Current research indicates a clear disparity in longevity for autistic people compared to the general population. Autism is a neurodevelopmental difference, meaning the brain processes information, social cues, and sensory input in an atypical manner. This difference does not inherently shorten life. The reduced lifespan is largely driven by co-occurring medical conditions and systemic societal factors that are often preventable or treatable with appropriate care. Understanding this reduced longevity requires examining the complex health and social challenges that disproportionately affect the autistic community.
Understanding the Data on Longevity Differences
Large-scale population studies consistently demonstrate a reduction in the average life expectancy for diagnosed autistic individuals. The most substantial reduction in lifespan is observed in the subgroup of autistic people who also have a co-occurring intellectual disability. For this group, the estimated life expectancy is approximately 69 to 71 years, a difference of roughly 10 to 14 years compared to the non-autistic population.
The longevity gap is noticeably smaller for autistic individuals without an intellectual disability, but a disparity still persists. For this group, average life expectancy estimates are closer to 74 to 76 years, several years less than the general population average. Mortality rates for autistic adults under the age of 45 can be four times higher than their non-autistic peers, underscoring the severity of the health inequalities faced in early adulthood. This confirms that while co-occurring intellectual disability is a major factor, the challenges that shorten life extend across the entire spectrum.
Co-occurring Physical Health Conditions
A significant portion of the reduced lifespan is attributable to a higher prevalence of specific physical health conditions that frequently co-occur with autism. Epilepsy stands out as a major contributor to premature mortality, affecting 20 to 40 percent of the autistic population, compared to about one percent of the general population. The risk for epilepsy is particularly elevated for those with co-occurring intellectual disability, and seizures are a leading cause of death in this subgroup.
Autistic people also experience higher rates of metabolic and cardiovascular issues, including metabolic syndrome. These conditions can be linked to factors like restrictive eating patterns due to sensory sensitivities or communication barriers that complicate adherence to medical advice. Gastrointestinal (GI) disorders, such as chronic constipation or inflammatory bowel issues, are also far more common. These chronic GI problems can lead to serious complications and diagnostic delays.
The challenges associated with communication can severely delay the diagnosis and treatment of internal medical issues. Autistic individuals, especially those who are non-speaking or have differences in pain perception, may struggle to articulate symptoms to healthcare providers. This can lead to a condition being overlooked or dismissed until it reaches a life-threatening stage, a phenomenon often described as diagnostic overshadowing. These physical vulnerabilities and difficulties in accessing timely medical care contribute directly to the observed mortality gap.
Mental Health Crises and Systemic Risk Factors
External and systemic factors, particularly mental health crises, represent another preventable cause of reduced longevity. Autistic adults, especially those without an intellectual disability, face a significantly elevated risk of death by suicide. Studies suggest the risk is up to nine times higher than for the non-autistic population, making it a leading cause of death in many subgroups. This heightened risk is linked to chronic stress from navigating a world not designed for their neurology, high rates of co-occurring anxiety and depression, and social isolation.
Systemic barriers within the healthcare system further prevent effective intervention. Diagnostic overshadowing occurs when symptoms are mistakenly attributed to the person’s autism or “challenging behavior,” delaying a correct diagnosis. This can lead to the neglect of serious and treatable mental health conditions until they reach a crisis point.
Access to accommodating healthcare is a persistent challenge that creates a health equity issue. Sensory sensitivities, communication differences, and difficulties with appointment scheduling can make routine medical visits overwhelming or impossible. A lack of autism-informed training among healthcare providers can result in miscommunication and a failure to address the unique needs of the patient. These societal failures lead to unmet health needs and increased vulnerability, manifesting as a shortened lifespan.
Strategies for Promoting Health and Longevity
Addressing the longevity gap requires systemic changes focused on providing comprehensive, autism-informed healthcare and social support. A primary strategy involves ensuring that all healthcare professionals receive training on the unique sensory, communication, and processing needs of autistic patients. Medical settings should proactively implement accommodations to reduce patient anxiety, such as providing sensory-friendly waiting areas, pre-visit social stories, and flexible scheduling.
Proactive screening for co-occurring conditions is necessary to prevent premature mortality. This includes routine monitoring for conditions like epilepsy and metabolic syndrome, as well as specialized mental health screening tailored to recognize the presentation of depression and suicidality. Since communication differences can mask symptoms, care providers must be trained to look for behavioral changes that signal physical pain or distress.
Systemic support must also focus on reducing the chronic stress and isolation that fuels mental health crises. Improving access to tailored suicide prevention programs and mental health services sensitive to autistic experiences is a necessary step. Encouraging early intervention and ongoing support services throughout the lifespan can enhance adaptive skills and self-sufficiency, which are protective factors against early mortality. Promoting longevity depends on recognizing and actively mitigating these preventable health and social inequities.