Adulthood and ageing

Overview

Life expectancy in Down Syndrome has greatly increased in recent years and mean life expectancy is currently around 60 years .

People with Down Syndrome should be supported to have the necessary skills to participate fully in the life of the community as adults. This includes education and training skills, social skills and opportunities, access to sport and leisure activities, and the ability to understand and manage their ongoing health needs.

Common health problems in adulthood include those seen in childhood, with Congenital Heart Disease follow up a more common problem for young adults now due to advances in and earlier surgery with increased survival to adulthood.

Thyroid disorders continue or arise in adulthood and annual thyroid function tests remain an important part of screening, along with blood glucose to detect early onset Type 2 Diabetes.

Obesity, Osteoporosis and constipation are much more common in adults with Down Syndrome requiring a high level of awareness of healthy eating, fibre and fluid intake, and Vitamin D supplements especially in winter.

Vision and Hearing also need to be monitored as they change with age, and the deterioration in vision or hearing can be gradual and lead to loss of life skills, anxiety and behaviour disturbance. The incidence of cataracts and keratoconus is much higher in Down Syndrome, with earlier onset of cataracts than the general population. Wax impaction can cause hearing loss.

Skin problems such as seborrhea, alopecia, dry skin, and infections are more common. Regular visits to the chiropodist help to manage foot problems.

Musculoskeletal problems such as flat feet, early onset osteoarthritis are common. Changes in gait, incontinence, and neck pain may be signs of spinal cord compression due to Atlanto-axial instability or spinal stenosis.

The risk of cancer seems to be lower in Down Syndrome, but all should participate in national screening programmes for breast, bowel, and cervical cancer.

Mental health is important and adults will encounter life events such as siblings leaving home, bereavement, social isolation which can trigger depression or anxiety.

Neurological problems such as epilepsy are rare but may be an early sign of dementia. Dementia occurs more frequently and at an earlier age in Down Syndrome, with 40% of those over 50 years being affected, with changes in behaviour and personality often being the earliest signs.

Additional Resources

Adult Health Book Down’s syndrome association (England Wales and N. Ireland)

Information for adults with Down syndrome, parents and carers on health and well- being , and annual health checks

 

Annual Health Check information for GP’s

Down’s syndrome association ( England Wales and N. Ireland)

Information for health professionals to be used alongside the Adult health book.

 

Health Series Down’s syndrome association ( England Wales and N. Ireland)

  • Ageing and it’s consequences
  • Alzheimer’s

 

Aging Matters. National Down Syndrome Society ( USA)

 

Book Chapter -Mental Health and Dementia in Adults with Down Syndrome

Annus, Wilson and Holland,

in

Down Syndrome Current Perspectives Mackeith 2015

ds-current-perspectives-book-coverEdited by Richard Newton , Shiela Puri and Liz Marder