The Physical and Mental Health of Middle Aged and Older Adults on the Autism Spectrum and the Impact of Intellectual Disability.
Expect most middle-aged and older autistic clients to carry at least one serious medical condition—screen early and tailor mental-health checks by IQ level.
01Research in Context
What this study did
Lauren and her team looked at 1,507 autistic adults . They used Medicaid records to count who had epilepsy, sleep, heart, immune, mood, or anxiety problems.
They split the group by IQ. One group had autism plus intellectual disability. The other had autism alone.
What they found
More than half carried at least one extra health problem. Epilepsy hit 30 % of the ID group but only 11 % of the non-ID group.
Sleep, heart, and immune illnesses were common in both groups. Depression and anxiety showed the opposite pattern: lower rates in the ID group.
How this fits with other research
Yarar et al. (2022) asked younger autistic adults (18-25) the same questions. Younger people reported more anxiety and worse social quality of life than the 40-plus group Lauren studied. The studies together show mental-health burden may ease with age, while physical illness piles up.
Leader et al. (2021) ran a survey and also found sleep trouble in most autistic adults. Lauren’s claims data back up that survey with hard numbers and add epilepsy and heart disease to the watch list.
Nah et al. (2018) screened autistic adults without ID and saw 39-46 % reach clinical cut-offs for anxiety or depression. Lauren found lower mood-disorder rates, but her sample included many with ID. The two results look opposite until you notice who was included: pure self-report versus mixed-ID claims.
Why it matters
If you serve autistic adults over 40, screen for epilepsy, sleep, heart, and immune problems, especially when ID is present. Add depression and anxiety tools for clients without ID. Use the SF-12v2 (validated by Rahul et al. 2015) to track changes over time. Early medical referral can prevent crises and keep adults in community placements.
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02At a glance
03Original abstract
BACKGROUND: People on the autism spectrum may have more physical and mental health conditions in midlife and old age compared to the general population. This study describes the physical and mental health of a unique sample of all middle aged and older Wisconsin Medicaid beneficiaries with an autism spectrum disorder diagnosis and tests differences between those with and without co-occurring intellectual disability. METHOD: Using de-identified Medicaid claims data for 143 adults with a recorded autism spectrum disorder diagnosis aged 40-88 years with any Wisconsin Medicaid claims in 2012 through 2015, we extracted diagnoses for physical and mental health conditions from fee-for-service claims. Logistic regression analyses-controlling for sex, race, and age-compared the adjusted odds of physical and mental health conditions for those with and without intellectual disability. RESULTS: Many physical and mental health conditions, including immune conditions (70.6%), cardiovascular disease (49.0%) and its risk factors (46.2%), sleep disorders (85.3%), gastrointestinal disorders (49.7%), neurologic conditions (55.9%), and psychiatric disorders (72.0%) were highly prevalent in our full sample. Although there were many similarities between those individuals with and without co-occurring intellectual disability, middle aged and older adults on the autism spectrum had higher prevalence of epilepsy and lower prevalence of depression and anxiety compared to those without co-occurring intellectual disability. CONCLUSIONS: Findings suggest that people on the autism spectrum have a high prevalence of physical and mental health conditions in midlife and old age, regardless of intellectual disability status.
Research in autism spectrum disorders, 2019 · doi:10.1016/j.rasd.2019.01.001