AGING AND INTELLECTUAL & DEVELOPMENTAL DISABILITY AN OVERVIEW
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1 AGING AND INTELLECTUAL & DEVELOPMENTAL DISABILITY AN OVERVIEW Presented by Julie A. Moran, DO Geriatrician, Aging and Intellectual/Developmental Disabilities Specialist Consultant, Tewksbury Hospital and Massachusetts Department of Developmental Services Clinical Instructor of Medicine, Harvard Medical School Massachusetts Dept. of Developmental Services (DDS) Produced on behalf of DDS by the Center for Developmental Disabilities Evaluation and Research (CDDER)
2 DOWN SYNDROME & AGING Massachusetts Dept. of Developmental Services (DDS) Produced on behalf of DDS by the Center for Developmental Disabilities Evaluation and Research (CDDER)
3 Accelerated Aging in Down Syndrome (DS) DS is the result of 3 copies of chromosome 21 Multiple genes on chromosome 21 have also been linked to middle-aged and older adults showing changes of premature or accelerated aging Source:
4 Common conditions in older adults with DS Alzheimer s disease Hypothyroidism Sensory deficits Early/aggressive cataracts Hearing loss Early menopause Atlantoaxial instability cervical spine disease Obstructive sleep apnea Osteoarthritis Decrease in functional ability Osteoporosis Celiac disease Used with permission from the National Down Syndrome Society, Aging and Down Syndrome Guidebook; copies available at no charge info@ndss.org.
5 Hypothyroidism Thyroid dysfunction is very common in adults with Down syndrome Can lead to symptoms of: fatigue, mental sluggishness, weight fluctuations and irritability. Detected via blood test Treated with oral replacement
6 Sensory Losses Vision impairment: Early/aggressive cataracts Keratoconus Hearing impairment: Conductive hearing loss Small ear canals, wax impaction Frequently mistaken as stubbornness, confusion, disorientation Correctable! Treatable! Source: healthpages.org
7 Atlantoaxial Instability and C-spine concerns Source:
8 Atlantoaxial Instability and C-spine concerns Gait disturbance Spasticity Change in bowel or bladder function Pain Screening x-rays recommended in adulthood More expert investigation if new/sudden change in symptoms
9 Obstructive Sleep Apnea Signs include: snoring, gasping noises, daytime sleepiness, morning fatigue, difficulty getting out of bed, excessive napping and fragmented sleep Undiagnosed or untreated apnea leads to symptoms of irritability, poor concentration, behavior changes, impaired attention, as well as strain on heart/lungs Diagnosis: sleep study
10 Osteoarthritis Hyperflexibility plus wear-and-tear Obesity Pain, limited mobility, decreased participation in activities Misinterpreted as confusion, behavioral changes Pain reporting can be variable Source:
11 Celiac disease Autoimmune disease due to reaction to wheat/gluten products Causes damage to lining of intestine, poor absorption of nutrients Higher prevalence in adults with DS Can be screened via blood test Source: GI referral to confirm diagnosis
12 Osteoporosis Bone thinning leads to fracture Risk factors Immobility Low body mass Family history of osteoporosis, Early menopause Longtime exposure to certain antiseizure medications Screened via bone density test Source:
13 Obesity and Functional Decline Decreased metabolism in adults with DS Inconsistent access to exercise and daily activity Variability in dietary options and healthy food choices Changing culture to change behavior Role modeling healthy habits is good for everyone involved (caregivers too!)
14 PRODUCED FOR THE DEPARTMENT OF DEVELOPMENTAL SERVICES BY THE CENTER FOR DEVELOPMENTAL DISABILITIES EVALUATION AND RESEARCH (CDDER)
15 Additional Aging with IDD Resources Massachusetts Department of Developmental Services (DDS) Center for Developmental Disabilities Evaluation & Research
16 Training produced by the Center for Developmental Disabilities Evaluation & Research (CDDER) on behalf of the Massachusetts Department of Developmental Services (DDS)
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