Healthcare barriers, what about older age? A comment on Malik-Soni et al.

This publication is included in the Autistic Autism Scholarship Project. one author of this publication is identified as autistic in the project.

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Mason, D. (2021). Healthcare barriers, what about older age? A comment on Malik-Soni et al. Pediatric Research, 91(5), 1025-1027. https://doi.org/10.1038/s41390-021-01596-2

Publication date: 9 Jun 2021 Added to AutiHub: 18 Sep 2026 Type: Article Article language: English
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Authors

Publication authors
1
Publication authors identified as autistic
1 / 1 (100.0%)
  1. David Mason *

Abstract

Autism is a neurodevelopmental condition; characteristics of autism comprise difficulties with social communication (e.g., atypical social gaze or poorly integrated verbal and nonverbal communication 1 ), and the presence of restricted interests and/or repetitive behaviours (e.g., repetitive lining up of objects, insistence on routines, and fixated interests of acute intensity 1 ). 2 A number of recent quantitative studies have found that autistic adults are at risk of poorer health outcomes. [A recent study by Kenny et al. 3 reported that there was no consensus on how to refer to those with an autism diagnosis. Hence, “autistic individual(s)”, “autistic person”, or “people on the autism spectrum” will be used interchangeably throughout.] First, the rates of a range of physical health conditions are elevated among samples of autistic adults compared to matched comparison samples. A study comparing health insurance records for patients in America (N = 1507 people on the autism spectrum and 15,070 non-autistic people matched on age and sex) found markedly elevated rates of most conditions, including anxiety (odds ratio, OR = 3.7), dementia (OR = 4.4), cardio-vascular disease (OR = 2.5), neurological diseases (OR = 2.2), sleep disorders (OR = 1.9), and nutritional conditions (i.e. metabolism or deficiency; OR = 2.7). 4 A follow-up study, with those aged 65+ (N = 4685 autistic individuals and N = 46,850 matched participants) found broadly the same pattern of results. 5 These data are consistent with Scottish census data measuring somewhat different conditions (e.g., global reports of physical disability or mental health conditions); those on the autism spectrum were at greater odds of having these conditions. 6 Second, autistic adults are more likely to die prematurely. Hirvikoski et al. 7 compared 27,122 autistic individuals (N = 6240 with an intellectual disability and N = 20,882 without) to 2,672,185 comparison participants. The autistic group died, on average, 16.3 years younger than the comparison group (53.9 versus 70.2 years). This was more pronounced in the autistic group with intellectual disability (mean age of death, 39.5 years) compared to the autistic group without (mean age of death, 58.4 years). Odds ratios for all ICD-10 codes examined in the study [infections, neoplasms, endocrine, mental and behavioural disorders, nervous system, circulatory system, respiratory system, digestive system, genitourinary system, symptoms/signs/abnormal findings/other, suicide, external causes/other, and other] were higher for the autistic group, except for death by infection (OR = 1.83): for example, conditions of the nervous system (OR = 7.5), respiratory system (OR = 2.7), and suicide (OR = 7.6). In the autism group these odds ratios were further elevated for those with an intellectual disability, and also for females. Clearly, these data indicate that autistic individuals are at risk of severely poor health outcomes.

Bibliography cited by this reference

Cited references are imported from external metadata sources when they are available. The list may be partial.

Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 11:55.

Cited references
28
With a DOI
27
Without a DOI, from raw bibliography text
0
3 / 28 (10.7%) cited references include at least one author identified as autistic.
References with data to complete
1 / 28 (3.6%)
References with detected author names
27 / 28 (96.4%)
Without detected author names
1
Without a structured title
0
Without a stable identifier
0
References with raw author names still to review
0
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
140
From DOI or external metadata
140
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
76 / 140 (54.3%) names are linked to an author already present in AutiHub. 64 / 140 (45.7%) names are not yet linked.
Names linked to a person identified as autistic
10 / 140 (7.1%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 10 / 76 (13.2%). Distinct people identified as autistic: 9 / 132 (6.8%).
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