information in order to delineate thenatural history of DS in adulthood. This information will assist family physicians, community health care workers, and families in anticipating health care concerns and planning to meet the needs of DS adults. DS adults in residential care may not be representative of all individuals with DS due to intrinsic biases in case ascertainment. The reported population may have more health care and be-havioural issues than adults with DS living in the community. Nonetheless, we consider the paucity of information in the medical literature and the ready access to reliable information from the experience at Woodlands warrants our study.METHODS We reviewed comprehensive yearly medical assessments and acute care notes from medical records on 38 individuals with DS residing at one of the provincial residential centres for individuals with mental retardation in British Columbia, Woodlands. There was complete ascertainment of medical charts from all individuals with DS residing at Woodlands during the time period 1981–1992. Charts were divided into two groups. Group 1 included middle-aged DS adults less than 50 years old (reviewed by J.F.), and group 2 included elderly DS adults 50 years and older (reviewed by S.J.).
In group 1, there were 18 middle-aged DS adults, 15 men and 3 women (Table I). At the time of chart review or death, their ages ranged from 30 to 43 years (mean age, 36.2 years). In group 2, there were 20 elderly DS adults, 13 men and 7 women. Their ages at the time of chart review, or death, ranged from 50 to 68 years old (mean age, 59 years).