-Original-

Medical Needs of Adults with Down Syndrome Presenting at a Regional Medical and Rehabilitation Center in Japan

Yoko Kanbara^1,2, Chisen Takeuchi³, Yoko Mochizuki³, Miho Osako³, Motoko Sasaki^1,4 and Hidehiko Miyake^1,4-6

¹Research and Development of Institute for Human Life Science, Ochanomizu University, Tokyo, Japan
²Department of Nursing, Tokyo Metropolitan Kita Medical and Rehabilitation Center for the Disabled, Tokyo, Japan
³Department of Neurology, Tokyo Metropolitan Kita Medical and Rehabilitation Center for the Disabled, Tokyo, Japan
⁴Department of Genetic Counseling, Graduate School of Humanities and Science, Ochanomizu University, Tokyo, Japan
⁵Division of Clinical Genetics, Nippon Medical School Hospital, Tokyo, Japan
⁶Department of Obstetrics and Gynecology, Nippon Medical School Hospital, Tokyo, Japan

Background: Down syndrome (DS) is the most frequent chromosomal aberration; however, knowledge of associated health issues in adulthood is inadequate. We analyzed health data from Japanese adults with DS.
Methods: We conducted a retrospective chart review of 151 patients with DS who visited the Internal Medicine Outpatient Department of the Tokyo Metropolitan Kita Medical and Rehabilitation Center for the Disabled.
Results: Endocrine disorders such as obesity, hyperlipidemia, and hyperuricemia were most common in adulthood (≤40 years) and senescence (>40 years); neurological diseases were more prevalent in senescence. Multimorbidity was noted even patients with DS who were younger than 30 years, and the prevalence increased with age. Only 21 patients (13.9%) with DS visited our hospital with referral letters from pediatricians; 94 patients (62.3%) visited without such referrals from other medical institutions. Patients without a referral letter had a mean of 3.1 comorbidities per patient. Moreover, medical care for some people with DS was interrupted during childhood.
Conclusions: Prevention and detection of comorbidities in patients with DS requires continuous medical care from childhood through adulthood. Recently, DS has been diagnosed by chromosome testing and genetic counseling. Clinical geneticists and genetic counselors can help patients with DS, and their caregivers, to obtain appropriate health care and achieve well-being on their own by seamlessly engaging them throughout childhood and adulthood.

J Nippon Med Sch 2023; 90: 210-219

Keywords
down syndrome, obesity, hyperuricemia, multimorbidity, health services for persons with disabilities

Correspondence to
Hidehiko Miyake, Division of Clinical Genetics, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
hide3yake@nms.ac.jp

Received, October 6, 2022
Accepted, December 28, 2022