Ageing with Autism: Memory and Quality of Life

Background: Longitudinal studies of ageing in autism spectrum disorder (ASD) report poorer outcomes for the majority of individuals, and that intellectual disability predicts later life outcomes (Howlin et al., 2013; Howlin & Moss, 2012). Cross-sectional studies paint a slightly different picture, reporting fewer age-related differences in relational processing (Ring et al., 2015), executive function and memory (Geurts & Vissers, 2012, Lever & Geurts, 2015). Whilst more longitudinal work is necessary, the time needed to complete such studies means that cross-sectional evaluations of age-related differences will continue to be important, albeit needing cautious interpretation. It remains largely unknown how the severity of autistic traits such as repetitive behaviours, and cognitive skills such as language and everyday memory, which are crucial in maintaining independence and quality of life in healthy ageing (Maylor, 1996; Henry et al., 2004), are affected by growing older with autism.

Objectives: (i) To identify cross-sectional age-related differences in language, intellectual functioning, repetitive behaviours and memory, between younger and older adults with ASD; (ii) Identify how these factors affect quality of life in older ASDs.

Methods: Our study includes 48 younger (YA) and older (OA) adults diagnosed with ASD and 44 non-autistic (non-ASD) adults, matched on age (18-80) and IQ (>70). Participants completed a series of tasks assessing IQ (WAIS), language ability (CREVT), autistic traits and repetitive behaviours (AQ; SRS;OCI-R), memory (CVLT) and Quality of Life (PWI; WHOQOL-BREF).

Results: Our preliminary data on (i) memory and (ii) Quality of Life show the following age-related differences in ASD (max n analysed to date = 21) and comparison participants (max n analysed to date = 11):

(i) Memory – no differences in recall were observed between younger and older ASDs (all p > .1), whereas older non-ASD comparison participants had significantly poorer recall than younger participants across short and long-delays (all p < .05).

(ii) Quality of Life was significantly worse overall for all ASDs compared to non-ASDs (all p’s <.02). Older ASD participants reported significantly more satisfaction than younger ASDs with personal relationships (p =.02) and future (p = .005) Quality of Life domains, but the comparison participants showed no age-related differences in any domain.

In comparison participants, long-delay recall significantly correlated with receptive language (p < .05), negatively correlated with overall Quality of Life (p < .05), and all recall negatively correlated with age (p < .05). However, in ASD participants, recall and learning across trials was significantly associated with Quality of Life in physical, standard of living, safety and future domains (all p < .05), whilst recall across short delays was associated with receptive language and comprehension (p < .05) and the community Quality of Life domain.

Conclusions: Our preliminary findings on memory and Quality of Life both confirm and extend existing cross-sectional comparisons of older and younger adults with ASD (Lever & Geurts, 2015; Ring et al., 2015). However, these findings need to be complemented by robust longitudinal investigations, which will emerge from on-going follow-up of the sample studied here.