Background. Mood, baseline functioning, and cognitive abilities as well as psychotropic medications may contribute to mortality in adults with and without Down Syndrome (DS). Methods. Population-based (nonclinical), community-dwelling adults with intellectual disabilities (IDs) were recruited between 1995 and 2000, assessed individually for 1–4 times, and then followed by yearly phone calls. Results. 360 participants (116 with DS and 244 without DS) were followed for an average of 12.9 years (range 0–16.1 years as of July 2011). 108 people died during the course of the followup, 65 males (31.9% of all male participants) and 43 females (27.6% of all female participants). Cox proportional hazards modeling showed that baseline practical skills, seizures, anticonvulsant use, depressive symptoms, and cognitive decline over the first six years all significantly contributed to mortality, as did a diagnosis of DS, male gender, and higher age at study entry. Analysis stratified by DS showed interesting differences in mortality predictors. Conclusion. Although adults with DS have had considerable improvements in life expectancy over time, they are still disadvantaged compared to adults with ID without DS. Recognition of potentially modifiable factors such as depression may decrease this risk. 1. Introduction Although much improvement has occurred during the last century, mortality rates in people with childhood onset intellectual disabilities (IDs) are still higher than those of the general population, especially in younger adults in their 20s and people with Down syndrome (DS) [1]. In general populations, increased age is known to be an important predictor of increased mortality, as is male gender, although some data suggests that males with DS may have a relative survival advantage [2]. In general, mortality rates are lower in community samples, although this may not be true for those with severe disabilities, whose needs may be met less well in the community [3, 4]. Also of potential significance to mortality is the Intelligence Quotient (IQ). Among people with ID, those with the most severe impairment were found in Patja et al’s cohort study (previously referenced) to have significantly lower life expectancy, whereas those with mild ID had similar life expectancy to the general population. This difference in life expectancy is likely related to increased severity of underlying medical illness in those with the greatest intellectual impairment. In the general population, excess mortality (especially due to cardiac and respiratory diseases) has been found in
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