Comorbidity in people with Down's syndrome: a criteria‐based analysis

Abstract

The aims of this study were to review what is currently known about comorbidity in people with Down's syndrome and to determine if their relative risk for certain disorders was increased. Analysis was carried out on the published literature from 1982 through 1994. In order to be included in this study, articles had to meet predetermined criteria. The strengths and weaknesses of the selected articles were considered in this review. The estimation of relative risks was done by calculating the odds ratio (OR). Odds ratios of > 2 or < 0.5 were found in more than one article for congenital heart defects, hypothyroidism, hearing impairment and hepatitis B. Only one article indicated an OR within this range for all of the following disorders: obesity, epilepsy, degenerative spine disorders and a wide atlanto-axial distance. The results were unclear in the areas of hyperthyroidism, visual disorders, dementia and psychiatric disorders. The concept of comorbidity, i.e. establishing the relationships between the various conditions in one person and understanding the implications for medical care, seems promising, especially for people with intellectual disability. Further work in this area may well improve the quality of care offered to these people.

Dermatological Manifestations of Down's Syndrome

“…Enhanced knowledge regarding comorbidity should improve the quality of life of people with DS who often have difficulty communicating their signs and symptoms. 10 Good medical care has been shown to not only improve their life expectancy but also to help maintain patients in active vocational and group-living programs. 45,46 Part of this comprehensive care involves an understanding and appreciation of the dermatological manifestations of DS and how they impact both the medical and psychological health of the patient.…”

“…Studies show both reduced number and function of both B-and T-lymphocytes, with thymusdependent function and morphology (T-cell) most consistently affected. 2,8,10 Phagocytosis also appears to be impaired. 10 In general, people with DS have a high incidence of mortality caused by infection, 5,10 increased incidence of malignancies such as leukemia, and are more likely to develop autoimmune conditions such as thyroiditis and alopecia areata.…”

“…2,8,10 Phagocytosis also appears to be impaired. 10 In general, people with DS have a high incidence of mortality caused by infection, 5,10 increased incidence of malignancies such as leukemia, and are more likely to develop autoimmune conditions such as thyroiditis and alopecia areata. 2 DS is also associated with accelerated aging and an increased incidence of acne vulgaris, anetoderma, cheilitis, cutis marmorata, elastosis perforans serpiginosa, fissured and geographic tongue, onychomycosis, palmoplantar hyperkeratosis, pityriasis rubra pilaris, psoriasis, seborrheic dermatitis, syringoma, tinea pedis, and xerosis.…”

Red blood cell metabolism in Down syndrome: hints on metabolic derangements in aging

“…For example, rates of most solid malignancies are lower among people with DS, yet they are highly predisposed to develop Alzheimer's disease (AD), several autoimmune disorders, leukemia, pulmonary hypertension, and various hearing and vision problems. [8][9][10][11][12][13] Some of the more prevalent comorbidities could be explained by the altered dosage of expression of genes encoded on chromosome 21, such as amyloid protein or interferon receptors, factors likely contributing to the early onset of AD and autoimmune disorders.…”

Chapter 4 Alzheimer's Disease in Adults with Down Syndrome

“…Despite improved survival rates, people with Down syndrome continue to experience atypical lifespan development, with anatomic, immunologic, neurological, endocrine, and metabolic disorders characteristic of the phenotype (van Schrojenstein Lantman-de Valk, Haveman, & Crebolder, 1996). Down syndrome is still associated with increased mortality rates, both during early and later lifespan development, and age-specific mortality risk remains higher in adults with Down syndrome (Miniño, Heron, & Smith, 2006), even compared with other people with intellectual disabilities .…”