Exploring the effects of age and sex on sensory sensitivities in middle and older aged autistic adults

Purpose: Although sensory sensitivities are common among autistic people, few studies have explored how they may be impacted by ageing. Little is known about the experiences of autistic people across adulthood or about the experiences of people assigned female-at-birth. Some results suggest that autistic people assigned female-at-birth report more sensory sensitivities, but little is known about experiences in middle-aged and older autistic people assigned female-at-birth. Methods: This study explored self-reported sensory sensitivities and sensory acuity in 210 autistic people aged 42-80 years old. Associations between age and sensory sensitivities were examined using correlational and regression analyses, and t-tests explored differences based on sex-assigned-at-birth. Results: No significant correlation was observed between age and sensory sensitivities, although older age was associated with poorer sensory acuity. Poorer acuity in vision and hearing was associated with more sensory sensitivities. People assigned female-at-birth reported higher scores for overall sensory sensitivities and low temperature/pain tolerance. Sex-assigned-at-birth, sensory acuity and an age-x-sensory acuity interaction term contributed significantly to a regression model explaining overall sensory sensitivity, but age did not contribute significantly. Conclusion: This cross-sectional study suggests that sensory sensitivities are stable across middle-age and older adulthood. Results contrast with previous studies in young adults which have suggested reduction in sensory sensitivities with age. In keeping with studies of younger people, middle-age and older autistic adults assigned female-at-birth report higher rates of sensory sensitivities than comparably aged autistic adults assigned male-at-birth. If further studies examining individual change in sensory sensitives replicate these results, then they may contribute to understanding care needs of autistic older people

Social Support and Links to Quality of Life Among Middle and Older Age Autistic Adults

Social support has a positive impact on quality of life (QoL) in neurotypical older adults and young autistic adults, but the association for older autistic adults is unclear. Autistic adults (n=388; mean age=40-83 years) were recruited via Simons Powering Autism Research for Knowledge research match. Participants completed questionnaires online querying demographic information, depression and anxiety symptomatology, QoL (Physical, Psychological, Social, Environmental, Autism-specific) and social support (instrumental, subjective and social interactions). Regression analyses examined whether different aspects of social support explained the variance in each domain of QoL. A significant proportion of the variance (36-58%) in QoL was explained. Subjective social support significantly contributed to the models for all aspects of QoL; Physical and Psychological QoL were also explained by social interactions, whereas Social, Environmental and Autism-specific QoL were additionally explained by instrumental support. Social support is an important contributor to the QoL of middle-aged and older autistic adults, after accounting for demographic factors and depression. Further studies are required to understand whether age-related changes in social support and QoL are the same for autistic as non-autistic older adults in order to identify and implement appropriate support

Cardiovascular risk and emotion regulation contribute to depression symptomatology in middle-aged and older autistic adults

Background: Cardiovascular risk factors (CVRF) and executive function difficulties increase during later-life and are associated with depression symptoms among non-autistic older people. These associations, however, have not yet been explored among middle-aged and older autistic people. Methods: Using data collected via Simons Foundation Powering Autism Research (SPARK), Research Match, we examined the frequency of CVRF, and associations between CVRF, executive function and depression symptoms in 387 middle-aged and older autistic people (aged 40-83 years). Results: Autistic adults reported high rates of CVRF (two, 28.9%; three or more, 23.2%). Rates of high cholesterol and obesity were greater among middle-aged and older autistic adults compared to the general population. CVRF, age, and emotion regulation (but not inhibitory control), were significantly associated with depression symptoms in middle-aged and older autistic adults. Conclusions: CVRF occur at high rates in middle-aged and older autistic adults, and it is important that healthcare providers monitor risk factors in order to implement preventative strategies. CVRF are associated with depressive symptoms among middle-aged and older autistic adults, but may not be as important as difficulties with emotion regulation

Self-reported prospective and retrospective memory among middle aged and older autistic and non-autistic people

Objective: Self-reported memory difficulties are common among older adults, but few studies have examined memory problems among autistic middle-aged and older people. The current study examines self-rated prospective (PM) and retrospective (RM) memory difficulties and their associations with age in middle-aged and older autistic and non-autistic people. Methods: 350 autistic people (58% assigned-female-at-birth; age-range: 40-83 years) and 350 non-autistic adults matched on age, birth-sex and education level were included in the analysis. Participants completed the Prospective and Retrospective Memory Questionnaire (PRMQ) which includes questions about PM vs. RM (memory type), environment-cued vs. self-cued (cue), and short vs. long delay (delay). Results: Autistic people reported significantly more PM and RM difficulties than the comparison group. Both groups reported more difficulties with PM (vs. RM), self-cued (vs. environment-cued), and short (vs. long) delay. No significant interactions were observed. Among autistic people, younger age was associated with reporting more PM and RM difficulties, but this pattern was not observed among non-autistic people. Conclusions: Autistic people may be at reduced risk for memory problems as they age, compared to their same-age non-autistic peers. Further studies are required to explore the association between self-reported memory challenges and memory task performance among autistic older people

