The question of whether having Autism Spectrum Disorder (ASD) shortens one’s life is a serious concern for many families and individuals. Autism is a neurodevelopmental condition characterized by differences in social interaction, communication, and patterns of behavior. While the diagnosis itself does not directly cause an earlier death, the co-occurring physical and mental health conditions and safety risks associated with ASD mean that longevity is often impacted.
The Statistical Reality of Longevity
Epidemiological studies consistently show a reduced life expectancy for individuals on the autism spectrum compared to the general population. The difference in life span varies significantly based on co-occurring conditions, particularly the presence of intellectual disability. One large-scale study found that people with ASD died, on average, 16 to 18 years earlier than their non-autistic peers. For individuals with ASD who also have an intellectual disability, this gap widens considerably, sometimes reaching a reduction of up to 30 years. Other research indicates the average life expectancy for autistic individuals ranges from approximately 54 years to as low as 39 years, and the mortality risk is estimated to be nearly twice that of the general population, with early mortality rates up to ten times higher during childhood and early adulthood.
Physical Health Comorbidities
A significant factor contributing to reduced longevity is the increased prevalence of serious physical health conditions that co-occur with ASD. Epilepsy and seizure disorders are highly overrepresented, affecting an estimated 25% to 40% of individuals with ASD compared to about 2% to 3% of the general population. This neurological condition is a major risk factor; the life expectancy for autistic individuals with epilepsy but without an intellectual disability has been estimated to be as low as 39 years. Gastrointestinal issues are also extremely common, with some reports suggesting they affect up to 85% of individuals with ASD. Chronic inflammation and metabolic irregularities, including higher rates of obesity, hypertension, and diabetes, are frequently observed, and these conditions are often complicated by difficulties in communicating physical pain and symptoms, leading to delayed diagnosis and treatment of underlying serious illnesses like cardiovascular disease and cancer.
Mental Health and External Safety Risks
Suicide and Mental Health Risks
Beyond physical illness, mental health crises pose substantial risks to the lifespan of people with ASD. There is a significantly increased risk of death by suicide, with some studies showing the risk is nearly ten times higher than in the general population, particularly among verbally fluent individuals and those without co-occurring intellectual disability. High rates of co-occurring mental health conditions, such as anxiety and depression, are contributing factors to this elevated risk. The act of camouflaging autistic traits is also strongly associated with poorer mental health outcomes and increased suicidal ideation.
External Safety Risks
External safety risks present another unique challenge, with accidents being a leading cause of premature death. Wandering, or elopement, is common, and drowning is cited as a frequent cause of accidental death, especially for children who are drawn to water. Overall, individuals with ASD are three times more likely to die due to injury than the general population. Barriers to accessing appropriate mental healthcare and crisis intervention further exacerbate these mental health and safety vulnerabilities.
Strategies for Improving Outcomes
Improving the life expectancy of individuals with ASD requires a multi-faceted approach focused on integrated, autism-informed healthcare. Early diagnosis and timely intervention are crucial, as they can lead to better long-term outcomes in communication and daily living skills. Comprehensive care models should integrate physical and mental healthcare, ensuring that co-occurring conditions are recognized and treated proactively. Healthcare professionals need specific training to recognize how physical symptoms may be presented differently by autistic patients, especially those with communication challenges. Community-based safety training, particularly for water safety, can mitigate the high risk of accidental deaths associated with wandering, and prioritizing accessibility and sensitivity in healthcare settings can help narrow the mortality gap.