Multimorbidity patterns and subgroups among autistic adults with intellectual disability: Results from the EFAAR study.
Among autistic adults with ID, immune-gut and nerve-joint illnesses travel together, so screen in clusters, not one by one.
01Research in Context
What this study did
Miot et al. (2023) looked at 63 adults who have both autism and intellectual disability.
The team listed every long-term medical or psychiatric condition each person had.
They used cluster math to see which illnesses show up together in the same adults.
What they found
Four clear illness groups appeared.
One group paired immune and gut problems.
Another group linked nerve pain and joint trouble.
These patterns mean doctors can watch for sets of problems, not just single ones.
How this fits with other research
Austin et al. (2015) already showed that adults with ASD plus ID carry more health problems across eight areas. The new study sorts those problems into tidy bundles.
Kaiser et al. (2022) pooled many studies and found that autistic people get inflammatory bowel disease more often. The gut-immune cluster in the target paper matches that finding.
Etyemez et al. (2022) saw fewer behavior or mood diagnoses in autistic children who also have ID. The adult study sees high neuro-psychiatric illness. Age explains the gap: kids vs grown-ups.
Why it matters
You can add a quick cluster checklist to intake forms. Circle immune-gut or neuro-joint red flags. Share the list with the person’s doctor so tests happen early. Better tracking can cut crisis visits and keep day programs running smoothly.
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02At a glance
03Original abstract
Multimorbidity relates to having multiple chronic health conditions. It is a risk factor for poor health and reduces life expectancy. Autistic people have multiple chronic health conditions and die prematurely, especially if they have an intellectual disability (autism spectrum disorder and intellectual disability). Certain pathophysiological processes observed in autism spectrum disorder are common to those related to the genesis and/or maintenance of multimorbidity. Furthermore, multimorbidity could be helpful in better identifying patient subgroups in autism spectrum disorder. It is therefore essential to better characterize multimorbidity and its consequences in the subgroup of autism spectrum disorder + intellectual disability individuals to offer them personalized care. We conducted a preliminary study of 63 autism spectrum disorder + intellectual disability adults to classify them according to their multimorbidity and search for a specific combination of chronic health conditions. We observed high and early multimorbidity in this sample and identified four classes of participants, distinguished by their multimorbidity status, independence and number of treatments. In addition, we observed a dominant combination of multimorbidity in our sample, combining immune dysfunction and gastrointestinal disorders, neurological and joint diseases. These findings support the hypothesis that an altered gut-brain relationship is involved in the risk of autism spectrum disorder, its outcome, and its association with chronic health conditions. Although larger studies are needed, our results suggest that subgroups of autism spectrum disorder + intellectual disability individuals can be identified based on their multimorbidity and potentially different ageing trajectories. A more comprehensive and personalized approach is needed to reduce the burden of multimorbidity and increase the quality of life and life expectancy in autism spectrum disorder/ intellectual disability.
Autism : the international journal of research and practice, 2023 · doi:10.1177/13623613221121623