For decades, when people talked about autism, they pictured children. Early intervention, school supports, transition programs — the scaffolding of autism care was built almost entirely around the young. But children grow up. And the generation of individuals diagnosed in the earliest waves of widespread autism awareness is now entering midlife and, increasingly, later adulthood.
A question that was once easy to defer has become impossible to ignore: What happens to autistic people as they age?
That question took center stage at the United Nations in October 2025, when the Autism Research Institute (ARI), in partnership with the Nancy Lurie Marks Family Foundation, co-sponsored the first-ever UN Think Tank on Aging and Autism. Held in New York City and hosted by the Autism Advisory Council of the Government of Malta, the event brought together researchers, clinicians, policymakers, and autistic individuals themselves — many of them senior-aged or approaching senior years — to map the landscape of a largely uncharted territory. The conversation that unfolded was urgent, complex, and long overdue.
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A Population We Weren’t Ready For
The numbers alone tell part of the story. The U.S. Department of Health and Human Services has estimated that approximately 50,000 autistic youth transition into adulthood in the United States every year. Over the coming decades, a growing wave of these individuals will reach later adulthood — and the systems meant to support them were simply not designed with them in mind.
Gerontology and geriatric medicine have made significant strides in improving quality of life for older adults. But as the Nancy Lurie Marks Family Foundation noted in framing the UN think tank, those advances have largely failed to address the distinct needs of autistic individuals. This population faces a different constellation of challenges as they age: higher rates of co-occurring medical and psychiatric conditions, atypical symptom presentation that makes diagnosis harder, communication differences that complicate clinical encounters, and severely limited access to care that is both age-appropriate and disability-informed.
The healthcare system, in short, was built around a version of “older adult” that doesn’t account for autism.
The Dementia Question
Perhaps no issue concentrates the urgency of autism and aging more sharply than dementia risk.
Research has shown that autistic individuals are significantly more vulnerable to dementia than the general population. One analysis of U.S. Medicaid claims data found that autistic individuals were approximately 2.6 times more likely to be diagnosed with early-onset Alzheimer’s disease and related dementias. A more recent and larger study — drawing on Medicare and Medicaid data from 114,582 autistic adults aged 30 and older — found that 8% had received a dementia diagnosis, rising to nearly 9% for those with both autism and intellectual disabilities.
Dr. Abha Chauhan of the New York State Institute for Basic Research in Developmental Disabilities, who presented at the UN think tank, explained why. The same biological mechanisms involved in aging and age-related neurological disease — inflammation, oxidative stress, the accumulation of amyloid plaques — appear to be implicated in autism in ways that may compound vulnerability over time. She recommended early cognitive assessment and attention to modifiable risk factors like cardiovascular health, sleep, diet, and alcohol consumption.
But there’s a complicating wrinkle: the diagnostic tools used to detect cognitive decline weren’t designed for autistic people. Standard cognitive screenings were built around neurotypical baselines. For autistic individuals, whose communication styles, cognitive profiles, and behavioral patterns differ in ways that are intrinsic — not pathological — these tests can be deeply unreliable. Distinguishing lifelong autistic traits from new neurodegenerative decline requires a fundamentally different approach. As researchers have put it, individualized neuropsychological baselines are needed, established early and revisited over time.
We don’t yet have a system to do that at scale.
What Autistic Seniors Said They Need
One of the most valuable aspects of the UN think tank was the direct involvement of autistic people in shaping its agenda. Autistic individuals who are senior-aged or approaching senior years helped identify which issues mattered most. Their priorities coalesced around five core areas:
Physical and Mental Health in Aging. Concern about dementia, Parkinson’s disease, cancer, and cardiac disease featured prominently — but so did the difficulty of navigating healthcare systems that weren’t built for them. Sensory sensitivities that go unaccommodated in clinical settings, difficulty communicating symptoms under stress, and the sheer administrative burden of managing complex care all emerged as compounding barriers.
