Prevalence of selected clinical problems in older adults with autism and intellectual disability

Abstract

BackgroundOriginally described as a disorder of childhood, evidence now demonstrates the lifelong nature of autism spectrum disorder (ASD). Despite the increase of the population over age 65, older adults with ASD remain a scarcely explored subpopulation. This study set out to investigate the prevalence of clinically relevant behaviors and medical problems in a sample of US adults aged 30 to 59 with ASD and intellectual disability (ID), in comparison to those with ID only.MethodsA cross-sectional study, with both an exploratory and replication analysis, was conducted using National Core Indicators (NCI) multi-state surveys from 2009 to 2010 and 2010 to 2011. There were 4,989 and 4,261 adults aged 30–59 with ID examined from the 2009 to 2010 and 2010 to 2011 samples, respectively. The two consecutive annual samples consisted of 438 (9%) and 298 (7%) individuals with ASD and ID. Variables were chosen from the NCI data as outcomes, including medication use for behavior problems, severe or aggressive behavior problems and selected medical conditions.ResultsNo age-associated disparities were observed between adults with ASD and ID versus adults with ID only in either sample. For the 2009 to 2010 sample, the prevalence of support needed to manage self-injurious, disruptive and destructive behavior in subjects with ASD and ID ranged from 40 to 60%. Similarly, the prevalence estimates of self-injurious, disruptive and destructive behavior were each almost double in adults with ASD and ID relative to those with ID only. These results were replicated in the 2010 to 2011 sample.ConclusionsThe findings of this study highlight the urgent need for research on the nature and treatment of severe behavior problems in the rapidly increasing population of older adults with ASD. They also suggest the importance of developing policies that expand our capacity to care for these individuals.

Autism Spectrum Disorder: Defining Dimensions and Subgroups

“…Recent investigations have found that up to sixty percent of adults with ASD and an intellectual disability present with difficult-to-manage behaviors, including self-injurious, disruptive, and destructive behaviors. [82]. In addition, a significant number of very young children present with difficult-to-manage behaviors, whereas oppositional and defiant behaviors can occur in children and adolescents [83–86].…”

“…With regard to the educational setting, cognitive ability and/or level of academic achievement, as well as severity of externalizing behavioral symptoms, may guide placements [119]. In comparison, adult-oriented treatment research may focus on subgroups of varying cognitive abilities or may focus on dividing groups according to adaptive behavior skills and the level of support required for managing day-to-day life [82, 120]. …”

High rates of parkinsonism in adults with autism

“…Autism spectrum disorder (ASD) is defined by the presence of characteristic behaviors present in early childhood [ 1 ]. While it is now recognized that ASD is typically a life-long condition, there exist only a handful of systematic studies of middle-aged and older adults [ 2 – 4 ]. According to the most recent estimate from the Centers for Disease Control (CDC), the prevalence of ASDs in US children is approximately 1.5 % [ 5 ].…”

Residential Care for Older Autistic Adults: Insights from Three Multiexpert Summits

“…[14][15][16][17] These conditions may lead to poorer well-being and impact on a person's ability to live independently. 18,19 Similarly, autistic people experience high levels of loneliness and isolation, which are associated with poorer cognitive function in older adults in the general population. [20][21][22] These factors independently or in conjunction may lead to an increased need for autistic people to transition to residential care in later life.…”