- People diagnosed with an autistic spectrum disorder (ASD) die an average of 18 years prematurely.
- Autistic patients are at significantly increased risk of suicide.
- Accidents such as drowning are frequently fatal to patients with autism.
- People with both ASD and an intellectual disability die even younger, on average 30 years earlier than those without the conditions.
Recent studies point to a number of causes of premature death among people diagnosed with autism spectrum disorders (ASDs). The mortality risk for people with ASDs is more than 2x that of people not considered to be on the autistic spectrum. Comorbid neurologic or behavioral conditions, as well as suicide were significantly associated with increased risk of death. While the causes of autism remain unknown, chromosomal abnormalities have been implicated (Figure 1).
that have been implicated in autism. (By Richard Wheeler [Zephyris]).
JAMA Pediatrics
A longitudinal cohort study of Danish children born between 1980 and 2010 published in JAMA Pediatrics found a mortality risk that was 2-fold higher through young adulthood for persons with ASD than for persons without ASD. “The mechanisms underlying ASD-associated mortality may be mediated through or shared with neurologic or mental/behavioral disorders,” the researchers conjectured. “Healthcare professionals and family members should recognize the importance of these disorders with regard to the mortality risk for persons with ASD.” The number of ASD cases in the U.S. has been increasingly steadily over the past 2 decades. The rates for years 1996 through 2007 are displayed in Figure 2.
British Journal of Psychiatry
A registry study conducted at the Karolinska Institutet in Solna, Sweden (Figure 3) was published in The British Journal of Psychiatry. The results of this study revealed a risk of premature death that is about 2.5 times higher for people with an ASD than among members of the general population.
The risk of premature death was especially high among people with both ASD and comorbid intellectual or behavioral disability. However, among patients with an ASD only, the most significant additional risk was suicide.
(Designed by Wingårdh Architects.)
Fatal accidents—often by drowning, when a child or adult with ASD wanders away from caregivers—are one of the most common causes of premature death in people who have both ASD and an intellectual disability, explained Professor Sven Bölte, a clinical psychologist at the Karolinksa Institute in Stockholm, Sweden, where the study was conducted. Epilepsy, along with several other neurological disorders, is another common cause of death among people with both ASD and learning difficulties.
“We can now see that the ASD group has a higher mortality risk in almost all cause-of-death categories, which means that knowledge of autism is essential for all medical specialties,” said Professor Bölte in a press release issued by the Karolinska Institutet. Dr. Bölte is Head of the Centre of Neurodevelopmental Disorders at the Institutet.
The study included 2,672,185 participants of whom 27,122 had been diagnosed with an ASD between 1987 and 2009. During the study period 24,358 individuals died among the general population. Among people with an ASD, 706 died (2.60%; OR = 2.56; 95% CI 2.38–2.76). “Cause-specific analyses showed elevated mortality in ASD for almost all analyzed diagnostic categories,” the researchers explained.
“We see an association between ASD and an increased risk of premature death,” explained Tatja Hirvikoski, researcher at Karolinska Institutet and head of research and development for the Stockholm County Council’s Habilitation Services. “A particularly at-risk group is women with ASD and intellectual disability.”
“There’s a very clear connection between ASD without intellectual disability and a raised suicide risk,” says Dr Hirvikoski. “Clinical guidelines for suicidal patients must be followed when dealing with people with ASD.”
