The Mental and Physical Health Profiles of Older Adults Who Endorse Elevated Autistic Traits

Abstract

Objective The mental and physical health profile of autistic people has been studied in adolescence and adulthood, with elevated rates of most conditions being reported. However, this has been little studied taking a dimensional approach to autistic traits, and in older age. Methods A total of 20,220 adults aged 50-81 years from the PROTECT study reported whether they experienced persistent socio-communicative traits characteristic of autism. Approximately 1%, 276 individuals, were identified as endorsing elevated autistic traits in childhood and currently, henceforth the ‘Autism Spectrum Trait’ (AST) group. An age and gender matched comparison group was formed of 10,495 individuals who did not endorse any autistic behavioral traits, henceforth the ‘Control Older Adults’ (COA) group. Differences between AST and COA groups were explored in self-reported psychiatric diagnoses, self-reported symptoms of current depression and anxiety, and self-reported physical health diagnoses. Associations were also examined between autistic traits and health across the whole sample. Results The AST group reported significantly elevated rates of psychiatric diagnoses compared to COAs. Additionally, the AST group showed significantly higher self-reported symptoms of current depression and anxiety than COAs. However, few differences were observed in individual physical health conditions, and no differences in total co-occurring physical diagnoses between groups. Similar associations between autistic traits and health were also found taking a dimensional approach across the whole sample. Discussion These findings suggest that older adults with elevated autistic traits may be at greater risk of poorer mental, but not physical, health in later life. Future studies should incorporate polygenic scores to elucidate the possible genetic links between propensity to autism/high autistic traits and to psychiatric conditions, and to explore whether those with elevated autistic traits experience particular barriers to mental health care.

The cognitive profile of middle‐aged and older adults with high vs. low autistic traits

“…Finally, the criteria used to identify the AST group was a short, bespoke (albeit validated) set of questions rather than a standardized measure. While the screener was found to correlate and have good cut-off overlap with widely used existing measures of autistic traits (the AQ-10, RAADS-14) in a separate validation study (Stewart et al, 2020), the questions included in this screener focus solely on socio-communicative difficulties, without items probing restrictive/repetitive behaviors or sensory problems. It is possible that participants may have scored highly on this screener for reasons other than autism-related traits; for this reason, we controlled for depression and anxiety in our analyses.…”

Traumatic life experiences and post‐traumatic stress symptoms in middle‐aged and older adults with and without autistic traits

“…Autism Spectrum Traits were measured using the PROTECT Autism Spectrum Traits questionnaire 26 . Constraints on the number of items in the PROTECT battery of questionnaires required the construction of a very short, 5‐item measure to assess childhood and current socio‐communicative traits characteristic of autism.…”

“…The prevalence of clinical PTSD among autistic adult populations has not been widely studied, but estimates suggest prevalence rates up to 17% in childhood 6,23 and 16% in adulthood, 13 while rates among older autistic adults are unknown. Elevated rates of depression (OR = 2.8−5.6) and anxiety (OR = 3.3−6.2) have also been documented in autistic populations across the lifespan, 24,25 and recently in older adults with high autistic traits 26 …”

Sleep problems and mental health difficulties in older adults who endorse high autistic traits

“…The findings of these studies suggest that sleep problems, mental health difficulties, and autistic traits are interrelated and should be studied concurrently. While autistic traits and genetic predisposition to autism have been associated with poor mental health in adult populations (Howlin, Moss, Savage, Bolton, & Rutter, 2015;Stewart, Charlton, & Wallace, 2018;Stewart et al, 2020), to the authors' knowledge, no studies have examined the relation between autistic traits and sleep problems beyond adolescence.…”