Autism in older adults: the health system must recognize its effects

"Emerging data suggest higher rates of heart disease, Parkinson's-like symptoms, osteoporosis and dementia in autistic adults, although intellectual disability, long-term psychotropic use and diagnosis bias can blur links. Systematic investigation is needed. Without identification and tailored screening pathways, health systems cannot anticipate risk or adapt care."

"Three priorities seem urgent. First, inclusion: autistic adults must not be excluded from ageing research, dementia studies or population-health data sets. Second, differentiation: clinicians require guidance to distinguish lifelong neurodevelopmental differences from neurodegenerative change. Third, co-production: older autistic adults should shape research agendas and service models to ensure meaningful support."

"As populations age globally, psychiatry, geriatric medicine and primary care must be prepared to take autism in older adults into account - through training, adapted assessment tools and neurodiversity-informed models of care."

Autism research disproportionately focuses on children, leaving a significant gap in understanding older autistic adults. Late autism diagnoses in older individuals provide clarity but raise concerns about unrecognized health risks. Emerging evidence indicates autistic adults experience elevated rates of cardiovascular disease, Parkinson's-like symptoms, osteoporosis, and dementia, though confounding factors like intellectual disability and medication use complicate these associations. Healthcare systems lack systematic approaches to identify and screen autistic older adults. Three urgent priorities emerge: inclusion of autistic adults in aging and dementia research; differentiation between neurodevelopmental traits and neurodegenerative changes; and co-production involving older autistic adults in shaping research and services. Healthcare providers across psychiatry, geriatrics, and primary care require training and neurodiversity-informed assessment tools.

Read at Nature