The prevalence and incidence of early-onset dementia among adults with autism spectrum disorder.
Giacomo Vivanti, Sha Tao, Kristen Lyall and 2 others
PMID 34378867WHAT IT FOUND
Adults with autism enrolled in Medicaid were diagnosed with early-onset dementia at a younger age and had a significantly higher risk of developing it than the general Medicaid population.
The risk was highest for those with co-occurring intellectual disability, but remained elevated for those with autism alone.
Key findings
01Individuals with autism were diagnosed with dementia at an earlier mean age than the general population, with the ASD-only group averaging 49.35 years compared to 53.77 years in the general population.
02After adjusting for covariates, adults with autism had a 2.6-fold increased risk of early-onset dementia compared to the general Medicaid population.
03The risk was stratified by diagnosis: those with autism and co-occurring intellectual disability had a 2.9-fold increased risk, while those with autism only had a 1.9-fold increased risk.
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 relies on Medicaid claims data, which may not capture dementia cases managed outside this system or misdiagnosed due to communication barriers. Individuals with Down syndrome were excluded, so findings do not apply to that subgroup. The data is limited to Medicaid beneficiaries, who often have lower socioeconomic status, which may independently increase dementia risk. The study could not distinguish between types of dementia, such as Alzheimer's or frontotemporal dementia.
Declared interests
One author provides support through a contracting position with the Pennsylvania Department of Human Services. Another author is co-owner of M-CHAT, LLC, which receives royalties from commercial products, and serves on the advisory board of Quadrant Bioscience, Inc. The study was supported by the National Institutes of Health.
The easy way to misread this
Do not assume these risk ratios apply to all adults with autism. The study only included Medicaid beneficiaries, a population with higher rates of poverty and medical comorbidities, which may independently elevate dementia risk. Additionally, diagnosis relied on billing codes, which can be inaccurate for complex cases.