Current Topic Survival in Down's Syndrome

Fryers, Tom

doi:10.1111/j.1365-2788.1986.tb01303.x

Cited by 24 publications

(19 citation statements)

References 19 publications

(22 reference statements)

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“…4 Increased infections have been attributed to a variety of factors including environmental exposure to pathogens in institutions, reduced mobility, congenital heart disease, abnormal pulmonary vasculature and abnormal immunological function (The latter exacerbated by age). 11,25 More serious respiratory infections tend to occur in the more profoundly intellectually impaired. 26,27 An increased rate of Hepatitis B infection has been found that may result in an increased mortality from liver cirrhosis and liver cancer.…”

Section: Infectiousmentioning

confidence: 99%

“…11,12 The most common lesion is an endocardial cushion defect in 43% of cases, followed by ventricular septal defect (32%), atrial septal defect (10%), tetralogy of Fallot (6%) and isolated patent ductus arteriosus (4%). Approximately one third of cases have multiple defects.…”

Section: Internalmentioning

confidence: 99%

“…10 There have also been advances in cardiac surgery that have improved survival for those with significant congenital cardiac defects. 11 For example, the percentage of survivors to one year and 10 years over the period 1944-1955 was 47% and 37% respectively, compared to 94% and 86% over the period 1966-1975. 11 The average life expectancy in 1929 of nine years contrasts with survival of 61% of affected individuals to the age of 50 years in 1987.…”

Section: Introductionmentioning

confidence: 97%

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Forensic issues in Down syndrome fatalities

Byard

2007

Journal of Forensic and Legal Medicine

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Section: Infectiousmentioning

confidence: 99%

Section: Internalmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

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Forensic issues in Down syndrome fatalities

Byard

2007

Journal of Forensic and Legal Medicine

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“…About 48% of people with Down syndrome have congenital cardiac defects, most commonly involving the 30,44 Females also exhibit accelerated mortality in the perimenopausal period compared with males of the same age, 41 possibly because of interaction between pre-existing cardiac anomalies and their changing endocrine status. Surgical correction for cardiac defects inherited as part of Down syndrome significantly improves survival, 45,46 and it has been reported that when cardiac anomalies are successfully treated in the early years of life, the mortality risk is decreased to that of affected individuals without cardiac defects. 47 The positive impact of heart surgery on childhood survival has become increasingly evident since the 1980s and is seen in the greatly reduced early mortality of recent patient cohorts.…”

Section: Epidemiologymentioning

confidence: 99%

Clinical, social, and ethical implications of changing life expectancy in Down syndrome

Bittles

Glasson

2004

Develop Med Child Neuro

321

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Between 1 and 4% of the populations of developed nations are diagnosed with learning disability*. 1,2 In Australia, an estimated 1.9% of the population exhibit learning disability either as a primary disability or as a secondary condition, and approximately half of these people require continuing support in daily living, including mobility, self-care, and socialization. 3 After improvements in basic public health measures, life expectancy in most developed nations increased over the course of the 20th century, and this trend included people with learning disability. Thus, by the end of that century, the survival estimates for people with mild learning disability living in developed countries was 70 years, and nearly 60 years of age for those with severe learning disability. 4,5 The estimates of increased life expectancy mirror improved access to medical treatment for those with learning disability, and a shift in public attitude during the past 20 to 30 years that has resulted in better care within the community. The increased availability of more appropriate medication, surgical intervention, and overall health care management strategies have led to a positive effect on general health and have decreased mortality. More recently, national and international agencies have strongly argued for further improvements in health care opportunities for individuals with disabilities, and for the narrowing of health differentials between people with learning disability and the general population. 6-9 However, this is a complex issue with challenging social, economic, and ethical ramifications, because many people with learning disability are affected by major adverse health issues throughout their lives. As a result, increased survival is not only associated with a longer period of care, but is also related to a longer period of more specialized needs. Here we discuss these issues with specific reference to the circumstances of people with Down syndrome, although it should be emphasized that to a large degree they equally apply to a wide range of inherited disorders resulting in learning disability. EpidemiologyDown syndrome is the most commonly inherited form of learning disability, with an incidence rate of 1 out of every 650 to 1000 live births, 10-12 and in developed countries it accounts for 12 to 15% of the population of those with learning disability. 4,13,14 The actual number of Down syndrome conceptions is unknown, but occurrence of the disorder increases significantly with advancing maternal age, 15 and there is some evidence that advanced paternal age might also be involved. 16 There is a high rate of spontaneous prenatal loss and, for example, in one study 43% of Down syndrome pregnancies detected by chorionic villus sampling at 10 weeks gestation failed to reach term. 17 The trisomy 21 karyotype is present in 93 to 95% of people with Down syndrome; a further 3 to 4% exhibit translocation anomalies, and 1 to 3% are mosaic. 18-20 Down syndrome is usually associated with moderate to severe levels of learning disab...

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“…This has been due to advances in medical care and to changes in community attitudes (Fryers 1986). There is a need to examine the impact of these changes on the quality of life of children with DS and their families.…”

mentioning

confidence: 99%

Medical aspects of school‐aged children with Down syndrome

Leonard

Bower

Petterson³

et al. 1999

Develop Med Child Neuro

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Current and comprehensive information about the medical issues affecting children with Down syndrome (DS) is of value in counselling parents who are considering prenatal diagnosis and in planning services for people with DS as they age, especially given the continued improvements in their survival. Parents of school-aged children (mean age 11.37 years, 57.3% male, 42.7% female) with DS were identified by linking registers from the Disability Services Commission and the Birth Defects Registry. Less than half the children had cardiac and bowel conditions. More than half had ear conditions and more than three quarters had eye conditions. Ear, nose, and throat professionals were the specialists seen most often and the rate of tympanostomy tube insertion was nearly 17 times that of the general childhood population. Children with DS were over five times more likely to wear glasses than other children. These findings suggest that chronic, non life-threatening conditions impose a burden on families but do not threaten quality of life.

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Current Topic Survival in Down's Syndrome

Cited by 24 publications

References 19 publications

Forensic issues in Down syndrome fatalities

Forensic issues in Down syndrome fatalities

Clinical, social, and ethical implications of changing life expectancy in Down syndrome

Medical aspects of school‐aged children with Down syndrome

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