Functional decline in adults with Down syndrome

When an adult with Down syndrome appears to lose skills or abilities, consider all treatable and reversible causes; differential diagnoses of functional decline are outlined in Differential diagnoses of functional decline in people with developmental disability. For advice on behavioural regression (eg associated with catatonia) in young people, see Mental health and behaviour in people with Down syndrome.

Although people with Down syndrome are at increased risk of dementia, onset is rare before the age of 40 years and uncommon before 45 years. Differential diagnoses of functional decline should be excluded before considering dementia.

Note: Loss of skills in an adult with Down syndrome has many causes that should be excluded before considering dementia.

The average age of diagnosis of Alzheimer disease in people with Down syndrome is 50 years. See here for further discussion of dementia in a person with developmental disability.

Refer people with Down syndrome for a baseline functional assessment in their 30s and record results in their personal health record. Health problems that are typically associated with ageing (eg sensory loss, frailty) can occur in people with Down syndrome at an earlier age than in the general population. See advice on managing a person with developmental disability who is ageing. Preventive health is vital to maintain optimal function and wellbeing.