The health status of adults on the autism spectrum.
Autistic adults face sharply higher rates of almost every major health problem and are more likely to die from them.
01Research in Context
What this study did
Boudreau et al. (2015) pulled insurance records for thousands of U.S. adults with autism. They matched each autistic adult to a non-autistic adult of the same age and sex. Then they counted every major medical and psychiatric diagnosis in both groups.
What they found
Nearly every condition was more common in the autism group. The list included diabetes, heart disease, depression, anxiety, and bipolar disorder. In short, autistic adults carried a heavier health burden across the board.
How this fits with other research
Two older studies seem to say the opposite. Tsakanikos et al. (2006) and Porter et al. (2008) both looked only at autistic adults who also have intellectual disability. After they controlled for IQ and Down syndrome, autism itself added no extra psychiatric risk. The 2015 study differs because it included autistic adults of all ability levels. The gap shows that higher-risk conditions cluster in autistic people without ID, pulling up the overall numbers.
Later work extends the warning. Akobirshoev et al. (2020) found that autistic adults are 50% more likely to die during a hospital stay, with women at nearly double risk. Tsai et al. (2023) tracked an entire country for 15 years and saw higher death rates from suicide, accidents, and natural causes. Together these papers turn the 2015 morbidity snapshot into a life-span crisis.
Why it matters
If you support autistic adults, schedule regular health screens for the big three: cardiac, metabolic, and psychiatric. Use plain-language reminders and visual checklists to boost follow-through. Flag hospital visits early—ask for autism-informed nurses and clear discharge instructions. Small care-plan edits can prevent the large risks these studies keep showing.
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02At a glance
03Original abstract
Compared to the general pediatric population, children with autism have higher rates of co-occurring medical and psychiatric illnesses, yet very little is known about the general health status of adults with autism. The objective of this study was to describe the frequency of psychiatric and medical conditions among a large, diverse, insured population of adults with autism in the United States. Participants were adult members of Kaiser Permanente Northern California enrolled from 2008 to 2012. Autism spectrum disorder cases (N = 1507) were adults with autism spectrum disorder diagnoses (International Classification of Diseases-9-Clinical Modification codes 299.0, 299.8, 299.9) recorded in medical records on at least two separate occasions. Controls (N = 15,070) were adults without any autism spectrum disorder diagnoses sampled at a 10:1 ratio and frequency matched to cases on sex and age. Adults with autism had significantly increased rates of all major psychiatric disorders including depression, anxiety, bipolar disorder, obsessive-compulsive disorder, schizophrenia, and suicide attempts. Nearly all medical conditions were significantly more common in adults with autism, including immune conditions, gastrointestinal and sleep disorders, seizure, obesity, dyslipidemia, hypertension, and diabetes. Rarer conditions, such as stroke and Parkinson's disease, were also significantly more common among adults with autism. Future research is needed to understand the social, healthcare access, and biological factors underlying these observations.
Autism : the international journal of research and practice, 2015 · doi:10.1177/1362361315577517