Hip disease in adults with Down syndrome

Mt, Hresko; McCarthy, JC; Mj, Goldberg

doi:10.1302/0301-620x.75b4.8331117

Cited by 76 publications

(48 citation statements)

References 9 publications

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“…49,50,53 Sensory losses are detected in 40 to 80% of individuals, usually related to hearing loss and cataracts, and hip disease can develop in about 28%. 54 Conversely, females with Down syndrome seem to be less likely to develop breast cancer than the general population, which might be influenced by their shortened life expectancy and/or earlier menopause compared with the general population. 55 The neuropathological features of Alzheimer disease are believed to develop in most people with Down syndrome by the age of 40 years, 56 possibly because of an extra copy of the amyloid-β precursor protein (APP) gene located on chromosome 21.…”

Section: Comorbid Disorders and Ageingmentioning

confidence: 99%

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

Bittles

Glasson

2004

Develop Med Child Neuro

326

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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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Section: Comorbid Disorders and Ageingmentioning

confidence: 99%

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

Bittles

Glasson

2004

Develop Med Child Neuro

326

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“…Age-related disorders also begin earlier in Down syndrome than in the general population. Adults with Down syndrome are at increased risk for skin and hair changes, early-onset menopause, visual and hearing losses,[12] adult-onset seizure disorder,[13] thyroid dysfunction,[14] diabetes,[15] obesity,[16] and musculoskeletal problems [17]. As life expectancy for individuals with Down syndrome has increased in infancy, childhood[18] and adulthood[19], [20] so has the incidence of dementia although development of Alzheimer's dementia is frequent but not inevitable [21]…”

Section: Introductionmentioning

confidence: 99%

Health Conditions and Their Impact among Adolescents and Young Adults with Down Syndrome

et al. 2014

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ObjectiveTo examine the prevalence of medical conditions and use of health services among young adults with Down syndrome and describe the impact of these conditions upon their lives.MethodsUsing questionnaire data collected in 2011 from parents of young adults with Down syndrome we investigated the medical conditions experienced by their children in the previous 12 months. Univariate, linear and logistic regression analyses were performed.ResultsWe found that in addition to the conditions commonly experienced by children with Down syndrome, including eye and vision problems (affecting 73%), ear and hearing problems (affecting 45%), cardiac (affecting 25%) and respiratory problems (affecting 36%), conditions also found to be prevalent within our young adult cohort included musculoskeletal conditions (affecting 61%), body weight (affecting 57%), skin (affecting 56%) and mental health (affecting 32%) conditions and among young women menstrual conditions (affecting 58%). Few parents reported that these conditions had no impact, with common impacts related to restrictions in opportunities to participate in employment and community leisure activities for the young people, as well as safety concerns.ConclusionThere is the need to monitor, screen and provide appropriate strategies such as through the promotion of healthy lifestyles to prevent the development of comorbidities in young people with Down syndrome and, where present, to reduce their impact.

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“…Their work demonstrated hip abnormality in 7.9% of their patient group, however some report this to be as high as 28% in adult groups. 1 They also noted an increase in acetabular depth, a more horizontal acetabular roof and reduced femoral anteversion. Theoretically these factors would confer an increase in hip joint stability.…”

Section: Discussionmentioning

confidence: 92%

“…Hresko et al demonstrated that hip instability may occur after skeletal maturity and indeed may become worse with time. 1 Given this information, our primary concern was to achieve optimal stability using a suitable prosthesis. We decided against a total hip arthroplasty in view of low patient demand and life expectancy.…”

Section: Discussionmentioning

confidence: 99%

Intracapsular fractured neck of femur in Down's syndrome—Special considerations in operative planning

McGillion

Shetty

2008

Injury Extra

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Hip disease in adults with Down syndrome

Cited by 76 publications

References 9 publications

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

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

Health Conditions and Their Impact among Adolescents and Young Adults with Down Syndrome

Intracapsular fractured neck of femur in Down's syndrome—Special considerations in operative planning

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