How do autistic people age — and what does it mean for their health?
Summary
Most autism research has focused on children and adolescents, leaving major gaps in understanding how autistic people fare in midlife and old age. The number of older autistic adults is rising — partly because of wider awareness and diagnostic changes — yet studies that include people over 50 are scarce.
Existing health-record and survey studies suggest older autistic adults have higher rates of several physical and neurological conditions (including Parkinson’s-like symptoms, dementia, heart disease, osteoporosis, mood disorders, epilepsy and gastrointestinal issues). However, findings are complicated by factors such as undiagnosed older cohorts, lifelong medication use, intellectual disability prevalence in some datasets and heterogeneity within autistic populations.
Brain-imaging and longitudinal work offer mixed results: some networks show less age-related decline in autistic people and possible compensatory mechanisms, while other individuals display accelerated memory or motor decline. Researchers call for targeted inclusion of autistic people in ageing studies, better recruitment strategies, longitudinal cohorts and health services tailored to their needs.
Key Points
- The population of autistic people aged 70+ has grown substantially and is expected to continue rising over the next decades.
- Research on autism overwhelmingly targets children; studies including people in midlife or older remain extremely limited.
- Older autistic adults show higher rates of several health conditions in electronic-health and survey data, including mood disorders, epilepsy, Parkinson’s-like symptoms and dementia, though interpretation is challenging.
- Some brain-imaging studies suggest autistic brains may not show accelerated ageing on certain measures, and some people show stable cognitive function — but there is great heterogeneity.
- Long-term effects of psychotropic medications, diagnostic biases, and a large undiagnosed older cohort complicate understanding of genuine ageing-related risks.
- Researchers urge inclusion of autistic people in ageing research, longitudinal studies, and healthcare planning that addresses distinct needs across later life.
Content summary
Autism was historically identified and studied as a childhood condition; diagnostic criteria evolved slowly and only fairly recently allowed adult diagnoses, leaving a “lost generation” of undiagnosed older adults. Surveys estimate high rates of undiagnosed autism in those over 50, which both hides true prevalence and makes research recruitment difficult.
Analyses of health records and large surveys point to elevated incidences of age-related conditions among autistic adults, including neurological and cardiometabolic disorders. Some genetic links (for example between autism-associated variants and Parkinson’s-related genes) and lifetime exposure to psychotropic medications may contribute, but disentangling lifelong neurodevelopmental differences from ageing processes is challenging.
Neuroimaging and behavioural studies offer a nuanced picture: while some measures show less age-related change in autistic adults (suggesting possible resilience or different ageing trajectories), other individuals exhibit accelerated declines in memory or motor function. Overall, heterogeneity is a dominant theme — not all autistic people age the same way.
Context and relevance
This article highlights an urgent blind spot in clinical research and public health. As populations age and more adults receive autism diagnoses, understanding specific health trajectories becomes important for clinicians, gerontologists, policymakers and carers. The findings touch on trends in diagnostic practice, the need for inclusive longitudinal cohorts, and the design of services (physical, mental-health and social care) that account for sensory, communication and cognitive differences in later life.
Author style
Punchy: This Nature feature is a crisp wake-up call — the ageing of autistic populations is not hypothetical. The piece pulls together large-record studies, neuroimaging work and expert testimony to show both worrying signals (higher rates of dementia-like and Parkinson’s-like diagnoses) and surprising positives (areas of apparent neural resilience). Read the detail if you work in health policy, geriatrics, neurology or autism support — the nuances matter for service design and future research priorities.
Why should I read this?
Quick and honest: if you care about the future health of autistic people (as a clinician, carer, researcher or autistic person), this saves you a lot of digging. It explains where evidence is solid, where it’s thin, and what needs fixing — more studies, smarter recruitment, and better health services. In short: it tells you what we know, what we don’t, and why that gap is a problem now.