Abstract
The differential diagnosis between Alzheimer's disease and hypothyroidism in adults with Down syndrome who begin to show clinical deterioration needs to be emphasised. This study investigated clinical features which could be used to differentiate between the two conditions. Memory loss, mood and personality change, speech and gait deterioration, and slowing down were significantly associated with dementia but not with hypothyroidism. It is recommended that specific questions should be asked to elicit the presence of these features particularly in those individuals in whom assessment of biochemical thyroid status is not possible.

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