Early Death Autism, ADHD

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Several previous studies have suggested these neurodevelopmental disorders might be linked with a higher risk of premature death, but findings were inconsistent, according to a new meta-analysis, or review of data from many previous studies, published Monday in the journal JAMA Pediatrics. The meta-analysis examined 27 studies that were based in North America and Europe and published between 1988 and 2021, amounting to more than 642,000 participants.
The new research found that early mortality -- which, in the meta-analysis, was usually death in childhood or by midlife -- from natural and unnatural causes was more than two times more likely for both people with autism and those with ADHD than for the general population, said the review's lead author Ferrán Catalá-López, via email. Natural causes included cardiac events and seizures; unnatural causes included unintentional injuries, suicide and homicide.

Among those with ADHD, the number of premature deaths from unnatural causes (847) was higher than expected, but their risk of early death from natural causes wasn't as significant as that of people with autism, according to the meta-analysis. But Catalá-López, a scientist at the National School of Public Health and Network Centre for Biomedical Research in Mental Health -- both at the Institute of Health Carlos III in Madrid -- said the findings shouldn't be viewed as a death sentence.

In a commentary on the meta-analysis, neurodevelopment experts Russell A. Barkley and Geraldine Dawson -- who weren't involved in the research -- also highlighted how preventive health care can make a difference.

People with autism or ADHD "frequently die of preventable natural causes," they also wrote. "This knowledge demands widespread recognition and the implementation of systematic screening and preventive approaches."

The authors of the meta-analysis didn't have details on participants' lifestyles, socioeconomic factors or specific causes of death. But prior research has highlighted several factors that could explain the higher early death rate among children and young people with autism or ADHD, the authors wrote.
Around 1% of people worldwide have autism, while roughly 5% of people have ADHD, according to the Autism Society and World Health Organization surveys, respectively. People with ADHD or autism have been found to be at higher risk for coexisting mental disorders and neurological conditions such as depression, anxiety, substance misuse or abuse, eating disorders, epilepsy, or conduct or tic disorders.

These groups have also been linked with higher rates of obesity; dental trauma or decay; sedentary behavior or low exercise participation; sleeping problems; migraines; heart disease; and less involvement in preventive practices concerning health, nutrition and dental hygiene, Barkley and Dawson wrote.

Impulsive or inattentive behaviors that are characteristic of these disorders can be contributing factors for injuries and unintentional incidents, according to the meta-analysis.

The editorial's authors suggested that early mortality could explain something that has stumped clinical researchers for decades: the decline in the prevalence of ADHD with age. Some researchers have thought this declining prevalence might be due to people experiencing fewer ADHD symptoms as they age or not getting rediagnosed. But the findings "make plain that another explanation is the greater loss of individuals with these conditions from the population over time owing to heightened mortality compared with typical peers," Barkley and Dawson wrote.

Addressing the issue of premature mortality in people with ADHD and autism is challenging and starts with health care providers, both the meta-analysis and editorial authors said.

"Clinicians and health care professionals can be encouraged to routinely collect information on behavioral, medical conditions and health outcomes related to ASD (autism spectrum disorder)/ADHD, emphasizing the need to recognize and address modifiable vulnerability factors and prevent delays in health care provision," the meta-analysis authors wrote.

A new study has revealed that a significant number of people who died by suicide were likely autistic, but undiagnosed, highlighting the urgent need for earlier diagnosis and tailored support for suicide prevention.

A team of researchers, led by Dr Sarah Cassidy from the University of Nottingham and Professor Simon Baron-Cohen from the Autism Research Centre at the University of Cambridge, are the first to examine evidence of autism and autistic traits in those who died by suicide in England. They analysed Coroners’ inquest records of 372 people who died by suicide and also interviewed family members of those who died. The research is published today in the British Journal of Psychiatry.

The researchers found that 10% of those who died by suicide had evidence of elevated autistic traits, indicating likely undiagnosed autism. This is 11 times higher than the rate of autism in the UK. The research team worked with Coroners’ offices in two regions of England to identify the records.

The team first examined the coroners’ inquests for each death by suicide for signs of elevated autistic traits indicating possible undiagnosed autism, or a definite diagnosis of autism. Evidence of autism was then checked by an independent researcher to make sure that these decisions were reliable. The researchers then spoke to 29 of the families, to gather further evidence to corroborate the elevated autistic traits in those who died. After speaking with the families, the researchers found evidence of elevated autistic traits in more people who died by suicide (41%), which is 19 times higher than the rate of autism in the UK.

Previous research by the same group has shown that up to 66% of autistic adults have thought about taking their own life, and 35% have attempted suicide. Around 1% of people in the UK are autistic, yet up to 15% of people hospitalised after attempting suicide have a diagnosis of autism. Previous research has also found that both diagnosed autistic people and those with elevated autistic traits are more vulnerable to mental health problems, suicidal thoughts and behaviours. The new research goes beyond this by examining Coroner’s records related to people who have ended their own life.

Dr Sarah Cassidy commented: “Many adults in the UK find it very difficult to obtain an autism diagnosis and appropriate support post-diagnosis. Our study shows that undiagnosed autistic people could be at increased risk of dying by suicide. It is urgent that access to an autism diagnosis and appropriate support post diagnosis is improved. This is the top autism community priority for suicide prevention, and needs to be addressed immediately by commissioners of services and policy makers.”

Professor Simon Baron-Cohen added: “Even a single suicide is a terrible tragedy for the person and a traumatic loss for their families and friends. Suicide rates are unacceptably high in autistic people and suicide prevention has to be the number one goal to reduce the worrying increased mortality in autistic people. Autistic people on average die 20 years earlier than non-autistic people, and two big causes of this are suicide and epilepsy. We published the preliminary data on elevated suicide rates back in 2014 as a wake-up call to governments, and yet nothing has been done.”

Currently evidence of an autism diagnosis or elevated autistic traits are not usually included in Coroners’ inquests in England.

Funding:
This research was supported by Autistica, the Economic and Social Research Council Future Research Leaders grant, Coventry University, and the University of Nottingham. SBC received funding from the Wellcome Trust. In addition, SBC received funding from Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No 777394. The JU receives support from the European Union's Horizon 2020 research and innovation programme and EFPIA and AUTISM SPEAKS, Autistica, SFARI. SBC also received funding from the Autism Research Trust, the Autism Centre of Excellence at Cambridge, SFARI, the Templeton World Charitable Fund, SFARI, and the NIHR Cambridge Biomedical Research Centre. The research was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care East of England at Cambridgeshire and Peterborough NHS Foundation Trust.

I think all these sorts of topics should have a trigger warning label. Because I hate having autism so much, reading things like this feels like it's a death sentence and makes me despise it even more.

Suicide doesn't frighten me if I decide to take my own life. It only frightens me if other people decide to take their own lives.
It's just when you read "shorter lifespan" it makes it sound like autism is a deadly disease that will kill you like covid or cancer can. It can be very misleading.

I had my mid life crisis at 60, so I'm living to 120.

There are some obvious reasons for this:-1. Around 40% of autistic adults have ID so will not look after themselves well in terms of exercise, monitoring their own health, eating right etc.. but increased risk of accidents

please tell me what "ID" is?

^^^
thank you