Cardiovascular disease risk factors in autistic adults: The impact of sleep quality and antipsychotic medication use

Approximately 40% of American adults are affected by cardiovascular disease (CVD) risk factors (e.g., high blood pressure, high cholesterol, diabetes, and overweight or obesity), and risk among autistic adults may be even higher. Mechanisms underlying the high prevalence of CVD risk factors in autistic people may include known correlates of CVD risk factors in other groups, including high levels of perceived stress, poor sleep quality, and antipsychotic medication use. A sample of 545 autistic adults without intellectual disability aged 18+ were recruited through the Simons Foundation Powering Autism Research, Research Match. multiple linear regression models examined the association between key independent variables (self-reported perceived stress, sleep quality, and antipsychotic medication use) and CVD risk factors, controlling for demographic variables (age, sex assigned at birth, race, low-income status, autistic traits). Overall, 73.2% of autistic adults in our sample had an overweight/obesity classification, 45.3% had high cholesterol, 39.4% had high blood pressure, and 10.3% had diabetes. Older age, male sex assigned at birth, and poorer sleep quality were associated with a higher number of CVD risk factors. Using antipsychotic medications was associated with an increased likelihood of having diabetes. Poorer sleep quality was associated with an increased likelihood of having an overweight/obesity classification. Self-reported CVD risk factors are highly prevalent among autistic adults. Both improving sleep quality and closely monitoring CVD risk factors among autistic adults who use antipsychotic medications have the potential to reduce risk for CVD

Baseline brain and behavioral factors distinguish adolescent substance initiators and non-initiators at follow-up

BackgroundEarlier substance use (SU) initiation is associated with greater risk for the development of SU disorders (SUDs), while delays in SU initiation are associated with a diminished risk for SUDs. Thus, identifying brain and behavioral factors that are markers of enhanced risk for earlier SU has major public health import. Heightened reward-sensitivity and risk-taking are two factors that confer risk for earlier SU.Materials and methodsWe characterized neural and behavioral factors associated with reward-sensitivity and risk-taking in substance-naïve adolescents (N = 70; 11.1–14.0 years), examining whether these factors differed as a function of subsequent SU initiation at 18- and 36-months follow-up. Adolescents completed a reward-related decision-making task while undergoing functional MRI. Measures of reward sensitivity (Behavioral Inhibition System-Behavioral Approach System; BIS-BAS), impulsive decision-making (delay discounting task), and SUD risk [Drug Use Screening Inventory, Revised (DUSI-R)] were collected. These metrics were compared for youth who did [Substance Initiators (SI); n = 27] and did not [Substance Non-initiators (SN); n = 43] initiate SU at follow-up.ResultsWhile SI and SN youth showed similar task-based risk-taking behavior, SI youth showed more variable patterns of activation in left insular cortex during high-risk selections, and left anterior cingulate cortex in response to rewarded outcomes. Groups displayed similar discounting behavior. SI participants scored higher on the DUSI-R and the BAS sub-scale.ConclusionActivation patterns in the insula and anterior cingulate cortex may serve as a biomarker for earlier SU initiation. Importantly, these brain regions are implicated in the development and experience of SUDs, suggesting differences in these regions prior to substance exposure

Dietary Long-Chain Omega-3 Fatty Acids Are Related to Impulse Control and Anterior Cingulate Function in Adolescents

Impulse control, an emergent function modulated by the prefrontal cortex (PFC), helps to dampen risky behaviors during adolescence. Influences on PFC maturation during this period may contribute to variations in impulse control. Availability of omega-3 fatty acids, an essential dietary nutrient integral to neuronal structure and function, may be one such influence. This study examined whether intake of energy-adjusted long-chain omega-3 fatty acids [eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA)] was related to variation in impulse control and PFC activity during performance of an inhibitory task in adolescents (n = 87; 51.7% female, mean age 13.3 ± 1.1 years) enrolled in a longitudinal neuroimaging study. Intake of DHA + EPA was assessed using a food frequency questionnaire and adjusted for total energy intake. Inhibitory control was assessed using caregiver rating scale (BRIEF Inhibit subscale) and task performance (false alarm rate) on a Go/No-Go task performed during functional MRI. Reported intake of long-chain omega-3 was positively associated with caregiver ratings of adolescent ability to control impulses (p = 0.017) and there was a trend for an association between intake and task-based impulse control (p = 0.072). Furthermore, a regression of BOLD response within PFC during successful impulse control (Correct No-Go versus Incorrect No-Go) with energy-adjusted DHA + EPA intake revealed that adolescents reporting lower intakes display greater activation in the dorsal anterior cingulate, potentially suggestive of a possible lag in cortical development. The present results suggest that dietary omega-3 fatty acids are related to development of both impulse control and function of the dorsal anterior cingulate gyrus in normative adolescent development. Insufficiency of dietary omega-3 fatty acids during this developmental period may be a factor which hinders development of behavioral control

