Cognitive functioning in autistic older adults
Research type
Research Study
Full title
Comparing the cognitive functioning of autistic older adults and typically developing older adults
IRAS ID
355232
Contact name
Charlotte Steel
Contact email
Sponsor organisation
Royal Holloway, University of London
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
1 years, 1 months, 31 days
Research summary
Research summary: Evidence suggests that autistic older adults report a lower quality of life compared typically developing older adults and autistic working age adults. Further research is necessary to understand the particular care needs of autistic older adults and improve the quality of support provided to such individuals. This research aims to explore differences that autistic older adults might possess in areas of cognitive functioning, such as processing speed, memory, attention and executive functioning. We hope that this research will provide a greater insight into cognitive functioning in autistic adults across the lifespan. This research also aims to be more representative of older adults accessing NHS services by exclusively recruiting individuals aged 60 and above. It is expected that differences will emerge between autistic older adults and typically developing older adults in several areas of cognitive functioning, such as processing speed, memory, executive functioning and social cognition. In improving our understanding of cognitive functioning in autistic older adults, this study will contribute to a growing body of research that will improve the quality of care provided by services for autistic older adults.
Summary of results: This research aimed to improve the understanding of the thinking skills of autistic older adults to help improve the accuracy of dementia assessments. Previously research has mostly included autistic older adults with an average age of 50. This study aimed to improve on this by increasing the minimum age of participants to 60 to better reflect autistic older adults using dementia services. The study had the following objectives:
1) To get an in-depth understanding of different thinking skills in autistic older adults using a range of questionnaires and tests.
2) To identify any strengths or challenges in the thinking skills of autistic older adults.Seven autistic people aged 60 and older participated in this research. This allowed for a detailed analysis of the test results. Participants completed 23 different questionnaires and tests exploring different types of thinking skills, including memory, problem-solving, learning new information, attention and making decisions.
Participants did not perform evenly across the different tests of their thinking skills. This suggests that autistic older adults have individual strengths and challenges in their thinking skills.
Most participants performed less well on tasks that involved quickly taking in and responding to information, suggesting this may be an area of difference.
Multiple participants performed less well on tasks in which they had to mentally manipulate information or control their impulsive responses. This could be related to differences in flexible thinking and problem-solving for some autistic older adults.
Many of the findings could be influenced by differences in how autistic older adults process sensory information (e.g., sights and sounds), to what degree they feel the need to conceal their autistic traits (i.e., ‘masking’), and the extent to which autistic people feel overwhelmed from these factors (i.e., ‘autistic burnout’). Future research must explore how these factors are related to thinking skills in autistic older adults.
The findings from the research study suggest that there is wide variation in the thinking skills of autistic older adults, and that there may not be a consistent pattern between individuals. The findings also indicate that autistic older adults may show strengths in some areas of their thinking skills but find other areas more challenging, but these areas will differ for different people.
This research has provided a baseline understanding of the thinking skills of autistic older adults, which can be used to improve the accuracy of dementia assessments for this group. The findings have highlighted the importance of considering individual strengths and difficulties when assessing the thinking skills of autistic older adults, as well as in-depth assessment to account for the wide variation of thinking skills amongst this group. This will help to make sure that clinical recommendations made to autistic older adults are specific, meaningful and strengths focussed. The research also suggests that autistic older adults may need more time on certain assessment tasks, which will help to improve how these tests are administered with this group.
This research has also provided important areas for researchers to focus on. Researchers could explore how thinking skills in autistic older adults change over time to further improve dementia assessments for this group. It is also important for future research to explore how sensory processing differences, masking and autistic burnout influence the thinking skills of autistic older adults. Finally, more research is needed to explore the experience of completing these assessments as an autistic older adult, and whether testing guidelines should be improved for this group.
REC name
Wales REC 7
REC reference
25/WA/0176
Date of REC Opinion
1 Jul 2025
REC opinion
Further Information Favourable Opinion