Community Living and Housing. Where and how to live in later life — with adequate support, appropriate sensory environments, and a meaningful daily structure — remains deeply uncertain for many autistic adults. The standard options available to aging populations often don’t translate.
Financial Vulnerability and Legal Capacity. Alistair de Gaetano, a lawyer and Chairperson of Malta’s Autism Advisory Council who is himself autistic, presented on the financial precarity many autistic seniors face — including challenges around exercising legal capacity, managing retirement, and navigating systems not designed to support them.
Social Determinants and Discrimination. Ableism and ageism don’t operate in isolation for autistic seniors — they layer. Participants also highlighted intersectionality, particularly for LGBTQIA+ autistic individuals, as a dimension of care and advocacy that has barely been addressed.
End-of-Life and Palliative Care. This final area may be the least discussed and most urgently needed. Planning for end of life — in ways that are autistic-informed, that honor communication differences, that center dignity and individual preference — remains almost entirely undeveloped as a field.
Late Diagnosis: A Hidden Population
There is another group aging into this conversation: people who were never diagnosed as children and are discovering their autism in midlife or later.
Dr. Mary Doherty, founder of Autistic Doctors International, presented at the think tank on her own experience and on the intersection of autism with serious health conditions like breast cancer. Dr. Wenn Lawson and Kimberly Armstrong of Spectrum Works presented on the benefits — and the particular emotional complexity — of receiving a late autism diagnosis in older adulthood. Recognition can bring relief, self-understanding, and community. It can also arrive alongside grief for a lifetime spent without accommodation, without answers, without the language to make sense of one’s own experience.
For clinicians and healthcare providers, late diagnosis demands a different skillset — one built on listening carefully, not assuming, and never mapping neurotypical assumptions onto a patient’s history.
A Field in Its Infancy — But Growing
Christine Wu Nordahl, scientific program chair for the 2026 INSAR conference and director of the UC Davis Autism Phenome Project, described aging and autism as “one emerging area of research” for which “there is some evidence for higher risk for age-related conditions like dementia.” She put the stakes plainly: as the number of autistic adults increases, so will the need for research that addresses the challenges they face as they age.
The UN think tank was a step toward meeting that need. Participants committed to writing a journal article summarizing their key findings and recommendations — a resource to be shared with aging and autism researchers worldwide. Those who organized the event have also expressed hopes of making the UN think tank an annual gathering, expanding beyond aging to other evolving needs of neurodivergent people across the lifespan.
Meanwhile, the Autism Research Institute continues to flag the critical shortage of research and clinical knowledge at this intersection. Medical problems that begin in childhood often persist throughout the lifespan — and are joined by new conditions that come with age. Rehabilitation hospitals, long-term care facilities, and acute care settings are often profoundly unprepared to communicate with or treat autistic patients.
The Path Forward
What does it look like to actually serve aging autistic people well? The emerging consensus points to a few essentials.
Start planning early — ideally in a person’s 50s — covering legal, financial, housing, and health preferences before crises force decisions. Conduct sensory-friendly evaluations of care environments. Build multidisciplinary care teams that span developmental disability services and aging services, which currently operate in silos. Train healthcare workers in autism-informed support. Promote autonomy through supported decision-making rather than paternalistic substitution.
And above all: involve autistic people in designing the systems meant to serve them. The UN think tank modeled exactly this — and the result was a richer, more honest picture of what’s needed than any purely academic exercise could have produced.
For too long, autism has been treated as a childhood condition with an expiration date. The science, the demographics, and the voices of autistic seniors themselves are telling us otherwise. The frontier is here. The work of crossing it has begun.
Sources: Autism Research Institute, Nancy Lurie Marks Family Foundation, AIDE Canada, UC Davis Health/INSAR 2026, Autism Spectrum News, WPS Publishing, ARI Editorial on Autism and Dementia.
AGBS provides ongoing care for children, adolescents, and young adults with autism to improve the quality of their lives. If you would like learn more about how AGBS can help please contact us here , or call 201-373-6947.
