Our Children's "Golden Years"

Article excerpt

If I could be granted one wish for my children, it would be that they enjoy long and happy lives, a wish I'm sure other parents share. The "miracles" of modern medicine, together with public health policies based on sound science, have helped to make this more achievable than ever before. I remember my grandparents thinking they had lived a long life in their late 60s, a huge contrast with today's attitude of "60 being the new 40." People commonly expect to stay active well into their 80s, and while it may be hard to believe, people over 100 make up the fastest growing segment of our population. Thankfully, these impressive increases in longevity have also benefited people with developmental disabilities (DD), most of whom can now expect to live just as long as their non-disabled peers.

Despite these advances, some causes of DD are still associated with reduced life expectancy. For conditions like the infantile form of Tay-Sachs, survival continues to be limited to early childhood, but thankfully, these conditions are quite rare. Other conditions, such as Down syndrome, have less severe but very real impacts on longevity. Despite the fact that aging with Down syndrome seems to be accelerated in some ways, survival well into adulthood has now become the rule rather than the exception, and an increasing number of individuals are reaching their 60s and 70s. This is an amazing advance from just two generations ago. A baby born in the 1940s with Down syndrome had less than a 50 percent chance of reaching 5 years of age, while babies born today should still be blowing out the candles on their birthday cakes 60 years from now.

Naturally, this increased longevity is a great blessing, and parents now have access to new and expanding supports that enhance the quality of life for both their children and themselves. However, increased longevity raises some new concerns for parents of children with developmental disabilities as they look to the future. Sons and daughters will be transitioning through the many stages of a long life, and concerns related to aging during "the senior years" are a potential source of anxiety. Fortunately, the topic of aging, broadly considered, has been attracting considerable interest within the field of intellectual and developmental disabilities, and investments in research have been steadily increasing relevant knowledge since the 1980s. Nevertheless, aging is a very complicated process, especially when it comes to changes in brain functioning, and it will be many years before we can explain all the "hows" and "whys" that shape our abilities and health as the decades pass. However, we have already learned some information that should be helpful for parents as they plan a richer life for their children.

One major area of concern has to do with declines in abilities with advancing age. There is broad recognition that, as we all age, some abilities decline, (but not necessarily all and not at the same rate for everyone). For people with pre-existing impairments, the functional impacts of these additional declines could be more severe. This parallels the more general concern about the increasing numbers of elderly adults with Alzheimer's disease, the most frequent cause of dementia in old age. Risk for Alzheimer's disease and other prevalent causes of aging-related dementia increases rapidly beginning in the early 70s, and it's natural to wonder if risk is affected by the presence of DD.

This is the question my colleagues and I (as well as other scientists) have been trying to answer for the past 20 years, and the short answer is, "It depends." For most people with intellectual impairment, their pre-existing disability does not seem to influence risk for dementia or, for that matter, the broader effects of aging on health status. Aging for them appears to be, biologically speaking, essentially the same as it is for everyone else. Of course, lifelong health concerns differ from person to person, and supports need to be developed to address individual needs. …