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News

Autism features may be more severe in old age

by ,  /  18 October 2016
fzant / iStock

If you mention autism to most people, they will think about children, but it is a lifelong diagnosis. Children with autism grow up to be adults with autism. Little is known about how the condition’s features change with age. This is because autism is a relatively new condition, first described in 1943 and not regularly identified until the 1970s. It is only now that those people first diagnosed are reaching older age that we can start to learn whether the condition changes over a lifetime.

There have been some suggestions that autism features may reduce as people get older. These reports, describing fewer difficulties with older age, are often from people with autism themselves and from their families. But how much evidence is there for this? Our latest research provides some answers, and also raises some new questions.
theConversation-logo The Conversation

Working with the Autism Diagnostic Research Centre in Southampton, United Kingdom, we assessed 146 adults who were referred to the center seeking a diagnosis of autism between 2008 and 2015, and who consented to take part in the research. People were between 18 and 74 years old. A hundred of these adults were diagnosed with autism, and 46 people did not receive a diagnosis. This gave us an opportunity to explore the subtle differences between people who receive a diagnosis and those who don’t, even though they may have some other similar difficulties.

Our analysis showed that age and severity of autism are linked; that is, as age increases so does the severity of autism traits in social situations, communication and flexible thinking (such as coping with change or generating new ideas or solutions). We also found that older people with autism are more likely than younger people to extract rules from situations or prefer structure (for example, wanting to know how committees are organized or always following the same routine during a task).

This pattern did not occur in the group of 46 people without autism. Whether this tendency to extract rules is a ‘worsening’ of autism features or a general trend among all older people is not yet clear.

Strategies for life:

It may seem surprising that people who received a diagnosis much later in life had more severe features, as we might expect people with severe features to be more likely to seek a diagnosis earlier in life. What we found was that the older adults with autism performed better than the young adults with autism on some cognitive tests we carried out. The group diagnosed with autism was faster on tests measuring speed of thinking during a task and did better when dealing with visual and shape information. Perhaps these abilities have helped adults with autism develop strategies across their lives that have helped them to cope with their difficulties, which may explain why they were not diagnosed until adulthood.

When the group with autism was compared with the group without autism, we found that rates of depression and anxiety were high in both groups. A third of adults diagnosed with autism report high levels of depression or anxiety — rates much higher than in the general population. Depression among older adults is a risk factor for developing problems in memory and cognition. Given the high rates of depression among people with autism, it may be important for doctors to monitor mood during aging to ensure that individuals are not at risk for cognitive decline due to depression.

The people described in our research are not typical of people with autism. They all had cognitive abilities in the normal range and did not receive a diagnosis in childhood when autism is most often recognized. Despite this, older people in the study showed more severe features of autism. This might suggest that autism features become more severe with age. However, reporting more autism-related problems could also reflect a change in self-awareness. Better self-awareness is generally a good thing, but it might lead to greater realization of one’s own difficulties.

It isn’t yet clear whether people with autism age in the same way as people without autism — it’s still early days, given the relative age of the condition. Aging may also be different for each person with autism. People with autism may have developed strategies to help them age better, or may be at risk for depression and cognitive decline. In future work, we aim to see people every few years so we can understand how they change over time.

We all deserve to age as well as we can. It’s only by understanding how people with autism change as they get older, that we can start to put services in place to support them.

Rebecca Ann Charlton is senior lecturer at Goldsmiths, University of London.

This article was originally published on The Conversation. It has been slightly modified to reflect Spectrum’s style.  


  • Randy

    It’s time to retire the phrase “with autism”. I am 54 years old and I don’t “have autism”. I’m Autistic. It’s nothing that needs distancing from. It is a naturally occurring variant of the human species. Your person first language perpetuates that we are less than the norm. Plus, it makes your writing really clunky and lacking in flow. Other than that criticism, it’s a valuable article…

    • Adrienne

      Thank you! I couldn’t agree more! I’m an autistic 18 year old, and I’m tired of reading about people “with autism.” I’m not a person “with shortness,” I’m a short person! Person-first language can’t fall out of fashion soon enough, in my opinion.

    • Velocitor

      I find that annoying too. I try to explain it by saying that I don’t have a car “with Honda”; I have a Honda. You can’t take the “Honda-ness” out of it, because it’s in every part.

  • Zoran Bekric

    for example, wanting to know how committees are organized or always following the same routine during a task

    Alternate explanations:

    As you get older your tolerance for bullshit slowly gets worn away and you get tired of people routinely changing the way something like a committee is organized to favor themselves. So you would like them to commit to a set of rules and abide by them. It doesn’t help — the capacity of hypocrites to find new bits of sophistry to justify screwing over other people is endless — but it does put an extra hurdle in their paths and, one hopes, slows them down a little.

    As for routines — when you find a way of doing something that works and reliably produces the results you want, I really don’t see any good reason to change it. Perhaps the fact that the non-autistics keep finding new and different ways of doing the same task indicates some form of memory impairment, so they end up wasting cognitive resources on continually solving the same problems over and over and over again.

