Health
The
medical consequences of the extra genetic material in Down syndrome
are highly variable and may affect the function of any organ system
or bodily process. The health aspects of Down syndrome encompass anticipating
and preventing effects of the condition, recognizing complications of
the disorder, managing individual symptoms, and assisting the individual
and his/her family in coping and thriving with any related disability
or illnesses.
Down syndrome can result from several
different genetic mechanisms. This results in a wide variability in
individual symptoms due to complex gene and environment interactions.
Prior to birth, it is not possible to predict the symptoms that an individual
with Down syndrome will develop. Some problems are present at birth,
such as certain heart malformations. Others become apparent over time,
such as epilepsy.
The most common manifestations of Down
syndrome are the characteristic facial features, cognitive impairment,
congenital heart disease (typically a ventricular septal defect), hearing
deficits (maybe due to sensory-neural factors, or chronic serous otitis
media, also known as Glue-ear), short stature, thyroid disorders, and
Alzheimer's disease. Other less common serious illnesses include leukemia,
immune deficiencies, and epilepsy.
However,
health benefits of Down syndrome include greatly reduced incidence of
many common malignancies except leukemia and testicular cancer—
although it is, as yet, unclear whether the reduced incidence of various
fatal cancers among people with Down syndrome is as a direct result
of tumor-suppressor genes on chromosome 21 (such as Ets2), because of
reduced exposure to environmental factors that contribute to cancer
risk, or some other as-yet unspecified factor. In addition to a reduced
risk of most kinds of cancer, people with Down syndrome also have a
much lower risk of hardening of the arteries and diabetic retinopathy.
Life
expectancy
These
factors can contribute to a shorter life expectancy for people with
Down syndrome. One study, carried out in the United States in 2002,
showed an average lifespan of 49 years, with considerable variations
between different ethnic and socio-economic groups. However, in recent
decades, the life expectancy among persons with Down Syndrome has increased
significantly up from 25 years in 1980. The causes of death have also
changed, with chronic neurodegenerative diseases becoming more common
as the population ages. Most people with Down Syndrome who survive into
their 40s and 50s begin to suffer from an alzheimer's-like dementia.
Fertility
Fertility
amongst both males and females is reduced; males are usually unable
to father children, while females demonstrate significantly lower rates
of conception relative to unaffected individuals. Approximately half
of the offspring of someone with Down's syndrome also have the syndrome
themselves. There have been only three recorded instances of males with
Down syndrome fathering children.