Clinical profile and main comorbidities of Spanish adults with Down syndrome

Asúa, Diego Real de; Quero, Miriam; Moldenhauer, Fernando; Suárez, Carmen

doi:10.1016/j.ejim.2015.05.003

Cited by 75 publications

(73 citation statements)

References 32 publications

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“…; Real de Asua et al . ). None were documented to have coronary artery disease or solid tumour (only one patient was diagnosed with ductal carcinoma in situ ), corroborating the theory of medical advantages in patients with DS (Kerins et al .…”

Section: Discussionmentioning

confidence: 97%

“…Likewise, the study done by Real de Asua et al . () revealed that younger patients tended to live and were cared for by their parents; after the age of 50 years, 35% of them lived in residential facilities, and 56% were cared for by their siblings or institutions. In our study, pneumonia and aspiration syndrome were the most common cause of hospitalisation, as well as the most common cause of death, readmission and ICU admission.…”

Section: Discussionmentioning

confidence: 99%

“…; Real de Asua et al . ), and 20% of the patients were taking GERD‐related medications (Kerins et al . ).…”

Section: Discussionmentioning

confidence: 99%

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Hospitalisation of adults with Down syndrome: lesson from a 10‐year experience from a community hospital

Chenbhanich

Phupitakphol

et al. 2018

J intellect Disabil Res

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Background Life expectancy of individuals with Down syndrome (DS) has improved significantly over the past decades. However, there are sparse data documenting the co‐morbidities and hospitalisation of adult patients with DS in the literature. The aim of this study was to characterise the co‐morbidities and pattern of hospitalisation in adult patients with DS during a 10‐year period at the community hospital as well as to compare hospitalisation parameters with the general adult population during the same years. Method We reviewed the medical records of 81 hospitalisations from 37 patients with DS aged 21 to 68 years at Metrowest Medical Center during a 10‐year period and compared with those of the general adult population during the same time. Co‐morbidities were also described. Results Adults with DS had a mean age at admission of 48.6 ± 8.8 years with the median length of stay of 3 days (interquartile range 4 days). Male patients were hospitalised longer than female patients (mean 5.0 vs. 2.8 days; P < 0.05), and patients who lived at home were admitted at earlier ages than those who came from residential healthcare facility (mean 41.5 vs. 52.2 years; P < 0.001). The most common cause of hospitalisation was pneumonia/aspiration syndrome (29.6%), and the most common co‐morbidity was gastroesophageal reflux disease (GERD)/dysphagia (70.3%). Presence of GERD/dysphagia or seizure disorder was significantly associated with multiple admission and readmission within 1 month (P < 0.05). The mortality rate was 4.9%, and the rate of intensive care unit admission was 8.6%. Conclusions Our cohort did not show statistically significant different hospitalisation parameters such as inpatient mortality and average length of stay when compared with general adult population hospitalised at the same years. The care of adult patients with DS presents challenges in internal medicine due to its unique co‐morbid profile and signifies the importance of multidisciplinary approach. In order to improve the care of this patient population, their co‐morbidities, particularly GERD/dysphagia and seizure disorder, should be optimally managed and comprehensively addressed when patients are hospitalised.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Hospitalisation of adults with Down syndrome: lesson from a 10‐year experience from a community hospital

Chenbhanich

Phupitakphol

et al. 2018

J intellect Disabil Res

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“…Moreover, obesity may suggest an increased propensity to develop type 2 diabetes in DS (Esbensen, ). Contributing factors to the high rate of overweight and obese individuals with DS may include a combination of eating behavior, intake, metabolic rate, hypothyroidism, and reduced physical exercise (Esbensen, ; Prasher, ; Real De Asua et al, ). Metabolic syndrome: Although the DS apparently predisposing phenotype and the high prevalence of obesity and sedentary lifestyle in people with DS the prevalence of metabolic syndrome in adults with DS is low (Real de Asua). Metabolic syndrome definition is based on the abdominal circumference, arterial hypertension, glycemic abnormalities, dyslipidemia, and hypertriglyceridemia.…”

Section: Vascular‐related Comorbidities and Down Syndromementioning

confidence: 99%

“…• Smoking: A less frequent smoking habit has been found within subjects with DS than in general population (Sobey et al, 2015). • Obesity: A high prevalence of obesity has been found in DS population (Flygare Wallén et al, 2018;Real De Asua et al, 2015) with up to 60% of individuals being overweight. Moreover, obesity may suggest an increased propensity to develop type 2 diabetes in DS (Esbensen, 2010).…”

Section: Comorbidities and Down Syndromementioning

confidence: 99%

Down syndrome, Alzheimer disease, and cerebral amyloid angiopathy: The complex triangle of brain amyloidosis

Carmona-Iragui

Videla

Lleó

et al. 2019

Developmental Neurobiology

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Down syndrome (DS) is the main genetic cause of intellectual disability worldwide. The overexpression of the Amyloid Precursor Protein, present in chromosome 21, leads to β‐amyloid deposition that results in Alzheimer disease (AD) and, in most cases, also to cerebral amyloid angiopathy (CAA) neuropathology. People with DS invariably develop the neuropathological hallmarks of AD at the age of 40, and they are at an ultra high risk for suffering AD‐related cognitive impairment thereafter. In the general population, cerebrovascular disease is a significant contributor to AD‐related cognitive impairment, while in DS remains understudied. This review describes the current knowledge on cerebrovascular disease in DS and reviews the potential biomarkers that could be useful in the future studies, focusing on CAA. We also discuss available evidence on sporadic AD or other genetically determined forms of AD. We highlight the urgent need of large biomarker‐characterized cohorts, including neuropathological correlations, to study the exact contribution of CAA and related vascular factors that play a role in cognition and occur with aging, their characterization and interrelationships. DS represents a unique context in which to perform these studies as this population is relatively protected from some conventional vascular risk factors and they develop significant CAA, DS represents a particular atheroma‐free model to study AD‐related vascular pathologies. Only deepening on these underlying mechanisms, new preventive and therapeutic strategies could be designed to improve the quality of life of this population and their caregivers and lead to new avenues of treatment also in the general AD population.

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Medical Care of Adults With Down Syndrome

Tsou

Bulova

Capone

et al. 2020

JAMA

137

121

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; for the Global Down Syndrome Foundation Medical Care Guidelines for Adults with Down Syndrome Workgroup IMPORTANCE Down syndrome is the most common chromosomal condition, and average life expectancy has increased substantially, from 25 years in 1983 to 60 years in 2020. Despite the unique clinical comorbidities among adults with Down syndrome, there are no clinical guidelines for the care of these patients. OBJECTIVE To develop an evidence-based clinical practice guideline for adults with Down syndrome. EVIDENCE REVIEW The Global Down Syndrome Foundation Medical Care Guidelines for Adults with Down Syndrome Workgroup (n = 13) developed 10 Population/Intervention/ Comparison/Outcome (PICO) questions for adults with Down syndrome addressing multiple clinical areas including mental health (2 questions), dementia, screening or treatment of diabetes, cardiovascular disease, obesity, osteoporosis, atlantoaxial instability, thyroid disease, and celiac disease. These questions guided the literature search in MEDLINE,

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Clinical profile and main comorbidities of Spanish adults with Down syndrome

Cited by 75 publications

References 32 publications

Hospitalisation of adults with Down syndrome: lesson from a 10‐year experience from a community hospital

Hospitalisation of adults with Down syndrome: lesson from a 10‐year experience from a community hospital

Down syndrome, Alzheimer disease, and cerebral amyloid angiopathy: The complex triangle of brain amyloidosis

Medical Care of Adults With Down Syndrome

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