Survival in Elderly Persons with Down Syndrome

Authors

  • Antonia M. W. Coppus MD,

    1. From the Departments of *Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the NetherlandsDichterbij Centre for the Intellectually Disabled, Gennep, the NetherlandsDepartment of General Practice, Intellectual Disability Medicine, Erasmus Medical Center, Rotterdam, the Netherlands§HeerenLoo-Midden Nederland Centre for the Intellectually Disabled, Ermelo, the NetherlandsClinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands#Department of Neurology, Academic Medical Centre, Amsterdam, the Netherlands**Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands.
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  • Heleen M. Evenhuis MD, PhD,

    1. From the Departments of *Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the NetherlandsDichterbij Centre for the Intellectually Disabled, Gennep, the NetherlandsDepartment of General Practice, Intellectual Disability Medicine, Erasmus Medical Center, Rotterdam, the Netherlands§HeerenLoo-Midden Nederland Centre for the Intellectually Disabled, Ermelo, the NetherlandsClinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands#Department of Neurology, Academic Medical Centre, Amsterdam, the Netherlands**Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands.
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  • Gert-Jan Verberne,

    1. From the Departments of *Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the NetherlandsDichterbij Centre for the Intellectually Disabled, Gennep, the NetherlandsDepartment of General Practice, Intellectual Disability Medicine, Erasmus Medical Center, Rotterdam, the Netherlands§HeerenLoo-Midden Nederland Centre for the Intellectually Disabled, Ermelo, the NetherlandsClinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands#Department of Neurology, Academic Medical Centre, Amsterdam, the Netherlands**Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands.
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  • Frank E. Visser MD, PhD,

    1. From the Departments of *Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the NetherlandsDichterbij Centre for the Intellectually Disabled, Gennep, the NetherlandsDepartment of General Practice, Intellectual Disability Medicine, Erasmus Medical Center, Rotterdam, the Netherlands§HeerenLoo-Midden Nederland Centre for the Intellectually Disabled, Ermelo, the NetherlandsClinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands#Department of Neurology, Academic Medical Centre, Amsterdam, the Netherlands**Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands.
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  • Ben A. Oostra PhD,

    1. From the Departments of *Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the NetherlandsDichterbij Centre for the Intellectually Disabled, Gennep, the NetherlandsDepartment of General Practice, Intellectual Disability Medicine, Erasmus Medical Center, Rotterdam, the Netherlands§HeerenLoo-Midden Nederland Centre for the Intellectually Disabled, Ermelo, the NetherlandsClinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands#Department of Neurology, Academic Medical Centre, Amsterdam, the Netherlands**Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands.
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  • Piet Eikelenboom MD, PhD,

    1. From the Departments of *Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the NetherlandsDichterbij Centre for the Intellectually Disabled, Gennep, the NetherlandsDepartment of General Practice, Intellectual Disability Medicine, Erasmus Medical Center, Rotterdam, the Netherlands§HeerenLoo-Midden Nederland Centre for the Intellectually Disabled, Ermelo, the NetherlandsClinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands#Department of Neurology, Academic Medical Centre, Amsterdam, the Netherlands**Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands.
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  • Willem A. Van Gool MD, PhD,

    1. From the Departments of *Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the NetherlandsDichterbij Centre for the Intellectually Disabled, Gennep, the NetherlandsDepartment of General Practice, Intellectual Disability Medicine, Erasmus Medical Center, Rotterdam, the Netherlands§HeerenLoo-Midden Nederland Centre for the Intellectually Disabled, Ermelo, the NetherlandsClinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands#Department of Neurology, Academic Medical Centre, Amsterdam, the Netherlands**Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands.
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  • A. Cecile J. W. Janssens PhD,

    1. From the Departments of *Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the NetherlandsDichterbij Centre for the Intellectually Disabled, Gennep, the NetherlandsDepartment of General Practice, Intellectual Disability Medicine, Erasmus Medical Center, Rotterdam, the Netherlands§HeerenLoo-Midden Nederland Centre for the Intellectually Disabled, Ermelo, the NetherlandsClinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands#Department of Neurology, Academic Medical Centre, Amsterdam, the Netherlands**Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands.
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  • Cornelia M. Van Duijn PhD

    1. From the Departments of *Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the NetherlandsDichterbij Centre for the Intellectually Disabled, Gennep, the NetherlandsDepartment of General Practice, Intellectual Disability Medicine, Erasmus Medical Center, Rotterdam, the Netherlands§HeerenLoo-Midden Nederland Centre for the Intellectually Disabled, Ermelo, the NetherlandsClinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands#Department of Neurology, Academic Medical Centre, Amsterdam, the Netherlands**Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands.
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Address correspondence to Prof. Dr. C. M. van Duijn, Department of Epidemiology and Biostatistics, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail: c.vanduijn@erasmusmc.nl

Abstract

The longer life expectancy now experienced by persons with Down syndrome (DS) makes it necessary to know the factors influencing survival in older persons with this syndrome. In a prospective longitudinal cohort study of dementia and mortality, 506 persons with DS aged 45 and older were followed for a mean of 4.5 years (range 0.0–7.6 years). Cognitive and social functioning were tested at baseline and annual follow-up. The diagnosis of dementia was determined according to a standardized protocol. Cox proportional hazards modeling was used for survival analysis.

Relative preservation of cognitive and functional ability is associated with better survival in this study population. Clinically, the most important disorders in persons with DS that are related to mortality are dementia, mobility restrictions, visual impairment, and epilepsy but not cardiovascular diseases. Also, level of intellectual disability and institutionalization are associated with mortality.

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