Age differences in fMRI adaptation for sound identity and location

We explored age differences in auditory perception by measuring fMRI adaptation of brain activity to repetitions of sound identity (what) and location (where), using meaningful environmental sounds. In one condition, both sound identity and location were repeated allowing us to assess non-specific adaptation. In other conditions, only one feature was repeated (identity or location) to assess domain-specific adaptation. Both young and older adults showed comparable non-specific adaptation (identity and location) in bilateral temporal lobes, medial parietal cortex, and subcortical regions. However, older adults showed reduced domain-specific adaptation to location repetitions in a distributed set of regions, including frontal and parietal areas, and to identity repetition in anterior temporal cortex. We also re-analyzed data from a previously published 1-back fMRI study, in which participants responded to infrequent repetition of the identity or location of meaningful sounds. This analysis revealed age differences in domain-specific adaptation in a set of brain regions that overlapped substantially with those identified in the adaptation experiment. This converging evidence of reductions in the degree of auditory fMRI adaptation in older adults suggests that the processing of specific auditory “what” and “where” information is altered with age, which may influence cognitive functions that depend on this processing

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

Aging with Elevated Autistic Traits: Cognitive Functioning Among Older Adults with the Broad Autism Phenotype

Background: Little is known about the impact of aging with autism spectrum disorder (ASD) on cognition. As a first step in addressing this gap in our knowledge, the current study examined cognitive functioning among older adults with elevated, but subclinical levels of autistic traits (i.e., the Broad Autism Phenotype; BAP) compared to older adults without the BAP. Method: Forty older adults (aged 60-91, M=73 years) were recruited and classified as meeting criteria for the BAP (n=20) or not (control older adults, COA; n=20). Different components of executive function as well as episodic memory were measured using standardized performance-based neuropsychological assessments in addition to a self-report questionnaire of executive function difficulties. Results: Despite no differences in age, sex ratio, educational history or IQ, the BAP group demonstrated poorer performance on measures of executive function and episodic memory compared to the COA group. The BAP group also self-reported more executive function difficulties in everyday settings. Moreover, differences in working memory and attentional shifting were maintained after accounting for the influences of IQ and both depression and anxiety symptoms. Conclusions: These findings suggest that aging with the BAP confers additional risk to cognitive function for older adults. As the BAP forms a bridge in the continuum from typical to atypical levels of autistic traits, these findings suggest that individuals with ASD might also incur cognitive costs as they age into older adulthood

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

Mnemonic function in small vessel disease and associations with white matter tract microstructure.

Cerebral small vessel disease (SVD) is associated with deficits in working memory, with a relative sparing of long-term memory; function may be influenced by white matter microstructure. Working and long-term memory were examined in 106 patients with SVD and 35 healthy controls. Microstructure was measured in the uncinate fasciculi and cingula. Working memory was more impaired than long-term memory in SVD, but both abilities were reduced compared to controls. Regression analyses found that having SVD explained the variance in memory functions, with additional variance explained by the cingula (working memory) and uncinate (long-term memory). Performance can be explained in terms of integrity loss in specific white matter tract associated with mnemonic functions

The mental and physical health profiles of older adults who endorse elevated autistic traits

Objective The mental and physical health profile of autistic people has been studied in adolescence and adulthood, with elevated rates of most conditions being reported. However, this has been little studied taking a dimensional approach to autistic traits, and in older age. Methods A total of 20,220 adults aged 50-81 years from the PROTECT study reported whether they experienced persistent socio-communicative traits characteristic of autism. Approximately 1%, 276 individuals, were identified as endorsing elevated autistic traits in childhood and currently, henceforth the ‘Autism Spectrum Trait’ (AST) group. An age and gender matched comparison group was formed of 10,495 individuals who did not endorse any autistic behavioral traits, henceforth the ‘Control Older Adults’ (COA) group. Differences between AST and COA groups were explored in self-reported psychiatric diagnoses, self-reported symptoms of current depression and anxiety, and self-reported physical health diagnoses. Associations were also examined between autistic traits and health across the whole sample. Results The AST group reported significantly elevated rates of psychiatric diagnoses compared to COAs. Additionally, the AST group showed significantly higher self-reported symptoms of current depression and anxiety than COAs. However, few differences were observed in individual physical health conditions, and no differences in total co-occurring physical diagnoses between groups. Similar associations between autistic traits and health were also found taking a dimensional approach across the whole sample. Discussion These findings suggest that older adults with elevated autistic traits may be at greater risk of poorer mental, but not physical, health in later life. Future studies should incorporate polygenic scores to elucidate the possible genetic links between propensity to autism/high autistic traits and to psychiatric conditions, and to explore whether those with elevated autistic traits experience particular barriers to mental health care

Cognitive and affective associations with an ecologically valid test of theory of mind across the lifespan

Objectives: Many studies have demonstrated that theory of mind (ToM) ability declines with increasing age. Research has found that ToM-age associations are often mediated by other cognitive abilities particularly executive function. However, older adults rarely complain about real-world ToM difficulties. It has been suggested that older adults may perform better in real-world situations compared to experimental settings. Methods: We examined performance on the Strange Stories Film Task (SSFT) which has been designed to assess ToM using naturalistic, video scenarios. Sixty adults aged between 17-95 years old completed the SSFT, inhibitory control (Stroop) and working memory (Letter-Number Sequencing) measures, the basic empathy scale (cognitive and affective empathy), and the broad autism phenotype questionnaire. Results: ToM performance correlated significantly with age, whereas performance on a control task did not. Partial correlations and stepwise regression analyses demonstrated that performance on the three SSFT ToM measures was explained by a combination of executive function and empathy measures, with age explaining none of the variance. Conclusions: Using a naturalistic test of ToM, performance was shown to decline with age for ToM but not control scenarios. Across the lifespan, the variance in ToM performance was explained by cognitive abilities and empathy but not age. Age alone may not influence ToM ability, but may be associated with age-related changes in cognition and social-cognition

The mental and physical health of older adults with a genetic predisposition for autism

Autism commonly aggregates in families, with twin studies stimating heritability to be around 80%. Subclinical autism-like characteristics have also been found at elevated rates in relatives of autistic probands. Physical and psychiatric conditions have been reported at elevated rates in autistic children and adults, and also in their relatives. However, to date there has been no exploration of how ageing may affect this pattern. This study examined cross-sectional data from the ongoing online PROTECT study. A total of 20,220 adults aged 50 years and older reported whether they have an autistic first-degree relative. In total, 739 older adults reported having an autistic first-degree relative (AFDR group) and 11,666 were identified as having no family history of any neurodevelopmental disorder (NFD group). The AFDR group demonstrated significantly higher frequencies of self-reported psychiatric diagnoses and a greater total number of co-occurring psychiatric diagnoses than the NFD group. Furthermore, the AFDR group reported elevated current self-report symptoms of depression, anxiety, traumatic experience, and post-traumatic stress than the NFD group. By contrast, few differences between AFDR and NFD groups were observed in physical health conditions, and no differences were observed in the total number of co-occurring physical health diagnoses. These findings suggest that adults who have an autistic first-degree relative may be at greater risk of poor mental, but not physical, health in later life. Older adults with autistic relatives may benefit from close monitoring to mitigate this susceptibility and to provide timely intervention