A significant number of autistic adults over the age of 60 are believed to be undiagnosed, a situation experts are calling a “neglected generation.” While awareness and support for neurodiversity have grown for children and middle-aged women, older adults have remained underserved, with estimates suggesting between 89% and 97% of autistic individuals over 60 have not received a diagnosis.
Late-Life Challenges for Neurodivergent Individuals
For older neurodivergent individuals, late life can present unique challenges, particularly when combined with a lack of diagnosis. Retirement, which can offer freedom for some, may be destabilizing for autistic individuals who have structured their lives around specific routines for self-protection. Experts note that retirement can also bring increased loneliness, health changes, bereavement, and a loss of control and predictability, all of which can intersect with core autistic traits.
Dr. Neil Drew, a chartered clinical psychologist, pointed out that for individuals with ADHD, a potential decrease in dopamine associated with retirement could contribute to depression. Dr. Louise Rutter, who co-authored a report on the subject for the British Psychological Society, has identified this group as a “neglected generation” due to the lack of support.
Identifying Potential Neurodivergent Traits in Older Adults
Identifying neurodivergent traits in older parents involves looking beyond mere preferences and focusing on whether these traits cause significant life issues. Dr. Gavin Stewart, who leads on ageing and autism for King’s College London’s ReSpect Lab, explained that it’s not just about a routine, like buying a newspaper daily, but the distress caused if that routine is disrupted. Clinical psychologist Dr. Emilie Moorhead suggests considering difficulties in managing social situations, communication challenges, social isolation, or the need for significant recovery time after social events.
Traits can become more apparent with age as an individual’s nervous system, which may have worked hard for decades to mask traits, has less capacity to do so. This can lead to increased stress, rigidity, sensitivity, forgetfulness, or reduced sociability. However, some individuals may still be masking, making it difficult for laypeople to detect. Signs of masking can include conversations sounding scripted and interactions ending prematurely due to fatigue, according to Dr. Lisa Williams, founder of the Autism Service.
The Value of Late-Life Diagnosis
Experts largely encourage seeking a diagnosis for older individuals, citing instances where it has been beneficial even for those in their 80s. Dr. Rutter stated that an autism diagnosis can initiate a process of lifelong reflection, helping individuals make sense of their identity and life journey. Dr. Moorhead added that a diagnosis can be instrumental for those who have felt different or struggled in social or professional settings throughout their lives.
Dr. Drew emphasized that it is never too late to live more authentically, especially for those who have spent decades masking their traits. He noted that individuals may still have many years ahead of them to live more genuinely.
Navigating Conversations and Support Pathways
Initiating conversations about neurodivergence with older adults can be challenging due to potential misconceptions. Dr. Drew suggests a gradual approach, offering small pieces of information rather than overwhelming them with resources. He also noted that shared traits or diagnoses within families can provide a basis for connection. Discussing neurodivergent celebrities who lead successful lives can also help dispel myths, according to Dr. Stewart.
Many older adults who receive a late diagnosis may have previously been given other mental health diagnoses that did not fully explain their experiences. Dr. Moorhead highlighted that coexisting conditions like anxiety, depression, or OCD are common among autistic individuals. Symptoms like forgetfulness or brain fog, sometimes mistaken for early-onset dementia, should be discussed with a doctor.
The family dynamic can also be impacted, with a diagnosis sometimes bringing family members closer and providing explanations for long-standing behaviors. However, Dr. Stewart cautioned that strategies effective for children may not be suitable for older adults, as needs can change with age.
For those considering a diagnosis, the first step is typically a GP. However, many older patients feel they are a low priority for NHS assessments, leading some to seek private providers. It is crucial to ensure private providers offer in-person assessments and employ clinicians regulated by bodies such as the Health and Care Professions Council or General Medical Council for accurate results.
Physical and Mental Health Benefits
A diagnosis can have significant physical health benefits. Dr. Georgia Pavlopoulou noted that neurodivergent individuals may be more prone to health issues exacerbated by chronic stress from masking. Research also indicates that people with ADHD have a higher risk of premature death due to accidents, a risk that could be mitigated by medication, potentially leading to longer, healthier lives.
Even without a formal diagnosis, practical support can be implemented by focusing on an individual’s needs, such as creating safer routines, using clear communication, and managing sensory overload.
Helene Elliott is the senior reporter for News Raise. She covers Science news. She also has a keen interest in photojournalism. Helene holds a nomination for the prestigious Red Smith Award. She is married to author Dennis D’Agostino, a former publicist with the New York Mets.
