Overview

• Re-analysis of 2018 UK health records estimates underdiagnosis at 89.29% for ages 40–59 and 96.51% for ages 60+, with sex-specific rates of 91.45% (men) and 79.48% (women) in midlife and 96.29% (men) and 97.19% (women) in later life.
• The review finds middle-aged and older autistic adults have higher rates of almost all physical and mental health conditions than non-autistic peers, including anxiety, depression, cardiovascular disease and neurological disorders.
• Older adults with high autistic traits are six times more likely to experience suicidal ideation or self-harm, underscoring acute mental health risks.
• Evidence indicates a fourfold increase in early-onset dementia diagnoses and an average life expectancy of 75 years versus 81 for non-autistic people, figures the authors caution may be skewed by underdiagnosis.
• Researchers highlight barriers to appropriate healthcare such as communication differences, sensory sensitivities, continuity-of-care issues and limited clinician understanding, and call for longitudinal studies, clinician training, tailored services and expanded social supports.