Autism spectrum disorder (ASD) may be a risk factor for a lower average lifespan. Autism itself is not a cause of a shortened lifespan, but conditions related to the disorder can affect mortality.
Autism & Lifespan
A March 2016 study published in the British Journal of Psychiatry documented that adults with an autism spectrum disorder who have a learning disability are 40 times more likely to have a lower average lifespan due to a neurological condition than adults in the general population who are not on the spectrum and have no learning disabilities.
Furthermore, the study found out that adults with autism who do not have a learning disability were up to nine times more likely to die by suicide than adults at similar ages who did not have autism.
In this study, people with autism spectrum disorder tended to die at age 54, which is 16 years sooner than the average age of mortality. Adults who have both autism and one or more learning disabilities died almost 30 years sooner than people who had neither, at an average age of 39.5 years old. Those with autism, but no learning disability, died at an average age of 58.
Autism & Suicidal Ideation
Past research has shown that the rates of suicidal ideation among people with ASD is much higher than in the general population.
The rates tend to be higher among girls with autism and people with milder forms of disorder.
Additionally, the Journal of Autism and Developmental Disorders writes that many people on the spectrum (children and adolescents primarily, but also adults) are victimized by bullying, sometimes on a daily basis. This often leads to the development of anxiety conditions and depressive disorders.
Those conditions, on their own, are leading factors in suicidal ideation and behavior. When combined with some of the challenges of living with autism, it significantly increases the risk factors for people with autism spectrum disorder.
Increased Stress for Autistic People
Other research has suggested that the general population tends to have better overall health than people with autism.
There are connections between autism spectrum disorder and other medical conditions, like gastrointestinal disorders and heart disease. One of the connections may be stress, resulting from discrimination and bullying because of the autism, distress from sensory overload, and alienation due to the socio-emotional and communication limitations caused by the autism.
Many people who have autism experience being in a chronic state of “fight or flight” when it comes to situations that would be considered “normal” for neurotypical individuals. Everything from having a job interview to attending a social engagement can be mentally debilitating, causing a number of physical and medical problems. Some adults struggle with stress and anxiety for the rest of their lives, even as they deal with the realities of living with autism.
Psychology Today notes that people with autism spectrum disorder are 40 times more likely to die as the result of various injuries, including but not limited to drowning, asphyxiation, and suffocation.
Children with autism between 5 and 7 years of age are at the greatest risk of dying by drowning. Given that wandering off or running away is a common occurrence with this demographic, a family with access to a body of water (anything from a swimming pool to a pond, lake, or river) will have to invest in swimming lessons and water safety precautions.
Heightened Risks for Autistic Individuals
In 2018, Sarah Kurchak penned an essay for Vox where she discussed facing mortality at age 36, “the average age when people like me die.” People with autism face challenges that neurotypical adults may never be aware of, she writes. While many might assume that those challenges end with socio-emotional language limitations, the fact that autistic people have a higher mortality rate adds to the burden.
For example, the American Journal of Public Health wrote that people with autism “appear to be at substantially heightened risk for death from injury” due to getting lost, not being able to ask for help, not being able to give their name or emergency contact information, or becoming so overstimulated that they panic and put themselves in harm’s way.
The lower-than-average lifespan for autistic people also has racial and gender overtones. Autism is a “deadly hazard when dealing with the police,” writes Forbes magazine, because of a number of cases where police officers have taken noncompliant and noncommunicative behaviors from autistic people to be signs of suspicion and, in the case of overstimulation, hostility.
In describing the story of a 15-year-old boy with Asperger’s syndrome who was killed by police, the Chicago Reader notes that “people with autism spectrum disorder are seven times more likely to encounter police” than people who have no such conditions. When the patients in question are Black, Latinx or otherwise non-white, those encounters are more likely to result in death.
Autism & ‘Medical Complexities’
Scott Wright, a researcher at the University at Utah and editor of a book about autism spectrum disorder in middle age and later life, said that the “medical complexities” of patients with autism, coupled with their limitations in language and communication, can lead to physicians, hospitals, and the health care system at large not being capable of providing the best level of care. It might be possible that patients with severe forms of autism spectrum disorder don’t even seek help for their ailments because they are overwhelmed by the awkwardness of talking with other people about themselves.
Wright suggests that a parent or a caregiver should find a specialist or a primary care physician who has training in working with autistic patients or otherwise demonstrates the necessary awareness and empathy for what the experience must be like for an autistic person. Beyond that, Wright recommended that there be more training for health care professionals so that autism can be recognized and appropriately responded to in a clinical setting.
Additionally, too many people continue to associate autism with pediatrics when in reality many people with autism spectrum disorder receive the proper diagnosis in adulthood.
Wright concluded that autism is an issue for every level of health care. It’s problematic at the pediatric level, but also at the levels of internal medicine, primary care, clinical practice, and geriatric care. It’s ultimately “a life course issue that we should all be aware of.”
For most people with autism spectrum disorder, continues Sarah Kurchak in Vox, the stress and exhaustion of living with autism are the more insidious contributors to shorter lifespans. Autistic people have to develop many different coping strategies to have a healthy life, build self-esteem, defy stereotypes, or simply make it through the day.
Autism has been connected to sleep disorders, which can cause insomnia, chronic fatigue, and a number of other physical and psychological problems, particularly when combined with the anxiety that many people on the spectrum have.
Increasing Health Factors for People With Autism
One way that this problem can be addressed is by educating parents, caregivers, and health care professionals to recognize the signs of depression in individuals with autism as early as possible while continuing to improve their social relationships and skills.
Treating social anxiety disorder (which has “partially overlapping symptoms,” according to the Journal of Autism and Developmental Disorders) can also help people manage the limitations they experience with social development and help them control their compulsion to avoid social situations, like scheduling a doctor’s appointment.
This can further teach people with autism how they can cope with the feelings of isolation and frustration that may naturally arise from having autism. If suicidal ideation occurs, they have a system in place to process those thoughts in a healthy manner and to get support.
Bullying also has to be addressed. Physical and verbal attacks prevent autistic children and adolescents from developing socially, and they can lead to depression and suicidal ideation on their own.
Parents concerned about this can seek out school programs that offer integrated classrooms, where students with special needs are part of the general education classrooms. This naturally helps children with autism who have difficulty fitting in. It also gives non-autistic children a chance to know children with autism, so they are less likely to see those children as targets.
For adults with autism, the Centers for Disease Control and Prevention recommends following the same health care principles that are recommended for neurotypical people. These include getting regular sleep, participating in regular exercise, eating a balanced diet, drinking lots of water, and maintaining regular physical and dental checkups.
As said earlier, it is important (or even necessary) to work with providers who know how to work with autistic individuals. From the array of health concerns that can present with autism to simple symptoms like not making eye contact, it can be helpful to have a professional who understands how to interact with a person with autism. In the words of Sarah Kurchak, “we’re not really comfortable with eye contact and are tired of being forced to make it.”
Health care professionals with knowledge of autism and experience with autistic individuals will be able to have more honest and open conversations with patients. If the patient feels comfortable, they are more likely to open up with the medical professional, helping issues to get effectively identified and addressed.
Addressing Factors That Influence Lifespan
While people with autism tend to have shorter lifespans on average than neurotypical individuals, this doesn’t mean that you will. Talk to your doctors and other treatment providers about how to assess your lifestyle and make any changes that can boost your overall health and decrease the likelihood of an earlier death.
Remember that autism itself does not cause a shortened lifespan. You can take steps to minimize your risk.
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