An Overview of Autism and Aging

Navigating Challenges and Embracing Identity at 50+

~ made by Autism-101.com ~

Jeff Owens - contact[AT]autism-101.com

What Is Autism?

Autism is a neurological and developmental difference
It is naturally occurring
It is not a disease 😷
It can’t be cured
It has always existed

Autistic People Differ

“If you have met one autistic person
you have met one autistic person.” ^[1]

— Dr. Stephen Shore (autism advocate)

Why Are We Talking About This Now?

The “Graying” of the population globally.^[2]
The first generation diagnosed as children are now entering middle age.^[3]
The massive, previously unidentified group of people aged 50-80+.^[4]
A critical lack of research and services for autistic seniors.^[5]

The Timeline of Invisibility

Why didn’t they get diagnosed 40 years ago?

1943-1944: Kanner & Asperger define the condition (mostly in children).
1980 (DSM-III): “Infantile Autism” enters the DSM. Strict criteria.
1994 (DSM-IV): Asperger’s Syndrome added. The beginning of broader recognition.
2013 (DSM-5): ASD becomes a spectrum; allows for adult diagnosis more easily.

“We aren’t part of an epidemic.
We are part of an awakening.”

— Autism-101

Who Are "Older Autistic Adults"?

Today, we are focusing generally on those 50+, but specifically two groups:

Diagnosed early: now aging.
"Lost Generation": diagnosed late in life, or still undiagnosed.

Why Were They Missed?

Diagnostic criteria historically focused on young, white males with high support needs.
"Masking" or "Camouflaging" to survive education and employment.
Traits attributed to other things: "quirky," "shy," "difficult," or misdiagnosed with personality disorders/anxiety.

What Triggers a Late Diagnosis?

Often, a life event drastically alters the person's capacity to cope:

Burnout: Decades of masking finally depletes energy reserves.
Hormonal Shifts: Perimenopause and menopause can intensify sensory/executive function struggles.
Major Transitions: Retirement, becoming an empty nester, or loss of a spouse removes stabilizing routines.
The "Genetic Mirror": Seeing their own traits while their child or grandchild is being assessed.

The Diagnostic Journey

As detailed in books like Lost & Now Found ^[6] , diagnosis is complex:

Relief & Validation

"I'm not broken; I'm Autistic. There is a name for this."

Grief & Anger

Mourning lost opportunities and decades of struggle without support.

Re-evaluation

Reviewing one's entire life history through a new lens.

Case Study: "Susan" (Age 64)

Background: Retired librarian. Always called "shy" and "rigid."
The Trigger: Husband passed away 2 years ago. The loss of his support (handling bills, driving, social buffer) caused a collapse.
The Misdiagnosis: Diagnosed with Treatment-Resistant Depression and Early Onset Dementia due to "confusion" (which was actually brain fog and burnout).
The Realization: Read a memoir by an autistic woman and recognized herself.

Sensory Differences

“Processing everyday sensory information can be difficult for autistic people. Any of their senses may be over- or under-sensitive, or both, at different times.” ^[7]

— NAS

Sensory Profiles

Unique to individual
Hyposensitive, hypersensitive, or both
Can change day to day
Are well outside the normal ranges
Impacts what we like to do

Do Sensory Issues “Mellow” With Age?

Short Answer: No. They often become harder to manage.

Older autistic adults report lower ability to “cope” with sensory input. The energy used to “mask” or “push through” in their 30s is gone.^[8]
Age-related hearing/vision loss increases cognitive load. The brain works harder to interpret data, leading to faster overload.^[8]
After age 40, the autistic nervous system may regulate stress less efficiently, making sensory triggers feel more physically painful.^[8]

The “Double Whammy”

Aging and Autism interact bidirectionally:

Aging processes (cognitive slowing, physical decline) can exacerbate autistic traits (sensory sensitivity, executive dysfunction).
A lifetime of autistic stress (masking, sensory overload) may accelerate certain aging processes (health outcomes).

Key Concept: Reduced physiological and cognitive "bandwidth" to cope with stressors.

Healthcare Barriers

Communication Mismatches: Difficulty describing pain accurately; doctors misinterpreting flat affect or direct/blunt communication as non-compliance.
Sensory Overload in Clinics: Bright lights, waiting rooms, and physical exams can lead to care avoidance.
Co-occurring Conditions: Higher rates of anxiety, depression, GI issues, and sleep disorders often complicate geriatric care.

Sensory and Cognitive Shifts

Sensory: Natural age-related hearing/vision loss combined with autistic sensory processing differences can be overwhelming and disorienting.
Executive Function: Aging impacts working memory and processing speed. For an autistic brain already working hard to organize, this can lead to significant functional decline quickly.
Burnout Recovery: Bouncing back from sensory or social overload takes significantly longer at 60 than at 30.

Shrinking Support Networks

Loss of “Buffers”: Many older autistics relied heavily on parents or a spouse to navigate the social world. Losing them is catastrophic.
The “Group Home” Fear: Intense fear of losing independence and ending up in communal senior living, which is rarely sensory-friendly.
Financial Vulnerability: Due to lifetime underemployment (common in the lost generation), financial resources for aging may be scarce.

Co-occuring Conditions

Will likely have other issues
Ex. ADHD may occur in 40% to 70% of autistic people ^[9]

The "Autistic Advantage" in Aging

It isn't all negative. Many older autistic adults possess unique resilience factors:

Solitude as Strength: Often better equipped to handle alone time than neurotypical peers.
Passionate Interests: "Special Interests" provide deep engagement, cognitive protection, and joy in retirement.
Non-Conformity: Less pressure to keep up with societal expectations of "how to act" at 70.

Supporting Older Autistic Adults

Believe them: If they say they are autistic late in life, validate it. Do not demand a difficult-to-obtain formal diagnosis to provide support.
Sensory Audits: Evaluate living spaces for sensory triggers (lighting, humming noises, textures).
Clear Communication: In healthcare and legal planning, use literal, clear language. Allow extra processing time.
Redefining "Social": Respect the need for solitude. Connection doesn't have to mean group activities in a noisy senior center.

Moving Forward: Unmasking

Unmasking is crucial for healthy aging.

Preserving energy by stopping the performance of "neurotypicality."
Allowing stimming and sensory aids (headphones, sunglasses) without shame.
Connecting with the autistic community (often online) to share lived experiences.