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

Verbal short-term memory deficits in Down syndrome: phonological, semantic, or both?

The current study examined the phonological and semantic contributions to the verbal short-term memory (VSTM) deficit in Down syndrome (DS) by experimentally manipulating the phonological and semantic demands of VSTM tasks. The performance of 18 individuals with DS (ages 11–25) and 18 typically developing children (ages 3–10) matched pairwise on receptive vocabulary and gender was compared on four VSTM tasks, two tapping phonological VSTM (phonological similarity, nonword discrimination) and two tapping semantic VSTM (semantic category, semantic proactive interference). Group by condition interactions were found on the two phonological VSTM tasks (suggesting less sensitivity to the phonological qualities of words in DS), but not on the two semantic VSTM tasks. These findings suggest that a phonological weakness contributes to the VSTM deficit in DS. These results are discussed in relation to the DS neuropsychological and neuroanatomical phenotype

Comparison of mental health and subjective quality of life in sexual minority versus heterosexual autistic adults

Background: Although disparities in mental health and subjective quality of life have been reported for autistic adults, reasons for these disparities are poorly understood. A potential factor in these disparities is exposure to social stressors related to minority status (i.e., minority stress), including stigma and discrimination. Autistic individuals are more likely than non-autistic individuals to possess other minority identities, including sexual minority identities. However, to date, few studies have examined whether sexual minority autistic adults experience diminished mental health relative to heterosexual autistic adults, and no research has examined subjective quality of life for sexual minority compared to heterosexual autistic adults. Methods: Participants were 679 autistic adults aged 18.5 to 83.3 years recruited through Simons Powering Autism Research Knowledge Research Match. Participants completed surveys online, including measures of anxious and depressive symptomatology, perceived stress, and subjective quality of life. Participants reported their sexual orientation and other socio-demographic variables. Results: A large proportion of autistic adults reported a sexual minority identity (43.4%). Sexual minority autistic adults showed poorer mental health and lower subjective quality of life relative to heterosexual autistic adults. Diminished quality of life in the sexual minority group appears to be driven by the strength of the effects for gay and pansexual compared to heterosexual autistic adults. Conclusion: Understanding factors that may be related to poorer mental health and decreased subjective quality of life in autistic adults is critical and has been identified as a research priority among autistic stakeholders. The findings reported here underscore the need to examine mental health and subjective quality of life disparities among autistic individuals within a societal context, taking into consideration the potential of intersecting minority identities and increased social stressors, as these hold the potential to increase risks for poorer outcome

Self-reported memory of autistic adults and associated real-world outcomes

Abstract Purpose: Although autistic adults have demonstrated weaker memory performance on lab-based measures in comparison to neurotypical peers, research on self-reported memory abilities in this group is scarce. Shedding light on memory abilities of autistic adults is important, as memory difficulties may impact daily living outcomes, an area of known weakness for autistic individuals. Thus, the current study aimed to characterize the self-reported memory complaints of large sample of autistic adults in comparison to neurotypical adults. Methods: The responses to the Prospective and Retrospective Memory Questionnaire were compared by diagnostic group and within the autistic group, relations between memory complaints and real-world outcomes (activities of daily living [ADLs] and postsecondary employment and educational activities) were examined. Results: The results indicated that autistic adults reported greater memory problems than neurotypical peers, regardless of memory type, and autistic adults reported a comparable pattern of complaints as their neurotypical peers (i.e., greater prospective memory complaints in comparison to retrospective memory complaints). Additionally, we found a negative association between memory complaints and outcomes (i.e., greater memory complaints were associated with less independence in ADLs and poorer postsecondary outcomes). Conclusions: The significant association between subjective memory complaints and real-world outcomes suggests targeting memory abilities may result in downstream improvements in daily living skills and post-secondary outcomes among autistic adults

Perceived stress and emotion regulation mediate associations between camouflaging and internalizing symptomatology among autistic adults

Camouflaging is associated with anxiety and depression in autistic adults; however, what drives these associations is unclear. We examined two potential drivers of the association between camouflaging and anxiety/depression: perceived stress and emotion regulation. 787 autistic adults (18.2-78.2 years) recruited via Simons Powering Autism Research (SPARK) Research Match completed questionnaires, including the Camouflaging Autistic Traits Questionnaire (CAT-Q), and measures of autistic traits, depressive and anxious symptomatology, perceived stress, and emotion regulation. Four moderated mediation models were tested. In all models the independent variable was CAT-Q total score, and the moderator variable was birth-sex. The dependent variable was depressive or anxious symptomatology, and the mediator variable was perceived stress or emotion regulation. In what is, to our knowledge, the first study to examine potential drivers of associations between camouflaging and depression/anxiety, we found that perceived stress and emotion regulation each significantly mediated the associations between camouflaging and both depression and anxiety. In the model with perceived stress and anxiety, sex moderated the mediation, with females showing a stronger mediation. There was no significant moderation in any of the other models. We contextualize the findings within the broader literature on camouflaging as a response to stigma and other facets of minority stress

Impacts of Co-Occurring ADHD Symptoms on Critical Markers of Outcome for Autistic Adults

Outcomes for autistic adults are generally poor across multiple foundational metrics, including quality of life and activities of daily living. Co occurring psychiatric conditions, including depression and anxiety, contribute to these poor outcomes. Attention-deficit/hyperactivity disorder (ADHD) is one of the most common co-occurring conditions in autistic individuals, yet its association with adult outcomes is largely unknown. 628 autistic adults (18-83 years; 58% female) recruited from the Simons Foundation Powering Autism Research for Knowledge cohort completed questionnaires on demographics, co occurring mental health conditions, activities of daily living and subjective quality of life. After controlling for age, birth-sex, socioeconomic status, autistic traits, and ADHD medications, ADHD symptoms explained an additional 2 to 9% of variance across activities of daily living and all domains of subjective quality of life. This is the first study to demonstrate an association between self-reported ADHD symptoms and lower activities of daily living and subjective quality of life ratings by autistic adults. These findings highlight that additional research and better supports for co-occurring ADHD symptoms may be critical to enhancing independence and quality of life for autistic adults