Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by differences in social communication, interaction, and the presence of restricted or repetitive behaviors. For families and individuals receiving a diagnosis, questions about long-term well-being are common. Research confirms that people on the autism spectrum face a significantly reduced life expectancy compared to the general population. This mortality gap is not caused by autism itself, but rather by complex, co-occurring medical and mental health conditions, as well as systemic challenges in healthcare and social support.
The Reality of Reduced Life Expectancy
The difference in lifespan for autistic individuals is a documented reality, with studies indicating a substantial mortality gap compared to the neurotypical population. The average age of death for some groups of autistic adults has been reported to be as low as 39 years, a stark contrast to the average life expectancy for the general population. Overall, the mortality rate for people with ASD is estimated to be twice as high as that of the general population.
This reduction in years lived varies significantly depending on the individual’s support needs and the presence of co-occurring conditions. Individuals with a co-occurring intellectual disability often experience the most severe gap, with some reports suggesting a reduction in life expectancy of up to 30 years. Conversely, those without an intellectual disability also face a shortened lifespan, though the reduction is generally less drastic. The elevated mortality risk is apparent across the lifespan, particularly during childhood and early adulthood.
Increased Risk from Co-occurring Medical Conditions
A major factor contributing to the reduced life expectancy is the high prevalence of co-occurring physical health conditions that are more common in the autistic population. Neurological disorders are concerning, with epilepsy affecting an estimated 20% to 30% of people on the spectrum, a rate much higher than in the general population. For individuals with ASD, the co-occurrence of epilepsy is associated with an increased risk of premature death.
Gastrointestinal (GI) issues are also far more prevalent, with many autistic individuals experiencing chronic problems such as constipation, diarrhea, and abdominal pain. Some studies suggest that GI symptoms are four times more likely in children with ASD compared to their peers. These chronic conditions can lead to nutrient deficiencies, chronic stress, and a diminished quality of life.
Cardiovascular and respiratory diseases appear to contribute to the mortality gap. Difficulties in communicating internal symptoms, such as pain or discomfort, can lead to delayed diagnosis and treatment for serious conditions. This diagnostic overshadowing means that treatable medical problems are often missed or misattributed to behavioral issues, resulting in advanced disease by the time appropriate care is sought.
Elevated Mental Health Crisis and Suicide Risk
The mental health crisis among autistic individuals, particularly those without a co-occurring intellectual disability, is a primary driver of the mortality gap. Autistic adults face extremely high rates of co-occurring psychiatric conditions, including anxiety disorders and depression. This constant psychological distress is compounded by social isolation, chronic bullying, and struggling to navigate a world built for neurotypical people.
The elevated mental health burden directly translates into a significantly higher risk of suicidal ideation and death by suicide. Autistic adults without an intellectual disability are estimated to be up to nine times more likely to die by suicide than the general population. Research indicates that as many as 66% of autistic adults have considered suicide at some point in their lives.
Many autistic individuals engage in “camouflaging” or “masking,” which involves suppressing natural behaviors to fit into social or professional settings. This intense effort to conceal autistic traits is strongly linked to burnout, severe anxiety, and suicidal thoughts. The unique presentation of distress, combined with systemic misunderstanding from clinicians, can lead to inadequate mental health support and intervention during a crisis.
Strategies for Improving Longevity and Health Outcomes
Addressing the life expectancy gap requires systemic changes focused on improving health access and professional understanding. Healthcare providers need better training to recognize and respond to the physical and mental health needs of autistic patients, particularly regarding subtle symptom presentation or communication differences. Improved screening protocols for high-risk conditions like epilepsy and chronic GI issues must be implemented as routine care.
Focusing on the social determinants of health is a necessary intervention to support longevity. Efforts to improve employment opportunities, housing stability, and community inclusion can reduce the chronic stress and isolation that fuels mental health crises. Supporting an autistic individual’s self-sufficiency in daily living activities is a known predictor of better long-term outcomes.
Comprehensive mental health screening should become standard practice across the lifespan, especially for anxiety, depression, and suicide risk. Early intervention that includes fostering social engagement and functional independence can build protective factors that extend well into adulthood. By prioritizing proactive, informed, and accessible healthcare, it is possible to mitigate the risks that currently lead to premature mortality.