Adults with autism more than two times likely to receive dementia diagnosis
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Adults with autism spectrum disorder were about 2.6 times more likely to be diagnosed with early-onset dementia than adults in the general population, according to a case control study published in Autism Research.
“Currently, there is a lack of knowledge on the co‐occurrence of autism and dementia, which leads to inadequate service provision and poor understanding of the social and economic implications for affected individuals, their care partners and society, leaving policymakers without an evidence base for formulating policies and programs,” Giacomo Vivanti, PhD, an associate professor at the A.J. Drexel Autism Institute at Drexel University in Philadelphia, told Healio Primary Care.
“Understanding the co‐occurrence of autism with early‐onset dementia might provide insight on the nature, mechanisms and treatment for each condition, as it has been the case for Down syndrome,” he said.
Vivanti and colleagues analyzed data from 2008 to 2012 Medicaid Analytic eXtract files. The study included adults with either ASD only (n = 12,648), ASD and another intellectual disability (n = 26,168), intellectual disability without ASD (n = 406,570) and neither ASD nor intellectual disability (n = 798,828). The mean age at dementia diagnosis was 49.35 years for those with ASD only, 47.51 years for those with ASD and simultaneous intellectual disability, 51.66 years for those with only an intellectual disability and 53.77 years for those who had neither ASD nor simultaneous intellectual disability.
The researchers reported that the 5-year prevalence of dementia was 4.04% among the adults who only had ASD and 5.22% for those who had ASD and another intellectual disability. The prevalence of dementia was lowest in individuals with no ASD and no intellectual disability (0.97%), and highest in individuals who only had an intellectual disability (7.1%).
The risk factors linked to the increased prevalence of dementia in the general population were similarly associated with the increased risk for dementia in individuals with ASD, according to the researchers. Even after accounting for these risk factors, dementia was more frequent in adults who only had ASD (adjusted HR = 1.96; 95% CI, 1.69–2.28) and adults with ASD and another intellectual disability (aHR = 2.89; 95% CI, 2.62–3.17).
Vivanti admitted that he was surprised by the findings.
“One theory in the field posited that autism [is] a protective factor against dementia, due to the fact that individuals with ASD have been found to have larger brain volume and increases in white matter connections, which might provide additional cognitive reserve —protecting against the impact of aging and/or dementia,” he said. “Our data did not support this notion.”
Vivanti recommended that health care professionals assess “individuals with autism showing signs of cognitive decline” for potential dementia, adding that there are “currently no diagnostic or intervention protocols for the co‐occurrence of autism and dementia.”
He also encouraged health care professionals who may need assistance caring for adults with autism to visit the website of the Life Course Outcomes Program at the Drexel Autism Institute.