Co-occurring medical conditions in aging adults with Down syndrome

Longevity has increased rapidly in the population with Down syndrome (DS) since around 1970 with many individuals surviving into the late 50s and 60s (born 1960-1985). There has been a notable increase in the number of aging adults between 35 and 60 years (born 1947-1972) who now require expert medical care. By the time individuals with DS reach their 40s, several age-related medical conditions are usually evident and may be expected to progress over time. As aging and medical complexity increases, this places further demands on aging caretakers and family members. In elderly adults who are experiencing sudden changes in behavior or adaptive status, it is essential to consider the contributory role of several high-impact medical conditions including sensory (hearing, vision) impairment, sleep apnea, seizures, hypothyroidism, chronic pain, or congestive heart failure. Deterioration in gait and motor function can have multiple causes unrelated to dementia including cervical spondylosis with neural canal stenosis, cervical spine subluxation, lumbar disc herniation, osteoarthritis of the hip or knee, and stroke. A high level of medical vigilance, close monitoring, and timely evaluation is required to detect and treat occult medical conditions early in their course.