    Oh, and I’m with Randy. I don’t “have autism” either. I’m autistic. Isn’t it time to stop this patronising nonsense.

    • carrie

      Zoran—-the horror is aging is that we will be forced to make changes. See my post. I had an accident and a mass which had to be addressed. I was not able to do it. The accident stopped everything that i ever did to cope with my autism. I have regressed to about age 12 with all the tempers and fears and yet all the fears of knowing I will soon be abandonned when my care givers, my parents, die. Aging with autism can be good if Fate is kind and treats you well…..but if you get sick? You can’t do the routines you need more than ever? Then what?

  • Kit Albrecht

    Given the nature of the Systemizing Quotient, it seems inappropriate to refer to increasing scores on it as ‘worsening’ of anything. The only test items that factor into the final score ask how interested the test taker is in different types of systems, or how confident they feel in their knowledge. The test items that directly reflect on social difficulties someone might have are filler questions.

    Higher scores on the systemizing quotient just mean that someone is interested in or has learned a lot about how different things in the world work. In some ways, higher scores actually indicate *less* restricted interests. If someone taking the test were exclusively interested in geology, they might mark “definitely agree” on “When I look at a mountain, I think about how precisely it was formed” and “I am interested in knowing the path a river takes from its source to the sea,” and “definitely disagree” to “I do not tend to watch science documentaries on television or read articles about science and nature,” but find few other test items applicable. Someone with more diverse interests in electronics, art, and economics could actually get a higher score. And, since it takes time to acquire knowledge of all these different systems, of course people are likely to get higher scores as they get older.

    This is a striking example of the truly bizarre places that assuming things linked to autism are by default bad leads to.

  • mishspaz

    It’s actually rather simple. They grew up in a different times. Parents were strict. Routine. It probably helped many who would have been diagnosed with Aspergers. But the stories I’ve heard about my dad? If Asperger had the chance to see him, he totally would have been diagnosed, but Kanner would not have diagnosed him. In any case, knowing what I know now as an Autistic woman (diagnosed late at 35) and my other undiagnosed family members, and my son who was diagnosed at 22 months old… My mom pretty much says my dad is too old to care anymore. She jokes he’s getting more Autistic as age related maladies set in. But she knows he was always Autistic (hell, they fell in love because she adored his weirdness and offbeat sense of humor). But I get it. After a lifetime of attempting to fit in (mimicry is common with autistic women) when I’m stressed, those blending and coping skills get shot to poop. Not much of a stretch for an older Autistic person.

  • piratepat

    what happens to Autistic people when they get old? jerobisn.blogspot.com, a good short piece on the elderly Autistic . .this actually happened to me, I was mistakenly diagnosed with Parkinsons as are a lot of autistic elderly, seems that Autism’s traits in elderly become exaggerated, hence the mistake.

    • Kelvin

      Blog not found.

  • carrie

    I am aging with autism. I had a car accident and a mass on my breast, same year. I was not able to get the biopsy. I also needed an endoscopy. The car accident so effected my daily routine and my ability to soothe myself and do my special interests (head injury) and could not even eat and I already had food problems. I tried to end my life but was not successful . When my parents die, I fear I wll try again. I cannot do medical stuff and if I get sick, I will end my life. We are forgotten and no one will care if I die. No one will take the place of my parents. When I am happy, I think of my 3 kids, all grown up. I am so so lucky to have them! I want to be here so badly! But getting old with this is not possible. I cannot even go to a dr and many of my accident injuries are still troubling me. My kids—-They may care for me, yes, but they cannot help me when I have to go running and I am hooked up after a heart attack to many wires, as happened to my dad. I hate that we have been so neglected by our world and as we age, we are going to be such trouble and cost so much if we don’t end our lives. But the world really asked for it. Did they think we were just going to go away?

    • Claire Cameron

      Hello. We would like to share these free and confidential resources with you.

      National Suicide Prevention Lifeline: 1-800-273-8255.
      This number operates 24/7 in the United States and is toll-free.
      The National Suicide Prevention Lifeline also has an online chat service, which is available here: http://chat.suicidepreventionlifeline.org/GetHelp/LifelineChat.aspx

      This is a list of other state-by-state and international crisis hotlines: http://www.suicide.org/suicide-hotlines.html

      This is the number for a text service which also operates 24-hours every day and is toll-free in the U.S.:
      Crisis Textline: Text “GO” to 741741.

      If you are in the U.K. or Ireland, the Samaritans’ free and confidential crisis hotline number is 116-123

      • carrie

        Nice of you to post what you must know I have already memorized. NTs will never understand us if you think a suicide number will stop people who have lived with autism for decades to suddenly….what? Get a job? Be more lovable? Be more socially interactive? Have enough money to live? Stop mixing up High Functioners with Low functioners. We are well aware of what we are facing and it’s insulting you would think after decades I would not know these telephone numbers? Sorry. If you want to stop the flood of autistic suicides, you have to provide ways for them to live. NEW STUDY:
        http://www.nhs.uk/news/2016/03March/Pages/People-with-autism-are-dying-younger-warns-study.aspx

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