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Background: Down syndrome (DS) is associated with variable intellectual disability and multiple health and psychiatric comorbidities. The impact of such comorbidities on cognitive outcomes is unknown. We aimed to describe patterns of physical health and psychiatric comorbidity prevalence, and receptive language ability, in DS across the lifespan, and determine relationships with cognitive outcomes. Methods: Detailed medical histories were collected and cognitive abilities measured using standardised tests for 602 individuals with DS from England and Wales (age range 3 months to 73 years). Differences in prevalence rates between age groups and between males and females were determined using chi-squared or Fisher’s exact tests. In adults, rates for psychiatric comorbidities were compared to expected population rates using standardised morbidity ratios (SMRs). Adapted ANCOVA functions were constructed to explore age and sex associations with receptive language ability across the lifespan, and regression analyses were performed to determine whether the presence of health comorbidities or physical phenotypes predicted cognitive abilities. Results: Multiple comorbidities showed prevalence differences across the lifespan, though there were few sex differences. In adults, SMRs were increased in males and decreased in females with DS for schizophrenia, bipolar disorder, and anxiety. Further, SMRs were increased in both males and females with DS for dementia, autism, ADHD, and depression, with differences more pronounced in females for dementia and autism, and in males for depression. Across the lifespan, receptive language abilities increasingly deviated from age-typical levels, and males scored poorer than females. Only autism and epilepsy were associated with poorer cognitive ability in those aged 16–35 years, with no relationships for physical health comorbidities, including congenital heart defects. Conclusions: Our results indicate the prevalence of multiple comorbidities varies across the lifespan in DS, and in adults, rates for psychiatric comorbidities show different patterns for males and females relative to expected population rates. Further, most health comorbidities are not associated with poorer cognitive outcomes in DS, apart from autism and epilepsy. It is essential for clinicians to consider such differences to provide appropriate care and treatment for those with DS and to provide prognostic information relating to cognitive outcomes in those with comorbidities.

Two decades of effort have been poured into both single-dish and interferometric millimeter-wave surveys of the sky to infer the volume density of dusty star-forming galaxies (DSFGs, with SFR>100M$_\odot$ yr$^{-1}$) over cosmic time. Though obscured galaxies dominate cosmic star-formation near its peak at $z\sim2$, the contribution of such heavily obscured galaxies to cosmic star-formation is unknown beyond $z\sim2.5$ in contrast to the well-studied population of Lyman-break galaxies (LBGs) studied through deep, space- and ground-based pencil beam surveys in the near-infrared. Unlocking the volume density of DSFGs beyond $z>3$, particularly within the first 1 Gyr after the Big Bang is critical to resolving key open questions about early Universe galaxy formation: (1) What is the integrated star-formation rate density of the Universe in the first few Gyr and how is it distributed among low-mass galaxies (e.g. Lyman-break galaxies) and high-mass galaxies (e.g. DSFGs and quasar host galaxies)? (2) How and where do the first massive galaxies assemble? (3) What can the most extreme DSFGs teach us about the mechanisms of dust production (e.g. supernovae, AGB stars, grain growth in the ISM), Concept Paper submitted to Astro2020