Stewart, Gavin R. Happé, Francesca
Aging Across the Autism Spectrum
2025 Annual Review of Developmental Psychology
https://doi.org/10.1146/annurev-devpsych-111323-090813
Abstract:
Aging in autistic populations is a historically neglected but now rapidly advancing area of research. This narrative review provides a broad overview of the current state of the field of aging on the autism spectrum by synthesizing and critically appraising findings from across a range of research priorities identified by autistic people and other stakeholder groups. These include (a) the trajectory of core autistic features; (b) health profiles, biological aging, and mortality; (c) influential life experiences and life outcomes (including transition periods such as retirement and menopause and events such as trauma and periods of crisis); (d) cognitive function, aging, and dementia; and (e) quality of life and social support. Where possible, empirical research focusing on diagnosed autistic people is presented, but due to very high rates of underdiagnosis of autism in this demographic, trait-based research is also considered. Research specifically focusing on midlife (i.e., 40–64 years) and older age (i.e., 65 years and older) is presented where available, but due to a dearth of such research, lifespan studies (i.e., samples including middle-aged and older people, but not differentiating them) are also discussed. This review concludes by identifying future research priorities, as well as key conceptual issues that researchers interested in the intersection of aging and autism should consider for this emerging and rapidly advancing area of research.
From the article:
This narrative review highlights that autistic people in midlife and older age likely face poorer aging outcomes than their nonautistic peers. Despite gaps in the literature, current research (using categorical and dimensional approaches) suggests that middle-aged and older people on the autism spectrum are likely to experience higher rates of physical and mental health conditions, greater health-care barriers, increased early mortality, and more challenges with life transitions. They also experience more adverse life events, more cognitive difficulties, potential dementia risk, lower quality of life, greater social isolation, and lower social support. While cohort effects and high rates of underdiagnosis may influence these findings, it is evident that aging autistic people likely require tailored support to improve their outcomes. This review identifies key areas for future research, proposing an improved conceptual framework to better integrate autism into the field of aging research. It also underscores the importance of meaningful engagement with the autistic community and stakeholders to develop effective resources for this historically underserved population.
