Developmental disabilties in older peoples

1. DEVOLOPMENTAL DISABILTIES IN OLDER
PEOPLE
GUIDED BY
Dr. VANISHREE
Dr. KAVITHA
SUBMITTED BY
HASHIM E

2. INTRODUCTION
 "Disability is an umbrella term, covering impairments, activity limitations, and participation
restrictions
 An impairment is a problem in body function or structure; an activity limitation is a difficulty
encountered by an individual in executing a task or action; while a participation restriction is a problem
experienced by an individual in involvement in life situations.
 Thus disability is a complex phenomenon, reflecting an interaction between features of a person's body
and features of the society in which he or she lives:
 Intro Frailty is found in 20-30% of the elderly population aged over 75 years and increases with
advancing age.
 It is associated with long-term adverse health-related outcomes such as increased risk of geriatric
syndromes, dependency, disability, hospitalisation, institutional placement, and mortality.

3. • According to the National Council on Disability (NCD), adults with
developmental disabilities are at risk for hearing and vision difficulties,
cardiovascular disease, obesity, seizures, mental health and behavioral problems,
poor oral health, and poor general fitness.

4. ETIOLOGY
• According to Canadian research, five types of chronic illness contribute largely to disability
in people aged over 65 years.
• Arthritis
• Cognitive impairment
• Heart problems
• Vision other common or important problems include :Hearing impairment.
• Chronic respiratory and cardiovascular disease such as chronic obstructive pulmonary
disease (COPD), chronic heart failure, coronary heart disease and cerebrovascular disease.
Falls and hip fracture.

5. • Autism Spectrum Disorder (ASD) can persist into older age. While symptoms may evolve, some
individuals continue to experience challenges related to social interaction, communication, and
repetitive behaviors.
• The life expectancy for individuals with Down syndrome has increased, they may face age-related
health issues sooner than the general population.
• Individuals with cerebral palsy age, they may face additional challenges related to aging, such as
increased muscle stiffness, joint pain, and mobility issues.
• Rett syndrome primarily affects girls and is a rare genetic disorder characterized by loss of acquired
skills, repetitive hand movements, and other neurological impairments.

6. ARTHRITIS
• These diseases and conditions affect joints, the surrounding tissues of the joints, and other
related connective tissues. Generally, arthritic states are characterized by pain, stiffness,
aching, and swelling of the affected areas.
• Arthritis can have a gradual or sudden onset.
• Rheumatoid arthritis is generally seen as a systemic inflammatory disease that affects the
connective tissue of multiple joints in the body, whereas osteoarthritis is considered a
degenerative joint disease typically affecting the cartilage in a few select joints.

7. TREATMENT AND MANAGEMENT
• If the TMJ is involved, the dental professional should consider several factors
including decreased jaw function, possible need for a soft food diet, and any
medication the patient is taking to manage discomfort.
• Dental practitioners need to consider the use of either heat or cold therapy to relax
and soothe the joint during and after treatment.
• The treatment for arthritis in older people often involves a combination of
strategies. These may include pain management with medications, physical therapy
to improve joint function and reduce stiffness, and lifestyle modifications like
exercise and weight management.

8. CARDIAC ARRYHTMIAS
• Cardiac arrhythmias occur when electrical impulses in the heart do not function properly.
This condition can be any change from a normal sequence of electrical impulses.
• These may leads to inadequate circulation of the blood supply, damage to or death of the
heart tissues, coronary artery disease, cardiomyopathy, and valvular heart disease.
• Tachycardia is an abnormally rapid heartbeat for an individual whereas bradycardia is an a
typically slow heartbeat.
• cardiac arrhythmia might not have any signs or symptoms. Some things to look for are a
fluttering feeling, racing or slow pulse rate, chest pain, shortness of breath, and
lightheadedness with dizziness and possible fainting.

9. TREATMENT AND MANAGEMENT
• Treatment and management of cardiac arrhythmias depend on the type and severity of the
arrhythmia.
• Approaches may include medications to control heart rhythm or rate, lifestyle changes such as
diet and exercise, and in some cases, medical procedures like ablation or implantation of devices
like pacemakers or defibrillators.
• Regular monitoring and collaboration with healthcare professionals are crucial to effectively
manage cardiac arrhythmias and minimize associated risks.

10. CONGESTIVE HEART FAILURE
• Congestive heart failure (CHF) is a life threatening condition in which the heart
can no longer pump enough blood to the rest of the body.
• Organs that do not receive enough blood are not getting adequate oxygen or
nutrients. This deficiency results in damage to the organs, which in turn reduces
their function.
• The most common causes of CHF are hypertension and coronary heart disease
• The symptoms associated with CHF are weight gain; swelling of the feet, ankles,
and abdomen; and pronounced neck veins. In addition, a person experiencing CHF
may have shortness of breath, general weakness, and decreased urine production.

11. TREATMENT AND MANAGEMENT
• These patients also most likely take medications related to the causative factors of
CHF and can cause xerostomia.
• Saliva substitutes and stimulants can help relieve the dry mouth.
• If the patient is taking digitalis, the amount of epinephrine used should be
carefully determined.
• Digitalis also exacerbates the gag reflex.
• In addition, dental appointments should be short and stress free.

