title: Health and disease in adults with Down syndrome.
abstract: BACKGROUND
  The increasing life expectancy of persons with Down syndrome calls for a knowledge of conditions that frequently occur in adults with the syndrome and of which health personnel should be particularly aware.
  
  
  METHODS
  The article is based on a literature search in PubMed and the authors' clinical experience with the patient group.
  
  
  RESULTS
  Altered immune system function, muscular hypotonia, dysmorphic otolaryngologic features and premature ageing contribute to health problems. The group is susceptible to infections, particularly of the respiratory and the gastrointestinal tract. Congenital heart defects may give rise to symptoms, also in adults. Many also develop mitral valve disease, including those without congenital heart defects. Hypothyroidism develops in up to half, and coeliac disease in one of five. Obstructive sleep apnoea syndrome occurs in approximately half. Sensorineural hearing loss and cataract may occur before the age of 30. Atlantoaxial instability occurs, and radiological examination of the neck must take place before intervention under general anaesthesia. Behavioural changes with loss of skills, withdrawal, psychomotoric retardation and mutism occur frequently from the age of 30 and may be symptoms of mental illness or the onset of Alzheimer's dementia.
  
  
  CONCLUSIONS
  Adults with Down syndrome need to undergo regular medical examinations, and we recommend an annual check-up with the primary doctor. Screening for hearing loss and cataract is also recommended every three and five years, respectively. In the event of concomitant symptoms, particularly related to neurological and psychiatric conditions, the patient can be referred to the habilitation service.
authors: Department of Adult Habilitation, Akershus University Hospital, Norway. emal@ahus.no
authors: Eva Albertsen
authors: EA
authors: Malt
authors: Renate Charlotte
authors: RC
authors: Dahl
authors: Trine Marie
authors: TM
authors: Haugsand
authors: Ingebjørg H
authors: IH
authors: Ulvestad
authors: Nina Merete
authors: NM
authors: Emilsen
authors: Børre
authors: B
authors: Hansen
authors: Yon Eduin Galezo
authors: YE
authors: Cardenas
authors: Rolf Olof
authors: RO
authors: Skøld
authors: Anne Tove Berge
authors: AT
authors: Thorsen
authors: Eva Merete Male
authors: EM
authors: Davidsen
mesh_terms: D000328:Adult; D000367:Age Factors; D000375:Aging; D019588:Aging, Premature / Q000209:etiology; D000544:Alzheimer Disease / Q000209:etiology; D002386:Cataract / Q000209:etiology; D002446:Celiac Disease / Q000209:etiology; D004314:Down Syndrome / Q000150:complications*; D006319:Hearing Loss, Sensorineural / Q000209:etiology; D006330:Heart Defects, Congenital / Q000150:complications / Q000209:etiology; D006801:Humans; D008017:Life Expectancy / Q000639:trends; D020181:Sleep Apnea, Obstructive / Q000209:etiology