Health and Aging with Autism

Contributed by Jill Matson, MSN, RN, CPNP, MiNavigator Clinical Specialist

Approximately 1 in 59 children in the US have autism according to the Center for Disease Control and Prevention. Over the next decade, it’s estimated that half a million children will enter adulthood. As the number of adults living with autism grows, so do concerns for their overall health care.
In many children with autism, a host of physical and mental health problems are also present. Such problems include seizures, obesity, anxiety and depression; and more often than not, these associated problems will accompany them into adulthood.

Statistics suggest that nearly all medical and psychiatric conditions are significantly more common in adults with autism than in adults without the disorder. In one of the first large scale studies to look at medical and psychiatric comorbidities in adults with autism, researchers at Kaiser Permanente in Oakland, California found that adults with an autism spectrum disorder had markedly higher rates of physical and mental health problems than adults without the disorder.

Medical Problems

  • Diabetes (6 percent [ASD] vs. 4 percent [general population])
  • Gastrointestinal Disorders (47 percent vs. 38 percent)
  • Epilepsy (12 percent vs. 1 percent)
  • Sleep Disorders (19 percent vs. 10 percent)
  • High Cholesterol (26 percent vs. 18 percent)
  • High Blood Pressure (27 percent vs. 19 percent)
  • Obesity (27 percent vs. 16 percent)

Mental Health Problems

  • Depression (38 percent [ASD] vs. 17 percent [general population])
  • Anxiety (39 percent vs. 18 percent)
  • Bipolar Disorder (30 percent vs. 9 percent)
  • Suicide Attempts (1.6 percent vs. 0.3 percent)

Like aging adults without autism, adults with the disorder should be screened
regularly by their primary care provider to identify and treat (through referral to a specialist, if needed) medical and psychiatric conditions commonly seen in adulthood.
This can be challenging, though, because many adults on the autism spectrum do not see their PCP regularly; and further, many don’t have one at all.

This may be due, in part, to the difficulty finding a PCP who is comfortable
examining, communicating and providing care for adults with autism. A lack of
preventative care may contribute to the number of health problems affecting more adults with autism than without.
It can be especially difficult for adults with autism to undergo more invasive health screenings like prostate and pelvic exams or colonoscopies.
Social difficulties may result in limited opportunities for regular exercise.

Restricted eating, common in individuals with autism, may result in unhealthy food choices. In addition, side effects from some of the medications commonly used to treat behavioral and mental health issues present in autism can lead to obesity, diabetes and heart disease, which are twice as likely to occur in adults with autism when compared to those without.
Notably, adults with autism are less likely to drink alcohol or smoke, possibly
because smoking and drinking are more social behaviors.
Autism is more than a brain or behavioral disorder. For many individuals, it affects the whole body resulting in physical and mental health problems across the lifespan.

The average lifespan of someone with autism was found to be half that of the
general population, which represents an average of 36 years versus 72 years is in one recent study (Guan 2017).
It’s important to note, however, that autism itself is not a cause of premature
mortality. Instead, research suggests that it relates to associated physical and
mental health conditions, most of which can be treated and managed medically.

Lisa Croen, PhD, May 15, 2014, Presentation, International Meeting for Autism Research, Atlanta. American Journal of Public Health (AJPH) May 2017. Injury Mortality in Individuals with Autism Joseph Guan BS, and Guohua Li MD, Dr. PH Author affiliations, information, and correspondence details
Accepted: January 29, 2017 | Published Online: April 11, 2017