12. ALZHEIMERS
• Alzheimer's disease, common in older individuals, is a progressive
neurodegenerative disorder affecting memory and cognitive function.
• Medications like cholinesterase inhibitors or memantine to alleviate symptoms.
• Alzheimer's disease can have oral manifestations, including difficulties with chewing
and swallowing, dry mouth (xerostomia), and changes in taste and smell perception.
• Individuals with Alzheimer's may also exhibit behaviors like grinding their teeth.

13. TREATMENT AND MANAGEMENT
• Managing Alzheimer's disease in older individuals involves a comprehensive approach.
• This may include medications to alleviate symptoms, cognitive stimulation through
activities and therapies, and support for daily living activities.
• Care gives involvement is crucial for emotional and practical support.
• Creating a safe environment, maintaining routines, and addressing behavioral changes
are also essential components.
• Regular medical check-ups and communication with healthcare providers help in
adjusting the care plan as the disease progresses.

14. AUTISM SPECTRUM DISORDER
• Autism Spectrum Disorder (ASD) can persist into older age.
• While symptoms may evolve, some individuals continue to experience challenges related
to social interaction, communication, and repetitive behaviors.
• The symptoms of Autism Spectrum Disorder (ASD) can vary widely, but they generally
fall into two main categories: social communication challenges and repetitive behaviors
• 1. Social Communication Challenges
• 2. Repetitive Behaviors

15. • Difficulty with social interactions, including making and maintaining eye contact.
• Challenges in understanding and using verbal and nonverbal communication, such
as gestures and facial expressions.
• Difficulty forming and maintaining peer relationships. - Limited interest in
sharing experiences or emotions with others.
• Engaging in repetitive movements or activities, such as hand-flapping or rocking.
• Insistence on sameness and resistance to change in routines. Intense focus on
specific topics or objects.

16. TREATMENT AND MANAGEMENT
• It's important to recognize that each individual with ASD is unique, and interventions
should be personalized.
• Regular assessments and adjustments to the treatment plan are essential to address
evolving needs.
• Occupational Therapy: engaging in repetitive movements or activities, such as hand-
flapping or rocking.
• Social Skills Training:Targeted interventions to improve social interactions and
understanding of social cues can be beneficial.

17. • Medication : In some cases, medications may be prescribed to manage specific
symptoms like anxiety, aggression, or hyperactivity. These are typically used as
part of a comprehensive treatment plan.
• Structured Environment: Creating a structured and predictable environment can
help individuals with ASD thrive, as they often benefit from routine and
sameness.

18. DOWN SYNDROME
• Down syndrome is a genetic condition caused by the presence of an extra copy of
chromosome 21.
• While life expectancy for individuals with Down syndrome has increased, they may face
age-related health issues sooner than the general population.
• Older individuals with Down syndrome may be more prone to conditions like Alzheimer's
disease and other health challenges.
• As individuals with Down syndrome age, they may experience certain health conditions
and exhibit symptoms associated with the syndrome.

19. COMMON ISSUES OF OLDER PEOPLE WITH DOWN SYNDROME
• 1. Early-Onset Alzheimer's Disease: People with Down syndrome have a higher
risk of developing Alzheimer's disease at an earlier age. Symptoms may include
memory loss, confusion, and changes in behavior.
• 2. Joint Problems: Osteoarthritis and other joint-related issues may become more
prevalent, leading to discomfort and reduced mobility.
• 3. Hearing and Vision Issues: Increased susceptibility to hearing and vision
problems, such as cataracts or hearing loss, may occur.
• 4. Cardiovascular Concerns: Heart conditions are more common in individuals
with Down syndrome.

20. TREATMENT AND MANAGEMENT
• 5. Thyroid Dysfunction: Older individuals with Down syndrome may be at a higher
risk of thyroid disorders.
1. Health Monitoring: Regular health check-ups are essential to identify and manage age-related
conditions, such as cardiovascular issues, thyroid disorders, and early-onset Alzheimer's
disease.
2. Cognitive and Behavioral Support :For those with Down syndrome and Alzheimer's disease,
interventions may include cognitive stimulation activities, behavioral therapies, and
medications aimed at managing symptoms.
3. Physical Therapy: Addressing joint problems and promoting mobility through physical
therapy can help manage arthritis and other musculoskeletal issues.

21. 4. Vision and Hearing Care :Regular eye and ear examinations are crucial for detecting
and managing vision and hearing impairments that may arise with age.
5. Heart Health: Managing cardiovascular risks with a heart-healthy lifestyle, including
regular exercise and a balanced diet, is important.
6. Social Support: Encouraging social interactions and engagement can enhance the
quality of life for older individuals with Down syndrome. This includes maintaining
connections with friends, family, and community.

22. 7. Individualized Care Plans: Recognizing that each person
with Down syndrome is unique, care plans should be
tailored to their specific needs and abilities. Consideration
of their preferences and involving them in decision-
making can enhance the effectiveness of care.

23. REFERENCE