Date Published: March 11, 2020
Autism is a life-long condition. But autistic adults have been studied much less often than autistic children. Scientists and doctors know very little about how autism affects people later in life, especially people age 50 and older. More accurate information on medical and other problems faced by this group would help to direct support and services to areas where it is most urgently needed.
A new study of almost 3,000 autistic adults found that more than two-thirds have psychiatric issues. The most common were anxiety and ADHD, which were both reported in about 4 in 10 participants. This is higher than the general population in the United States, in which about 3 in 10 have anxiety and less than 1 in 10 have ADHD.
The study used data from SPARK, a large online research partnership funded by the Simons Foundation Autism Research Initiative. SPARK has enrolled tens of thousands of people who have autism, providing an opportunity to study a much larger group of autistic adults than has been possible before.
People who enroll in SPARK fill out online surveys, including information on medical and psychiatric diagnoses, language skills, and intellectual and developmental disability. Scientists can use this resource to address a variety of research questions.
The new study focused on legally-dependent adults, meaning those with a caregiver. “Dependent adults have been too rarely studied,” says Eric Fombonne, a psychiatrist at Oregon Health and Science University who led the study. “We had a wide age range, from 18 to over 70, which allowed us to examine how autism symptoms and needs have changed with age.”
Almost half of participants in the study had intellectual disability. Almost a third had very limited language as adults. About 4 in 10 had sleep issues, and 3 in 10 had eating problems. More than 2 in 10 had motor delays, and fewer than 2 in 10 had a history of seizures. The study was published in the Journal of Autism and Developmental Disorders in February.
About 20 percent of the people in the study — or 2 in 10 — were female. Researchers found that women and older people were more likely to have both psychiatric and medical issues.
Participants who had language issues were less likely to have psychiatric issues. However, researchers say that people in this group may have difficulty communicating their symptoms, making it a challenge to diagnose these issues. “Far from meaning that they are less vulnerable to mental health issues, it means that mental health problems go undetected among this group, suggesting that their medical care is inadequate,” Fombonne says. “For them, and their parents with whom they often live, this issue must be urgently tackled by adult health care providers.” Fombonne says that providers need more training to detect, diagnose, and manage mental health issues in people who have autism, especially those with serious language limitations.
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Fombonne E. et al. J. Autism Dev. Disord. (2020) PubMed