Ageing as an autistic person: what research is beginning to tell us

A field that barely existed

For decades, autism research focused mainly on childhood. Studies involved children, interventions were designed for children and the public image of autism was a child. Autistic people growing older were largely overlooked.

This is changing. In June 2026, Abigail Dickinson and her colleagues published 'Aging in Autism' online, a systematic review that brings together evidence on the cognitive, neural and physical health of older autistic people. That same month, the Autism Research Institute co-sponsored a side event at United Nations Headquarters on autism and ageing. These are two examples of a field that received very little attention for many years and is now beginning to grow.

Physical health is the most urgent issue

This is the area in which research provides the clearest evidence. Across the lifespan, autistic people experience more physical and mental health problems than the general population, and some require ongoing monitoring.

Epilepsy is one of the most extensively studied examples. Other concerns include digestive problems, sleep disorders, cardiovascular disease and mental health conditions that do not always receive the attention they require. Having more health problems, however, does not mean that they are all identified.

A 2024 UK study analysed diagnoses recorded in primary care using the IQVIA database. It included 15,675 autistic adults without intellectual disability and 6,437 with intellectual disability, as well as a comparison group. Among autistic adults without intellectual disability, more new diagnoses of anxiety, depression, self-harm and substance use were recorded. By contrast, no greater number of diagnoses of migraine or gynaecological conditions was recorded, while diagnoses of neck or lower-back pain were less common. Among people with intellectual disability, several conditions were diagnosed at the same or a lower rate than in the comparison group.

The study does not establish how many conditions went undiagnosed. Its authors explain that the findings contrast with research based on interviews and questionnaires, in which autistic people report more health problems. They therefore suggest that some common conditions may be underdiagnosed, particularly among people with intellectual disability.

Other studies help to explain the barriers. Autistic adults describe difficulties deciding when a symptom requires medical attention, booking an appointment by telephone, explaining what they feel or being understood during a consultation. They also mention noise, lighting, waiting and other sensory input that can become overwhelming. These barriers do not prove that a particular condition was identified late, but they do show why health care needs to adapt.

Life expectancy: a cautious interpretation

One figure is widely repeated: autistic people's life expectancy is sixteen years shorter. It deserves closer examination because a later UK study has questioned it.

The study, published online in The Lancet Regional Health – Europe in 2023, compared people with a recorded autism diagnosis with others of the same age and sex. Its estimates varied according to sex and the presence of intellectual disability. Among autistic people without intellectual disability, the estimated reduction was approximately six years for both men and women. Among those with intellectual disability, it was approximately seven years for men and almost fifteen years for women.

The authors themselves urge caution. The study could include only people with a recorded diagnosis, and very few autistic adults in the generations studied had been diagnosed. Those who did appear in the records may, on average, have had greater support needs or more health problems than the autistic population as a whole. The figures therefore cannot predict how long a particular autistic person will live and may overestimate the average reduction in life expectancy.

The study confirms that premature mortality exists among diagnosed autistic people, but it does not establish all its causes or demonstrate that the main causes are preventable. The researchers note that further work is needed to understand why some people die earlier. Several related inequalities can, however, be addressed: barriers to receiving care, a lack of support and health conditions that are not identified or treated appropriately.

The brain and mind: no firm conclusions yet

Research still cannot say very much about how the autistic brain ages, and the most rigorous approach is to acknowledge this.

A systematic review by Marine Bessé and her colleagues, published in Autism Research in 2025, brought together 36 studies of cognitive and cerebral ageing in autism. It organised them around three hypotheses: accelerated ageing, in which decline would begin earlier or progress more quickly; parallel ageing, in which it would follow a similar course to that seen in non-autistic people, although it might begin from a different point; and the safeguard hypothesis, under which some abilities would show less decline.

The review found no pattern that confirmed any one of the three hypotheses. The findings also varied according to study design. Cross-sectional studies, which compare people of different ages at a single point in time, more often aligned with parallel ageing or the safeguard hypothesis. The few longitudinal studies, which follow the same people over several years and provide a better view of change, were more consistent with parallel or accelerated ageing.

This distinction matters. When different generations are compared, it is not always possible to know whether a difference is due to age or to the fact that older people grew up under different diagnostic criteria, with less support and different life experiences. It is therefore not yet possible to say that the autistic brain ages more quickly or that it is protected against ageing.

There is also a bias that should be kept in mind: much of this research has involved autistic adults without intellectual disability and with lower support needs, because they are more likely to take part in studies. What is currently known about autistic ageing therefore describes only part of the spectrum.

Ageing also changes everyday life

Research on ageing needs to include retirement, menopause, housing, relationships, isolation and social support alongside health and memory. A review by Gavin Stewart and Francesca Happé, published in 2025, notes that these subjects remain under-researched.

Retirement can abruptly remove a routine that has been maintained for years. Menopause may coincide with physical, sensory and emotional changes that remain under-researched in autistic people. A time may also come when parents, partners or other relatives who have provided support grow older, become ill or can no longer continue in that role. It then becomes necessary to consider who will support the person, where they will live and what assistance they will need to maintain their daily life.

There are not yet sufficient answers for all these situations. What is clear is that planning for the future cannot be limited to medical appointments. It must also include each person's routines, housing, decisions, relationships and support network.

Why this matters now

Increasing numbers of autistic people are reaching later adulthood and old age. Some received a diagnosis decades ago; others are being diagnosed now, while many still do not know that they are autistic.

A 2025 review estimated that 89% of autistic adults aged 40 to 59 and 97% of those over 60 remained undiagnosed in the UK. These estimates refer specifically to the UK and should not simply be applied to other countries, but they show the scale of the gap. Many people have reached this stage of life without their needs being recognised and without being represented in research.

Research still has many unanswered questions, but it already points to two priorities. The first is to adapt health care to each person's communication, sensory needs and way of expressing pain or distress. The second is to plan for changes in daily life: routines, housing, the support network and what will happen when the people providing support also grow older.