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Aging with autism spectrum disorder: an emerging public health problem

  • Ana Hategan (a1), James A. Bourgeois (a2) and Jeremy Goldberg (a1)

Extract

From 1943, when Leo Kanner originally described autism, and to the first objective criteria for “infantile autism” in DSM-III and the inclusion of Asperger's disorder in DSM-IV, the subsequent classification scheme for autistic disorders has led to a substantial change with the 2013 issuance of the DSM-5 by including subcategories into one umbrella diagnosis of autism spectrum disorder (ASD) (Baker, 2013). ASD is a lifelong neurodevelopmental disorder, characterized by social and communication impairments and restricted, stereotypical patterns of behavior (Baker, 2013). It is currently expected that most, or all of the actual cases of ASD, are identified in a timely way (i.e. in early childhood). However, there are many undiagnosed older adults who may have met the current diagnostic criteria for ASD as children, but never received such a diagnosis due to the fact it had yet to be established. In addition, some patients with relatively less impairing phenotypes may escape formal diagnosis in childhood, only to later be diagnosed in adulthood. Nevertheless, the first generation of diagnosed patients with ASD is now in old age. Many such ASD patients have needed family and institutional support for their lives subsequent to childhood diagnosis. Due to aging and death of their parents and other supportive figures leading to a loss of social structures, there is no better time than now for the medical community to act.

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References

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Baker, J. P. (2013). Autism at 70 – redrawing the boundaries. New England Journal of Medicine, 369, 10891091.
Bauman, M. L. (2010). Medical comorbidities in autism: challenges to diagnosis and treatment. Neurotherapeutics, 7, 320327.
Biever, C. (2007). Web removes social barriers for those with autism. New Scientist, 2610, 2627.
Geurts, H. M. and Vissers, M. E. (2012). Elderly with autism: executive functions and memory. Journal of Autism and Developmental Disorders, 42, 665675.
James, I. A., Mukaetova-Ladinska, E., Reichelt, F. K., Briel, R. and Scully, A. (2006). Diagnosing Aspergers syndrome in the elderly: a series of case presentations. International Journal of Geriatric Psychiatry, 21, 951960.
Raznahan, A. et al. (2010). Cortical anatomy in autism spectrum disorder: An in vivo MRI study on the effect of age. Cerebral Cortex, 20, 13321340.

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