Ageing and its consequences for people with Down's syndrome

The importance of supporting children with special needs so that they have the opportunity to acquire the necessary educational, living and social skills to equip them for adult life has been recognised for some time. However, in contrast, the needs of adults, and the importance of supporting people with learning disabilities and their families at times of transition, has been relatively neglected. Whilst the potential difficulties associated with the transition from childhood to adult life is now receiving more attention the fact that needs may change yet again in later adult life is only now beginning to be considered.

In the transition from full-time education, a major concern is that there are a very limited selection of support services for adults, and individuals can move from a relatively structured environment of special education to very limited support and opportunities. The recent Community Care Act provides the framework for decision making at times of such change and has placed a statutory responsibility on social services to undertake a ‘needs-led assessment’ at this transition, the purpose of which is to help individuals and their families to plan for adult life. Whether this happens still appears arbitrary and the options available vary considerably across the country. In an ideal situation there should be a range of imaginative services that can cater for the considerable range of individual need and individual choice. This would include access to full-time employment, supported employment schemes, more sheltered work environments, adult education and so on.

Old age in particular is associated with social and biological changes. For example, family networks alter as parents age and for all of us there is an increasing risk of age-related health problems. Outlined below is the evidence which suggests that ageing and the problems of old age are particularly relevant to people with Down’s syndrome as some of these age-related problems develop earlier in life than would normally be the case.

Throughout life there are changes occurring in brain structure and function. These are particularly marked at the two extremes of life, childhood and old age. In early childhood this is primarily growth and the rationalisation of connections between the brain cells (neurones). It is a combination of these brain changes in childhood and the parallel educational and social opportunities, which result in the read more