities, due to the complex interplay of cognitive, communicative, and behavioral factors. This article addresses key diagnostic issues and post-diagnostic considerations for this population.

Method

A consensus report was developed by the Summit's Autism/Dementia Working Group through background reviews, expert discussions at the Summit, and iterative draft revisions, incorporating feedback from internal and external stakeholders. Key issues were extracted from the report and abridged for this manuscript.

Results

Diagnostic challenges stem from overlapping symptoms of co-occurring neurodevelopmental and psychiatric conditions, rendering standard dementia tools insufficient. Comprehensive evaluations tailored to autism-related traits, sensory sensitivities, and alternative communication methods are essential. Building diagnostic capacity among clinicians and fostering multidisciplinary collaboration are critical. Longitudinal assessments, initiated before dementia symptoms appear, facilitate early detection of subtle changes. Emerging biomarkers and neuroimaging techniques show promise and should be incorporated where feasible. Accommodations, such as virtual assessments in familiar settings, can enhance diagnostic accuracy by reducing anxiety. Creating transition processes from diagnostics to post-diagnostic supports will aid in mitigating challenges and enhance life quality when dementia is a factor.

Conclusions

Research and clinician education are urgently needed to improve diagnostic approaches and streamline the transition from diagnosis to tailored post-diagnostic support. An integrated framework of comprehensive efforts is vital for our better understanding of age-associated neuropathological diagnostics and enabling long-term well-being of older autistic adults with dementia.

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自闭症、诊断和痴呆：第二届智障和痴呆国际峰会的共识报告

在2023年举行的第二届智力残疾和痴呆症国际峰会上，强调了由于认知、交流和行为因素的复杂相互作用，诊断老年自闭症患者（特别是智力残疾患者）痴呆症的独特挑战。本文讨论了该人群的关键诊断问题和诊断后注意事项。方法峰会自闭症/痴呆症工作组通过背景审查、峰会专家讨论和反复修订草案，结合内部和外部利益相关者的反馈，制定了一份共识报告。关键问题已从报告中摘录，并为本手稿作了删节。结果诊断挑战源于神经发育和精神疾病共同发生的重叠症状，使得标准的痴呆工具不足。针对自闭症相关特征、感官敏感性和替代沟通方法的综合评估是必不可少的。建立临床医生的诊断能力和促进多学科合作至关重要。在痴呆症状出现之前就开始进行纵向评估，有助于早期发现细微的变化。新兴的生物标记物和神经成像技术显示出希望，在可行的地方应该加以结合。在熟悉的环境中进行虚拟评估，可以通过减少焦虑来提高诊断的准确性。创建从诊断到诊断后支持的过渡过程将有助于减轻挑战，并在痴呆症是一个因素时提高生活质量。结论迫切需要研究和临床医生教育来改进诊断方法，并简化从诊断到量身定制的诊断后支持的过渡。综合努力的综合框架对于我们更好地理解与年龄相关的神经病理学诊断和使老年自闭症痴呆症患者长期健康至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.