Mortality in the mentally handicapped: a 50 year survey at the Stoke Park group of hospitals (1930-1980).

Mortality trends during the past 50 years in the population of a hospital group for the mentally handicapped are reported. There has been a marked change in the causes of death during this period. Whilst tuberculosis is no longer a major cause, other terminal respiratory tract infections are still prevalent. Deaths due to status epilepticus have decreased, with a concomitant increase in those due to carcinoma, myocardial infarction and cerebrovascular accident. Similarly, the mortality rate has altered significantly. Fifty years ago the patients' mortality was considerably higher at all age groups in comparison with the general population, whereas the difference is now relatively small. These changes have been most marked during the past 25 years, with the introduction of new drug therapy, better diet, care and environment for the mentally handicapped. The result of this is increased longevity in the mentally handicapped, in particular in those with Down's syndrome whose longevity has increased by 40 years, and over 30 years in others. These findings have important implications for the planning of future services for the ageíng mentally handicapped population, in hospital and in the community alike, with associated geriatric ailments, and pre-senile and senile dementias.