Self‐reported cognitive decline among middle and older age autistic adults

• Published in: Autism research 2023-03, Vol.16 (3), p.605-616
• Main Authors: Klein, Claire B., McQuaid, Goldie A., Charlton, Rebecca A., Klinger, Laura G., Wallace, Gregory L.
• Format: Article
• Language: English
• Subjects: Adult; adulthood; Adults; Age; Aged; aging; Autism; autism spectrum disorder; Autism Spectrum Disorder - complications; Autism Spectrum Disorder - diagnosis; Autism Spectrum Disorder - epidemiology; Autistic Disorder; Birth; Cognitive ability; cognitive decline; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - epidemiology; Dementia; Dementia - diagnosis; Dementia - psychology; Dementia disorders; Education; Female; Humans; Infant, Newborn; Male; Memory; mild cognitive impairment; Psychometrics; Public health; Quantitative psychology; Recreation; Screening; Self Report; Surveys and Questionnaires; Vitamin E
• ISSN: 1939-3792; 1939-3806
• DOI: 10.1002/aur.2877

Very little is known about autistic adults as they age. Early evidence suggests a potentially high risk for dementia and atypical cognitive decline in autistic middle and older age adults. Research in the general population indicates that self‐reported cognitive decline may predict future dementia earlier than performance‐based measures. Nevertheless, self‐report dementia screeners have not been used to date in autism research. In a sample of middle and older age autistic adults (N = 210), participants completed a self‐rated dementia screener, the AD8, to describe the rate of cognitive decline, examine associations of cognitive decline with age, educational level, sex designated at birth, and autistic traits, and document the psychometrics of a dementia screener in autistic adults. We found high rates of cognitive decline with 30% of the sample screening positive. The most common symptoms were declining interest in leisure activities, and increases in everyday problems with thinking, memory, and judgment. There was evidence that autistic individuals designated female at birth may be more vulnerable to cognitive decline than autistic individuals designated male at birth. Notably, reports of cognitive decline did not vary by age or educational level. Modestly elevated autistic traits were found in those screening positive versus negative for cognitive decline. Finally, the dementia screener showed good psychometrics, including convergent validity with an independent measure of current memory problems. These results could signal an emerging public health crisis in autistic adults as they age, and support the potential utility of self‐report measures for early screening for cognitive decline in this population. Lay Summary This study used a self‐report dementia screener to look at increasing problems in thinking and memory in middle and older age autistic adults. Rates of thinking and memory problems were high, with 30% of the autistic adults reporting experiences of cognitive decline. Autistic individuals designated female at birth and adults with greater autistic traits were more likely to screen positive for likely cognitive decline.