In recent years, advances in medical, surgical and nursing care have resulted in a dramatic increase in the life expectancy of children born with Down's syndrome (DS), giving rise to an older population of people with DS not previously seen. It has become clear from the study of the ageing DS population that an association exists between DS and Alzheimer's disease (AD). This paper reviews neuropathological and clinical evidence of an association between DS and AD. The clinical features of AD in people with DS and apparent differences between the signs and symptoms of AD seen in individuals with DS and older people with AD in the general population are discussed. Issues pertaining to the diagnosis of AD in people with DS, such as diagnostic criteria, the process of diagnosis, and specific problems of diagnosing AD in people with DS are also discussed. The therapeutic needs of individuals with DS who are diagnosed as having AD are considered and the necessity to strive to make the diagnostic procedure as valid as possible is expressed. The paper concludes that neuropsychological testing has an important role to play in the diagnostic process.
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