Prevalence of physical and mental health conditions in Medicare-enrolled, autistic older adults.
Brittany N Hand, Amber M Angell, Lauren Harris and 1 others
PMID 31773968WHAT IT FOUND
Autistic older adults had significantly higher odds of nearly every physical and mental health condition compared to non-autistic peers.
This included high risks for epilepsy, Parkinson’s, gastrointestinal issues, and suicidality. Clinicians should anticipate complex comorbidities in this population.
Key findings
01After adjusting for demographics, autistic adults had significantly greater odds of all health conditions except for menopausal disorders, multiple sclerosis, back conditions, and substance use disorders.
02The largest differences in physical health were for epilepsy (OR 18.9), Parkinson’s disease (OR 6.1), and gastrointestinal conditions like constipation (OR 5.2).
03Autistic older adults were 11 times more likely to have a medical encounter for suicidality or intentional self-injury (OR 11.1).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study relied entirely on medical billing codes, which may be inaccurate due to clinician bias or diagnostic challenges. Only institutional provider claims were included; visits to private physicians or therapists were not captured, potentially missing some diagnoses. The sample consisted of adults born before 1950, who may have different health profiles and support needs than younger autistic adults. The study could not control for variables like socioeconomic status beyond estimated income, or unmet healthcare needs. It examined prevalence at a single time point, so it cannot show how these conditions change over time.
Declared interests
The authors received no financial support for this research.
The easy way to misread this
Do not assume these findings apply to all autistic older adults. The sample was drawn from Medicare beneficiaries with recorded diagnoses, potentially missing those with undiagnosed autism or those who did not seek care. Additionally, because the participants were born before 1950, their health profiles may differ significantly from younger autistic adults who had access to early intervention and modern diagnostic criteria.