Cardiovascular risk and emotion regulation are linked with depression symptomatology in middle-aged and older autistic adults

Abstract

Cardiovascular risk factors (CVRF) increase during later-life and are associated with depression symptoms and difficulties with executive function among non-autistic older people. Few studies have examined CVRF among autistic people. Using data from the Simons Foundation Powering Autism Research for Knowledge research match, this study examined the frequency of CVRF and associations between CVRF, depression symptoms and executive function in 387 middle-aged and older autistic people (aged 40-83 years). Individuals provided demographic and health information to assess the number of CVRF (presence of hypertension, high cholesterol, diabetes, obesity). Participants also self-reported their depression symptoms and executive functions in the domains of inhibitory control and emotional regulation. CVRF were common among autistic middle-aged and older people, with 28.9% reporting two and 23.2% reporting three or more CVRF. Regression analyses explored the variables associated with depression symptoms. After accounting for the effects of age and sex assigned at birth, CVRF contributed a small but significant amount to the model. A regression model examined the impact of executive function. Emotional regulation (but not inhibitory control), CVRF and age were significantly associated with depression symptoms in middle-aged and older autistic people. In conclusion, CVRF was significantly associated with depression symptoms, and depression symptoms, in turn, were primarily associated with emotional regulation. CVRF occur at high rates in middle-aged and older autistic people but may not be as important a mechanism for depression symptoms as among non-autistic older people.