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Problem drinking includes a spectrum of drinking habits ranging from excessive alcohol intake to alcohol dependence. Numerous risk factors are thought to increase the susceptibility to such drinking patterns ‐ genetic, environmental and constitutional. Although alcohol misusers are frequently stereotyped, from interviewing numerous patients it is evident that there is no ‘typical alcoholic’. Alcohol consumption screening is widely used; however, it is important for healthcare professionals to understand the social and psychological aspects of problem drinking before advising abstinence. With this understanding, it is clear that governmental legislation with regards to alcohol is more likely to cut down the number of social binge drinkers than the number dependent on alcohol. The onus of reducing the number of individuals developing diseases as a result of chronic alcohol misuse, therefore, lies with the healthcare profession; early screening of alcohol consumption and early psychological intervention for susceptible individuals is key in this prevention.

Dementia is a condition that involves inevitably progressive deficits in numerous cognitive domains, including thought, language, memory, understanding and judgement. A difference in behaviour may be noted, as well as overall loss of skills. Dementia is more than four times as prevalent in people with intellectual disabilities as in the general population. Diagnosis of the condition in people with intellectual disabilities, however, is often difficult due to lack of baseline skill assessment, high staff turnover in supported accommodation and low expectations of capabilities. Current National Institute for Health and Clinical Excellence (NICE) guidelines on anti‐dementia medication state that treatment should not be initiated until the condition has reached moderate severity. Determining whether symptoms are at this stage in people with intellectual disabilities is difficult because their skill level is already impaired. An accurate and extensive record of baseline skill levels in people with intellectual disabilities is therefore crucial, and regular comparison with baseline is key to early diagnosis of dementia.