Increased rates of chronic physical health conditions across all organ systems in autistic adolescents and adults

Abstract
Background
The poorer physical health of autistic adults compared to non-autistic adults has been highlighted by several epidemiological studies. However, research has so far been limited to specific geographical areas and has primarily focused on young autistic individuals (aged 35 years and younger). Recent studies indicate a higher rate of mortality in autistic people, as well as poorer quality of self-reported healthcare interactions. This study aims to determine, first, whether autistic people experience greater levels of non-communicable health conditions and second, whether these are explained by differences in demographics (i.e. sex, country of residence, ethnicity, education level), alcohol use, smoking, body mass index (BMI), or family history of medical conditions.

Method
We employed a cross-sectional, convenience-sampling study via an anonymous, online survey of autistic and non-autistic adults (n = 2305, mean age = 41.6, 65.9% female, 49% autistic). The survey asked participants to self-report information about their demographics, autism diagnosis, diet, exercise, sleep, sexual health, substance use, personal medical history, and family medical history (for all first-degree, biological relatives). Binomial logistic regression across four iterative models of increasing complexity was applied to assess rates of physical health conditions. The Benjamini–Hochberg correction was used to account for multiple testing, and only physical health conditions that achieved at least 1% endorsement within the overall sample (n > 22) were included in the analysis to reduce risk of Type I errors. We also used novel network analysis methods to test whether there are increased levels of multimorbidity between autistic and non-autistic people.

Results
There were significantly elevated rates of non-communicable conditions across all organ systems in autistic people, including gastrointestinal, neurological, endocrine, visual, ear/nose/throat, skin, liver and kidney, and haematological conditions. We confirmed previous findings by showing highly significant differences in rates of neurological and gastrointestinal symptoms (p < 0.0001). In addition, we established in the largest sample to date that Ehler-Danlos Syndrome (EDS) was more likely to occur among autistic females compared to non-autistic females. Finally, we found a higher prevalence of Coeliac’s disease among autistic individuals compared to non-autistic individuals after controlling for sex, ethnicity, country of residence, alcohol use, smoking, and BMI, but these results became non-significant after accounting for family history.

Limitations
Our study is biased towards females, white individuals, highly educated people, and UK residents, likely due to sampling biases. Our self-report study design may also exclude those who lack access to computers, or those with intellectual disability. Our network analysis is also limited in size.

Conclusions
This study provides evidence of widespread, physical health comorbidity that spans nearly all major organ systems in autistic adults compared to non-autistic adults, using both binary logistic regression and network models. Healthcare professionals must be made aware of the range of co-occurring physical health conditions that may be more common among autistic people. However, our findings also point towards potential avenues requiring further exploration, such as the association of autism with both Coeliac’s disease and EDS.

Increased rates of chronic physical health conditions across all organ systems in autistic adolescents and adults | Molecular Autism | Full Text (biomedcentral.com)

 

Autistic people have higher rates of chronic physical health conditions across the whole body and are more likely to have complex health needs, according to a study led by researchers at the University of Cambridge. Their findings, published in the journal Molecular Autism, have important implications for the clinical care of autistic people.

Autistic individuals have increased risk of chronic physical health conditions across the whole body | University of Cambridge

 

Surely this is no great mystery? Autistic people have a much lower life expectancy than healthy people and that could well be a result of poor health treatment. I suspect that autistic people are lumped in with the mentally ill, and in that group all health problems are, at least initially, assumed to be caused by mental illness, rather than physical illness, and are therefore "not true" or "not real" and can therefore be dismissed.

It would be interesting to find out how long it takes an autistic person to be diagnosed with, say, appendicitis, or a heart attack, compared to healthy males.

Anyone with a health condition that is not recognised, or is recognised late, is bound to be less well than a healthy person, and is more likely to develop a chronic condition. And of course, anyone autistic or mentally ill is given psychiatric drugs instead of thorough investigation or treatment.