Tuesday, 20 December 2011 19:42

Down Syndrome Health Care Guidelines: Adulthood

(Based on 1999 Down Syndrome Health Care Guidelines) Adulthood
  • TSH and T4-Thyroid Function Test (annual).
  • Auditory testing (every 2 years).
  • Cervical spine x-rays (as needed for sports); check for atlanto-axial dislocation.
  • Ophthalmologic exam, looking especially for keratoconus & cataracts (every 2 years).
  • Clinical evaluation of the heart to rule out mitral/aortic valve problems.
  • Baseline Mammography (40 years; follow up every other year until 50, then annual).
  • Pap smear and pelvic exam (every 1-3 yrs. after first intercourse). If not sexually active, single finger bimanual exam with finger-directed cytology exam. If unable to perform, screen pelvic ultrasound (every 2-3 years). Breast exam (annually).
  • General physical/neurological exam. Routine adult care.
  • Clinical evaluation for sleep apnea.
  • Low calorie, high-fiber diet. Regular exercise. Monitor for obesity.
  • Health, abuse-prevention and sexuality education. Smoking, drug and alcohol education.
  • Clinical evaluation of functional abilities (consider accelerated aging); monitor loss of independent living skills.
  • Neurological referral for early symptoms of dementia: decline in function, memory loss, ataxia, seizures and incontinence of urine and/or stool.
  • Monitor for behaviour/emotional/mental health. Psych referral (as needed).
  • Continue speech and language therapy (as indicated).