When compared to the general population, people who have Down syndrome are at a higher risk for some health problems. These health problems range from hearing problems to early onset of Alzheimer's disease. Caregivers should be aware of these conditions so they can assist the physician in diagnosing and providing treatment for the individual being served.
Individuals who have Down syndrome are at an increased risk for celiac disease. This condition affects the body’s ability to process a protein that is found in wheat and other grains. Although the typical symptoms of the disease include diarrhea/loose stools and difficulty gaining weight, it can also affect his or her energy level and behavior.
Significant constipation is another gastrointestinal condition that people with Down syndrome are predisposed to: This condition may lead to severe abdominal pain, restlessness and loss of appetite.
Down syndrome and Alzheimer’s disease are genetically connected; thus, there is an increased risk for the onset of dementia at an earlier age than is typically seen in the general population. Furthermore, 90 percent of people who have Down syndrome will have Alzheimer’s disease by the time they turn 70 years old, whereas, in the general population, only 11 percent of people who are 65 years have the disease and approximately 30 percent of people over the age of 85 have Alzheimer’s.
Neuropathological Changes Already Evident at 40 Years Old
According to a study conducted by Columbia University Medical Center, an individual who has Down syndrome already has the neuropathological changes of Alzheimer’s disease when he or she turns 40 years old. These changes include the buildup of amyloid plaques and neurofibrillary tangles (tau tangles), both of which are indicative of Alzheimer’s. This premature accumulation of amyloid plaques occurs in people with Down syndrome because they carry an additional copy of chromosome 21, which is the gene responsible for producing the protein that precedes amyloid.
The Age of Onset Varies Greatly
The onset of dementia in individuals who have Down syndrome varies greatly, with ages ranging from under 40 to more than 70 years old. These variances suggest that the progression of the disease may be affected by additional biological, genetic and environmental factors.
Caregivers Need to Recognize Changes and Provide Appropriate Support
Alzheimer’s disease causes short term memory loss, as well as an inability to learn and then recall new information; therefore, expectations related to increasing an individual’s independence or teaching new skills are no longer feasible goals. Managing dementia requires providing the appropriate assistance/support to the individual as the disease progresses. To accomplish this, caregivers need to learn the general principles and strategies that are specific to the changing needs of the individual being served.
Obstructive Sleep Apnea
It is not uncommon for an individual who has Down syndrome to have difficulty sleeping. According to the Centers for Disease Control and Prevention (CDC), 50 to 75 percent of people with Down syndrome also have sleep apnea: This makes it one of the most common sleep conditions experienced by individuals who have Down syndrome. Sleep apnea refers to the incidence of an individual neglecting to breathe for short periods of time while he or she is asleep.
Anatomy Differences Make Sleep Apnea Common
People who have Down syndrome tend to have a small, flaccid upper airway that may become blocked by adenoids and large tonsils or the floppy walls of the upper airway that collapse during exhalation. No matter what the obstruction, the individual wakes briefly to recommence breathing. This lack of restful sleep negatively affects an individual’s ability to focus and learn new things.
Symptoms of Sleep Apnea
Some of the symptoms associated with (but not specific to) this condition include:
- Excessive thrashing about during sleep
- Unusual sleep positions (sleeping while seated or hunched forward)
- Daytime sleepiness
- Breathing through the mouth
Attention Deficit Hyperactivity Disorder (ADHD)
Children who have Down syndrome display ADHD-like symptoms more frequently than children within the general population.
There are certain traits associated with ADHD, these traits include:
- Impulsive behavior
- Decreased attention span
- Nondirected motor activity
- Excessive fidgeting
While all children display the aforementioned traits from time to time, a child who has Down syndrome may display these traits more frequently than their counterparts do. If symptoms such as repetitiveness, extreme irritability or anxiety are also present, another disorder may need to be diagnosed and addressed.
These disorders may include:
- Bipolar disorder
- Obsessive Compulsive Disorder (OCD)
According to the National Down Syndrome Society (NDSS), approximately 30 percent of the people who have Down syndrome also have thyroid disease at some time in their lives. The majority will have an underactive thyroid (hypothyroidism); whereas, a few will have an overactive thyroid (Grave’s disease). An underactive thyroid may cause fatigue and listlessness, while an overactive thyroid may cause impatience and anxiety.
The CDC states that up to 75 percent of individuals who have Down syndrome will experience some form of hearing loss. Individuals with Down syndrome have structural abnormalities in their middle ear: These abnormalities may cause a lifetime of mild to moderate hearing loss. In addition, ear infections are a common occurrence (especially in children) and can cause increased hearing loss that lasts for weeks at a time.
Near- and far-sightedness, Amblyopia (lazy eye), and cataracts are all common among individuals who have Down syndrome. The CDC states that up to 60 percent of individuals who have Down syndrome also have eye issues that require corrective lenses.
Although individuals who have Down syndrome experience substantial cognitive delays, in conjunction with other physical conditions associated with this syndrome, each individual has his or her own range of abilities. These individuals develop at their own pace. Furthermore, despite the fact that their progression may be delayed and they have numerous health issues to contend with or overcome, many of these individuals accomplish significant developmental milestones while leading enjoyable and enriched lives.