Because of improved public
health policy and advances in medical care, the average life span of people in
the United States has increased dramatically; up to 74.1 years for men and 79.5
years for women. We see the same trend in people with Down syndrome, but they
still have a shorter lifespan than the general population. In recent decades, life expectancy for people with Down syndrome has more than doubled, from 25 years in 1983 to 60 years today.
it is unusual for them to reach 65 years of age.
Yang, Rasmussen, and Friedman
(2002) extracted information from the death certificates of 17,897 individuals
with Down syndrome who died in the United States between 1983 and 1997. The
median age at death increased dramatically, from 25 years in 1983 to 49 years
in 1997, or an average of 1.7 years per year studied. In contrast, the median
age of the population in general increased only .2 years per year during this
same period of time. The major causes of death in people with Down syndrome
were congenital heart defects and respiratory infections. Except for leukemia
and testicular cancer, malignancies were reported much less frequently in individuals
with Down syndrome.
general, adults with Down syndrome die sooner and of different causes than the
population at large.
The authors postulate that
the following factors contributed to the increasing life expectancy of people
with Down syndrome:
and initial placement of infants with their families
- Better treatments for
common causes of death, such as respiratory infections
- Changes in medical practice,
including more advanced and readily available surgical procedures to correct
congenital heart defects
Although the overall life
expectancy increased dramatically for adults with Down syndrome, the researchers
found that the improvement was most noticeable in whites with Down syndrome.
Blacks and people of other races had a significantly shorter lifespan than whites
with Down syndrome. The authors postulated that this discrepancy is a function
of the following:
- Socioeconomic status
- Parental education
- Community support
- Access to, use of, or
quality of preventive health care
to Yang, Rasmussen and Friedman, blacks with Down syndrome have shorter lifespans
than whites with Down syndrome because of their genetic makeup.
Quite simply, adults with Down
syndrome are live longer and healthier lives if they receive good quality preventive health
care, have adequate community support, and have the education and resources to
take care of themselves. Nurses have an obligation to ensure that their patients
have access to these basic components.
Yang, Rasmussen and Friedmans study has found racial disparity in lifespan, nurses need to be vigilant
to ensure that their patients all receive are not white. Depending on the nurses role and scope
of employment, nursing interventions may include:
- Researching and presenting
options for community supports
- Providing healthcare
information in a useable form to the patient and/or caregivers
- Facilitating the patients
access to preventive, general, and specialized health care
- Advocating for the patient
with healthcare providers, community agencies, and funding sources
- Ensuring that the patient
receives all public and private benefits to which he or she is entitled (i.e.
Medicaid, Medicare, SSI, developmental programs)
can do little to enhance the life expectancy of their adult patients with Down