Baseline brain and behavioral factors distinguish adolescent substance initiators and non-initiators at follow-up

Background Earlier substance use (SU) initiation is associated with greater risk for the development of SU disorders (SUDs), while delays in SU initiation are associated with a diminished risk for SUDs. Thus, identifying brain and behavioral factors that are markers of enhanced risk for earlier SU has major public health import. Heightened reward-sensitivity and risk-taking are two factors that confer risk for earlier SU. Materials and methods We characterized neural and behavioral factors associated with reward-sensitivity and risk-taking in substance-naïve adolescents (N = 70; 11.1–14.0 years), examining whether these factors differed as a function of subsequent SU initiation at 18- and 36-months follow-up. Adolescents completed a reward-related decision-making task while undergoing functional MRI. Measures of reward sensitivity (Behavioral Inhibition System-Behavioral Approach System; BIS-BAS), impulsive decision-making (delay discounting task), and SUD risk [Drug Use Screening Inventory, Revised (DUSI-R)] were collected. These metrics were compared for youth who did [Substance Initiators (SI); n = 27] and did not [Substance Non-initiators (SN); n = 43] initiate SU at follow-up. Results While SI and SN youth showed similar task-based risk-taking behavior, SI youth showed more variable patterns of activation in left insular cortex during high-risk selections, and left anterior cingulate cortex in response to rewarded outcomes. Groups displayed similar discounting behavior. SI participants scored higher on the DUSI-R and the BAS sub-scale. Conclusion Activation patterns in the insula and anterior cingulate cortex may serve as a biomarker for earlier SU initiation. Importantly, these brain regions are implicated in the development and experience of SUDs, suggesting differences in these regions prior to substance exposure

Exploring the effects of age and sex on sensory sensitivities in middle and older aged autistic adults

Purpose: Although sensory sensitivities are common among autistic people, few studies have explored how they may be impacted by ageing. Little is known about the experiences of autistic people across adulthood or about the experiences of people assigned female-at-birth. Some results suggest that people assigned female-at-birth report more sensory sensitivities, but little is known about experiences in middle-aged and older people assigned female-at-birth. Methods: This study explored self-reported sensory sensitivities and sensory acuity in 210 autistic people aged 42-80 years old. Associations between age and sensory sensitivities were examined using correlational and regression analyses, and t-tests explored differences in sex-assigned -at-birth. Results: No significant correlation was observed between age and sensory sensitivities, although older age was associated with poorer sensory acuity. Poorer acuity in vision and hearing was associated with more sensory sensitivities. People assigned female-at-birth reported higher scores for overall sensory sensitivities and low temperature pain tolerance. Sex-assigned-at-birth and sensory acuity contributed significantly to a regression model explaining overall sensory sensitivity, but age did not contribute significantly. Conclusion: This cross-sectional study suggests that sensory sensitivities are stable across middle-age and older adulthood. Results contrast with previous studies in young adults which have suggested reduction in sensory sensitivities with age. In keeping with studies of younger people, people assigned-female-at-birth report higher rates of sensory sensitivities than people assigned-male-at-birth. If further studies examining individual change in sensory sensitives replicate these results, then they may contribute to understanding care needs of autistic older people

Social Support and Links to Quality of Life Among Middle and Older Age Autistic Adults

Social support has a positive impact on quality of life (QoL) in neurotypical older adults and young autistic adults, but the association for older autistic adults is unclear. Autistic adults (n=388; mean age=40-83 years) were recruited via Simons Powering Autism Research for Knowledge research match. Participants completed questionnaires online querying demographic information, depression and anxiety symptomatology, QoL (Physical, Psychological, Social, Environmental, Autism-specific) and social support (instrumental, subjective and social interactions). Regression analyses examined whether different aspects of social support explained the variance in each domain of QoL. A significant proportion of the variance (36-58%) in QoL was explained. Subjective social support significantly contributed to the models for all aspects of QoL; Physical and Psychological QoL were also explained by social interactions, whereas Social, Environmental and Autism-specific QoL were additionally explained by instrumental support. Social support is an important contributor to the QoL of middle-aged and older autistic adults, after accounting for demographic factors and depression. Further studies are required to understand whether age-related changes in social support and QoL are the same for autistic as non-autistic older adults in order to identify and implement appropriate support