Deceased DS Adults

Thirteen of 38 of our DS adults were deceased. The mean age of death was
48.5 years (range, 32–67 years). In the middle-aged group, 4/18 were deceased. Lack of provision of cardiac surgical treatment, in keeping with health care policies at the time, resulted in the deaths of three of the four. Two individuals died at ages 32 and 36 years, respectively, from complications of uncorrected atrioventricular canal defects and pulmonary hypertension. One man died at age 35 years from complications of rheumatic heart disease with valvular changes causing aortic insufficiency and mitral valve stenosis. The fourth man died unexpectedly at 36 years old from bilateral pneumonia. In the elderly group, 9/20 were deceased. At the time of death, 7/9 had a clinical diagnosis of advanced Alzheimer disease; they were bedridden and noncommunicative, requiring 24-hour nursing care for assistance with all their needs. Autopsies done on 3/9 (who died at ages 53, 61, and 65 years, respectively) confirmed advanced Alzheimer disease changes in the brain, terminal pneumonia, and arteriosclerosis. No autopsies were done on the remaining 4/9 who had advanced Alzheimer-type disease. Their ages ranged from 63 to 67 years. Before death, all were bedridden for a number of years, were minimally responsive, and had clinical evidence of Alzheimer-type disease. Death was attributable to pneumonia in all four. Two of the nine who were deceased had clinical evidence of early Alzheimer-type disease. One man had post-traumatic paraplegia and died of pneumonia at 54 years old following an orthopaedic operation. The other man died unexpectedly at 48 years old during an influenza epidemic. He had an adult-onset seizure disorder. There was inadequate information to assess the clinical question of whether the seizure disorder stemmed from early symptoms of Alzheimer-type disease.