Almost all Down's syndrome (DS) patients over the age of 35 to 40 year
s have histologic features of Alzheimer's disease (AD). However, the p
resence of extrapyramidal features in up to 36% of these patients has
no satisfactory pathologic explanation. We report an older patient wit
h DS, dementia, and parkinsonian signs who showed pathologic changes o
f Parkinson's disease and cortical Lewy bodies in addition to AD. Thes
e parkinsonian changes may be related to chromosome 21 abnormalities.