The AAMR/IASSID practice guidelines, developed by an international workgroup, provide guidance for stage-related care management of Alzheimer's disease, and suggestions for the training and education of carers, peers, clinicians and programme staff. The guidelines suggest a three-step intervention activity process, that includes: (1) recognizing changes; (2) conducting assessments and evaluations; and (3) instituting medical and care management. They also provide guidance for public policies that reflect a commitment for aggressive care of people with Alzheimers's disease and intellectual disability, and avoidance of institutionalization solely because of a diagnosis of dementia.
The present study prospectively examined the age at menopause of 92 women with Down's syndrome (DS) and the influence of hypothyroidism on the age of menopause. Three methods were used to determine the distribution and median age at onset of menopause: (1) Kaplan-Meier life tables; (2) Cox proportional hazards modelling; and (3) maximum likelihood logistic regression. All three methods provided distributions and similar estimates of the median age at menopause, which was approximately 46 years. The presence of hypothyroidism did not influence age at menopause. The earlier-than-expected age at onset of menopause suggests that women with DS are at an increased risk for post-menopausal health disorders.
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