Heather Bloom hasn't been seen or heard from since 2005.
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ABC7 News has learned the woman's only caregiver may have also moved out of the country.
Bloom is a dependent adult last seen living at an apartment complex on Parker Street in Berkeley. Police say Bloom and her mother visited from Brooklyn, but then she stayed with her sister Shari when their mom returned to New York.
"I guess she must be hiding her or something because we never saw her. Never," said Berkeley resident Abby Telda.
Bloom would now be 40 years old. Her mom reported her missing in 2009. Police say she has down syndrome and requires daily medication and care.
"Our hope is that she's being cared for at a medical facility and that somebody working at that medical facility see the picture and comes forward," said Sgt. Andrew Frankel of the Berkeley Police.
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Shari moved in 2007. ABC7 News spoke with the landlord of her building and says he never saw Bloom. He evicted Shari after about a year because he says she owed anywhere from $13 to $14,000 in missed rent.
ABC7 News tracked down Shari to a former employer in El Cerrito. They say she left about a year ago, moving to Norway on a student Visa.
Our attempts to reach Shari via email and phone have been unsuccessful. Anyone who may recognize Bloom is asked to call the police.
You can reach Berkeley Police at (510) 981-5900.