Ageing in adults with Down's syndrome in institutionally based and community-based residences

Seventy-one subjects with Down's syndrome (DS), between the ages of 29 and 68 years, and 46 matched controls (without DS) were examined for intelligence, memory (short- and long-term memory, and spatial and temporal orientation), communication (receptive, expressive and written language) and daily living skills (personal, domestic and community daily living skills). All subjects were screened on hearing and visual functions, thyroid functions, depression and dementia. DS-subjects and controls were matched on chronological age, mental age, living conditions and male/female ratio. Comparisons were made between five subgroups (1) non-demented institutionalized subjects with DS (DSi-group; n = 35); (2) non-demented institutionalized controls without DS (Ci-group; n = 22); (3) demented institutionalized subjects with DS (n = 10); (4) non-demented subjects with DS living in group homes (DSg; n = 26); and (5) non-demented controls without DS living in group homes (Cg; n = 24). Institutionalized and non-institutionalized subjects, as well as demented and non-demented subjects differed significantly on all functions measured. Multiple regression analysis was performed to examine the influence of age and sensory deficits on adaptive and cognitive functioning. In DSg subjects, significant associations were found between age and mental age, and between age and performances on written language. In (non-demented) DSi subjects, significant relations were found between age and memory functions observed in daily circumstances. Moreover, in the (non-demented) DSi elderly, visual impairment was significantly related to depressed performance on daily living skills. No age effects were seen in control subjects. Infirmities of old age like dementia and sensory deficits were far more common in people with DS than in controls. Psychiatric and diagnostic aspects of clinical depression and dementia were emphasized in particular.