Causes of mortality among adults with Down syndrome before and after the COVID-19 pandemic in Spain.
COVID vaccination slashed deaths in Spanish adults with Down syndrome, and heavy psychotropic drug use emerged as a new mortality risk.
01Research in Context
What this study did
Sánchez Moreno et al. (2024) tracked what kills Spanish adults with Down syndrome. They compared deaths before and after COVID-19 arrived. The team looked at medical records to spot any new risks that showed up during the pandemic.
What they found
Lung infections stayed the number-one killer both before and after COVID-19. Adults who got the COVID vaccine were far less likely to die. After the pandemic, heavy use of psychotropic medicines also showed up as a new death risk.
How this fits with other research
Lineberry et al. (2023) asked families why they got the shot. Doctor trust and clear facts drove higher uptake. Their survey extends the Spanish finding: good information saves lives by getting needles into arms.
Ingham et al. (1992) gave hepatitis B shots to preschoolers with Down syndrome. Every child made strong antibodies. That early proof of robust vaccine response foreshadows why COVID vaccines worked so well for Spanish adults.
Higgins et al. (2021) counted high anticholinergic loads in Scottish adults with ID. Their drug-burden paper supports the Spanish warning: psychotropic meds need close watch because they can tip the scale toward death.
Why it matters
Keep every adult with Down syndrome on the fast-track list for future COVID boosters. One shot cut deaths sharply. At the same time, audit psychotropic prescriptions each quarter. If a client is on multiple mood or seizure drugs, ask the doctor whether doses can drop. These two moves—vaccinate and deprescribe—take minutes but add years.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Check your caseload: if an adult with DS lacks a COVID booster, call the doctor today to schedule it.
02At a glance
03Original abstract
BACKGROUND: The life expectancy of people with Down syndrome (DS) is limited by Alzheimer's disease (AD)-related deaths, mainly due to respiratory infections. The emergence of the COVID-19 pandemic could have changed known, past trends in mortality in this population. We analysed the differences in causes of mortality between individuals with DS deceased before and after the onset of the pandemic. METHOD: This is a cross-sectional study of adults with DS recruited at a tertiary, university outpatient clinic in Madrid, Spain. Demographic and clinical data were retrospectively collected from their medical records, including information on their deaths, if any. RESULTS: Five hundred seventy-two adults were included in the study, and 67 (11.7%) died. The main cause of death was respiratory infections, which occurred in 36 participants [9 (45.0%) before, and 27 (58.7%) after the appearance of COVID-19]. No significant differences were found in the determinants of pre-pandemic and post-pandemic death after adjusting for age and AD, except for an association between the use of psychotropic medication and death in the post-pandemic period (odds ratio: 2.24; 95% confidence interval: 1.04-4.82). Vaccination against COVID-19 showed a marked protective effect against mortality (odds ratio: 0.0002; 95% confidence interval: 6.7e10-6 to 0.004). CONCLUSIONS: The appearance of COVID-19 has not impacted the overall trend of increase in mean age of death of adults with DS in our milieu, probably thanks to the very important protective effect of vaccination, which supports prioritising people with DS in future immunisation campaigns. The association between psychotropic medication use and mortality requires further exploration.
Journal of intellectual disability research : JIDR, 2024 · doi:10.1111/jir.13096