brand logo

Am Fam Physician. 2022;105(4):436-437

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Key Points for Practice

• Assess adults with Down syndrome annually for dementia starting at 40 years of age.

• Screen adults with Down syndrome and obesity for type 2 diabetes mellitus with an A1C level every two to three years starting at 21 years of age and earlier if other diabetes risk factors are present; in adults with Down syndrome at a healthy weight, start screening at 30 years of age.

• Avoid routine cervical radiography in adults with Down syndrome unless suggested by neurologic symptoms.

• Screen adults with Down syndrome for hypothyroidism with a thyroid-stimulating hormone test every one to two years starting at 21 years of age.

From the AFP Editors

Down syndrome occurs in one of every 691 live births in the United States, making it the most common chromosomal condition and cause of developmental delay. Screening for comorbid conditions, early intervention programs, and subsequent medical management have helped increase life expectancy from 25 years in 1983 to 60 years today. In addition to mild to moderate intellectual disability, people with Down syndrome have increased risks of congenital cardiac and gastrointestinal anomalies, autoimmune disorders, leukemias, respiratory infections, sleep disorders, hearing and vision loss, and early development of dementia. People with Down syndrome often have limited expressive language skills, delayed motor skill development, and reduced executive functioning capacity. Inequitable access to care, issues of guardianship, and social stigma also contribute to the vulnerability of adults with Down syndrome.

Already a member/subscriber?  Log In


From $145
  • Immediate, unlimited access to all AFP content
  • More than 130 CME credits/year
  • AAFP app access
  • Print delivery available

Issue Access

  • Immediate, unlimited access to this issue's content
  • CME credits
  • AAFP app access
  • Print delivery available
Purchase Access:  Learn More

Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Michael J. Arnold, MD, associate medical editor.

A collection of Practice Guidelines published in AFP is available at

Continue Reading

More in AFP

More in Pubmed

Copyright © 2022 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.