how do we all deal with aging, as spectrumites or otherwise

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I read somewhere that autistic folk have a lesser life expectancy than NT's do, sometimes to the effect of a decade or two decades shorter. I am not sure how true that is, but it sounds a bit daunting.

Congenital heart malformations used to be a death sentence for many newborns. But as medical care and surgeries have improved, most infants born with heart defects — nearly 1 in 100 babies in the United States — live to adulthood. As they do, another matter has come to light: As many as half of people with congenital heart disease (CHD) have neurodevelopmental issues such as autism.

Having CHD may raise the chances of being diagnosed with autism by anywhere from about one-third to sixfold, according to estimates from the past five years; A 2023 meta-analysis of all previous studies pegged the increased likelihood at twofold.

Many children with CHD also have some traits that resemble autism but don’t merit a diagnosis, such as problems with theory of mind and executive function, which includes working memory, cognitive flexibility, planning and self-regulation. “There’s also the question of what do we do with everything that lies in between,” says Johanna Calderon, chair in neurodevelopment at the University of Montpellier in France and lead scientist of the Cardiac Neurodevelopmental Team at the French National Institute of Health and Medical Research.

Scientists used to think that these neurodevelopmental issues stemmed from the life-saving surgeries that infants with CHD typically undergo. Techniques such as deep hypothermia to achieve circulatory arrest and circulating the blood externally were thought to damage the brain by reducing blood flow to it or causing blood clots.

But as it turns out, factors related to heart surgery account for only 5 to 8 percent of differences in neurodevelopmental issues among people with CHD, according to a 2019 review. And milder heart defects are more strongly linked to autism than severe ones, another 2019 study showed. What’s more, many children with CHD show signs of atypical brain development before they even enter the operating room.

I only recently stumbled across this possible Autism effect:

"Change of heart and mind: Autism’s ties to cardiac defects"
This is near and dear to my heart because in 2012 (when I was 59) an angiogram identified a defect in my heart which I have since been told was probably congenital. In 2020 I had nontrivial surgery to "repair" it. If the defect had not been detected and "repaired" I was progressing toward an aortic aneurysm...which could've been very inconvenient.

Oh s**t. My father (very likely Aspie) died of sudden unexpected heart failure at the age of 75. Did you have any symptoms?

From the congenital heart problem? I'm not sure. I was always OK at lower levels of physical exertion but I could not do the same extreme exertion as the other kids.

Eventually I was stuck at a lower energy level. I felt fine but I could not increase my exertion level.

Then they operated to repair my heart valve. I guess I feel like I have more energy than before. But I still feel like someone in their late 60s who never did heavy exercise.

I've always dreaded a slow, lingering death under fluorescent lights in a big, "heartless" hospital (excuse the pun).

There are ways of avoiding that. You can sign advanced directives to limit care.
You can also elect the Hospice care route and skip expensive medical procedures.

The Medicare Hospice benefits pretty much cover everything. Something to consider if you have an estate to leave to your loved ones.

My bride, however, had had a very bad 32 hours.

Yes, even if we die painlessly in our sleep, there's the matter of those we leave behind. It's particularly awful for old, bereaved partners. Some of them never recover from the loss.