Mortality in individuals with autism spectrum disorder: Predictors over a 20-year period

DaWalt, Leann Smith; Hong, Jinkuk; Greenberg, Jan S.; Mailick, Marsha R.

doi:10.1177/1362361319827412

Cited by 67 publications

(51 citation statements)

References 43 publications

(58 reference statements)

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“…Thus, this study cannot yet provide evidence of such an effect among autistic females. In addition to providing key information regarding excess health risks, this finding may have wider implications for length and quality of life, as studies suggest that increased health burden contributes to premature death among autistic adults [ 8 , 9 ]. Future research must work to establish these relationships and identify whether lifestyle behaviors could serve as key targets for intervention for improving long-term outcomes among autistic adults.…”

Section: Discussionmentioning

confidence: 99%

“…Autistic individuals may be more likely to develop a variety of physical and mental health conditions, including Type II diabetes, certain cancers, respiratory conditions, and cardiovascular conditions [ 3 – 7 ], with relatively greater risk for autistic females compared to autistic males [ 3 , 4 , 7 ]; and these conditions may contribute to increased risk of premature mortality seen among autistic individuals [ 8 , 9 ]. Estimates of risk of premature mortality are alarming, suggesting that autistic individuals die 16–38.5 years younger on a average than expected [ 8 , 9 ], with greatest risk among autistic females and those with intellectual disability (ID) [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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An investigation of the diet, exercise, sleep, BMI, and health outcomes of autistic adults

et al. 2021

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Background Studies of autistic children suggest that restricted eating, reduced physical activity, and sleep disorders are common; however, no studies attempt to broadly describe the diet, exercise, and sleep patterns of autistic adults or consider relationships between lifestyle behaviors and the widely reported increased risks of obesity and chronic conditions. To address this, the authors developed the largest study of lifestyle patterns of autistic adults and assessed their relationships to body mass index, health outcomes, and family history. Methods We administered an anonymized, online survey to n = 2386 adults (n = 1183 autistic) aged 16–90 years of age. We employed Fisher’s exact tests and binomial logistic regression to describe diet, exercise, and sleep patterns; mediation of seizure disorders on sleep; body mass index (BMI); relationships of lifestyle factors to BMI, cardiovascular conditions, and diabetic conditions; and sex differences among autistic adults. Results Autistic adults, and particularly autistic females, exhibit unhealthy diet, exercise, and sleep patterns; they are also more likely to be underweight or obese. Limited sleep duration and high rates of sleep disturbances cannot be accounted for by epilepsy or seizure disorders. Lifestyle factors are positively related to higher risk of cardiovascular conditions among autistic males, even more than family history. Limitations Our sample may not be representative of all autistic and non-autistic people, as it primarily comprised individuals who are white, female, have a high school education or higher, and reside in the UK. Our sampling methods may also exclude some individuals on the autism spectrum, and particularly those with moderate to severe intellectual disability. This is a cross-sectional sample that can test for relationships between factors (e.g., lifestyle factors and health outcomes) but cannot assess the direction of these relationships. Conclusions Autistic adults are less likely to meet minimal health recommendations for diet, exercise, and sleep—and these unhealthy behaviors may relate to excess risk of cardiovascular conditions. Although the present study can only provide preliminary, correlational evidence, our findings suggest that diet, exercise, and sleep should be considered and further investigated as key targets for reducing the now widely reported and dramatically increased risks of health comorbidity and premature death among autistic individuals compared to others. Physicians should work cooperatively with patients to provide health education and develop individualized strategies for how to better manage challenges with diet, exercise, and sleep.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An investigation of the diet, exercise, sleep, BMI, and health outcomes of autistic adults

et al. 2021

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“…It is suggested that the constant demands of 'fitting-in" to a non-autism world; the stress of "camouflaging" to avoid being perceived as different [60] and the absence of appropriately structured support or daily activities all contribute to high levels of stress, anxiety, and depression. Physical problems and chronic health disorders are also more common than in the general population [74,75] and recent studies highlight the risk of premature mortality [76][77][78]. Premature mortality is particularly high in autistic adults with intellectual disability and epilepsy.…”

Section: Prognosis In Autismmentioning

confidence: 99%

ESCAP practice guidance for autism: a summary of evidence-based recommendations for diagnosis and treatment

Fuentes

Hervás

Howlin

2020

Eur Child Adolesc Psychiatry

111

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Across Europe, there is increased awareness of the frequency and importance of autism spectrum disorder (ASD), which is now recognised not only as a childhood disorder but as a heterogeneous, neurodevelopmental condition that persists throughout life. Services for individuals with autism and their families vary widely, but in most European countries, provision is limited. In 2018, European Society of Child and Adolescent Psychiatry (ESCAP) identified the need for a Practice Guidance document that would help to improve knowledge and practice, especially for individuals in underserviced areas. The present document, prepared by the ASD Working Party and endorsed by the ESCAP Board on October 3, 2019, summarises current information on autism and focuses on ways of detecting, diagnosing, and treating this condition.

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“…37 Premature mortality is estimated to be three to ten times higher for individuals with ASD. [38][39][40] Many early deaths are attributed to physical conditions, including seizures, sepsis, cancer as well as immune, respiratory and GI conditions such as constipation, outside of other accidental factors. Post-mortem studies have also revealed an association between ASD and the presence of often undiagnosed physical conditions.…”

Section: Introductionmentioning

confidence: 99%

<p>Bridging the Gap Between Physical Health and Autism Spectrum Disorder</p>

Sala¹,

Amet²,

Blagojevic-Stokic³

et al. 2020

NDT

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Autism spectrum disorder (ASD) is a highly complex and heterogeneous developmental disorder that affects how individuals communicate with other people and relate to the world around them. Research and clinical focus on the behavioural and cognitive manifestations of ASD, whilst important, have obscured the recognition that ASD is also commonly associated with a range of physical and mental health conditions. Many physical conditions appear with greater frequency in individuals with ASD compared to non-ASD populations. These can contribute to a worsening of social communication and behaviour, lower quality of life, higher morbidity and premature mortality. We highlight some of the key physical comorbidities affecting the immune and the gastrointestinal systems, metabolism and brain function in ASD. We discuss how healthcare professionals working with individuals with ASD and parents/carers have a duty to recognise their needs in order to improve their overall health and wellbeing, deliver equality in their healthcare experiences and reduce the likelihood of morbidity and early mortality associated with the condition.

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Mortality in individuals with autism spectrum disorder: Predictors over a 20-year period

Cited by 67 publications

References 43 publications

An investigation of the diet, exercise, sleep, BMI, and health outcomes of autistic adults

An investigation of the diet, exercise, sleep, BMI, and health outcomes of autistic adults

ESCAP practice guidance for autism: a summary of evidence-based recommendations for diagnosis and treatment

<p>Bridging the Gap Between Physical Health and Autism Spectrum Disorder</p>

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