Self-reported cognitive decline among middle and older age autistic adults.
One quick dementia-risk screener shows thirty percent of middle-aged and older autistic adults already feel cognitive slips.
01Research in Context
What this study did
The team asked middle-aged and older autistic adults to fill out the AD8. This is an eight-question yes/no form about memory and thinking slips.
They wanted to see how many would screen positive for early dementia signs. They also checked if the AD8 scores matched other thinking tests.
What they found
Three out of ten participants scored in the risk range on the AD8. The screener lined up well with longer thinking tests, so it appears to work.
How this fits with other research
Taşkıran et al. (2021) already showed the MoCA-NL beats the MMSE when screening autistic adults. The new study adds the quick AD8 to the toolbox.
Spriggs et al. (2016) saw that older autistic adults complain about executive problems even when lab tests look fine. The AD8 results echo this gap: people feel decline before tests catch it.
Nah et al. (2018) used a two-minute mood screener and found about 40% of autistic adults flagged anxiety or depression. The AD8 now shows a similar share flagging memory worries, so brief screeners keep revealing hidden needs.
Why it matters
If you serve adults over 40 with autism, add the AD8 to your intake packet. It takes one minute and spots the third who may need a fuller memory work-up. Pair it with the MoCA-NL when scores are high and plan extra support time, because subjective reports often run ahead of test scores.
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02At a glance
03Original abstract
Very little is known about autistic adults as they age. Early evidence suggests a potentially high risk for dementia and atypical cognitive decline in autistic middle and older age adults. Research in the general population indicates that self-reported cognitive decline may predict future dementia earlier than performance-based measures. Nevertheless, self-report dementia screeners have not been used to date in autism research. In a sample of middle and older age autistic adults (N = 210), participants completed a self-rated dementia screener, the AD8, to describe the rate of cognitive decline, examine associations of cognitive decline with age, educational level, sex designated at birth, and autistic traits, and document the psychometrics of a dementia screener in autistic adults. We found high rates of cognitive decline with 30% of the sample screening positive. The most common symptoms were declining interest in leisure activities, and increases in everyday problems with thinking, memory, and judgment. There was evidence that autistic individuals designated female at birth may be more vulnerable to cognitive decline than autistic individuals designated male at birth. Notably, reports of cognitive decline did not vary by age or educational level. Modestly elevated autistic traits were found in those screening positive versus negative for cognitive decline. Finally, the dementia screener showed good psychometrics, including convergent validity with an independent measure of current memory problems. These results could signal an emerging public health crisis in autistic adults as they age, and support the potential utility of self-report measures for early screening for cognitive decline in this population.
Autism research : official journal of the International Society for Autism Research, 2023 · doi:10.1002/aur.2877