Autism causes dramatic lifestyle changes. Research suggests the disorder can cause early death.

Researchers are working hard to understand why a developmental disorder like autism can shorten lifespans. A combination of genetics and environmental factors may work together to cause early death. Watching for study results is wise for anyone living with autism.

But for now, families should know that the issue exists. They should work closely with doctors and therapists to mitigate risks as much as possible, so the people they love can live long and healthy lives.

What the Research Says About Mortality

Two groups participate in autism mortality studies. One has autism, and the other does not. Researchers determine when each set of people died and of what. These are observational studies, so researchers can't say why an early death happens. But they can make assumptions about how long one group lives when compared to another.

In 2016, a group of Swedish researchers selected more than 27,000 people with autism and more than 2,000 people without for an observational study. At the end of the study, 0.91% of people without autism died, but 2.6% of those with autism died.

This study was remarkable, and it caused many people to pay attention to early death in those with autism. The study contained few clear, simple answers about causes.

What Might Cause an Early Death?

The researchers didn't want to make guesses about mortality. Families of those with autism want to know what could cause early death. Knowledge can lead to prevention, and that might lead to a longer life.

Potential causes of early death in people with autism include:

  • Communication struggles. Some people with autism don't talk at all, and others have limited skills. They may not be able to describe symptoms or body changes to their families or their doctors, and that can lead to missed intervention opportunities. For example, people with autism have higher epilepsy rates. Researchers say seizures can get missed in people who can't communicate clearly. That could lead to disease worsening and life-threatening episodes.
  • Fatal accidents. People with autism may wander or run from their families, and often, they're drawn to pools or large bodies of water. These episodes can lead to drowning, which researchers call a "classic cause" of premature death in people with autism.
  • Gastrointestinal distress. Experts say people with autism are eight times more likely to have chronic GI problems than their peers. Some develop chronic constipation, which can lead to life-threatening complications, including prolapse of the rectum. A poor diet that is low in fiber, which is often preferred by people with autism, plays a role.
  • Suicide. Researchers say people with autism and no learning disability die early due to suicide. It's the leading cause of early death in this group of people. Everyone who commits suicide has an independent reason for doing so, but reduced job opportunities, few social connections, and general misunderstanding by peers likely exacerbate this risk.
  • Relentless bullying. Differences invite teasing and bullying. Research suggests that 68% of children with autism are bullied, and 47% had been hit by peers or siblings. Victimization leads to chronic stress, and that can impact a person's cardiovascular health and mental well-being. The effects build over time.
  • Underlying health conditions. Researchers say people with autism are, in general, less healthy than their peers. They have higher rates of heart disease, stroke, diabetes, and respiratory problems than neurotypicals. All of these diseases could lead to an early death.

These risk factors can intertwine. A child constantly bullied, for example, might choose suicide as a way out. Similarly, a child with heart disease and poor communication skills may never disclose chest pain or other early warning signs.

What Can Families Do?

You can't reach into your loved one's body and make genetic code changes. But there are things you can do to help ease the damage autism can cause.

Research suggests that early death risks are highest in people with poor social and daily living skills. Hire a specialist to help the person you love build up these vital communication and life skills. That could reduce frustrations and help you catch issues early, when they are easier to address.

Choose a medical professional who is well aware of autism. Schedule regular physicals, and keep those appointments. Screen for common health issues and include a quick mental health check. The more you can catch at annual appointments, the better.

Oftentimes, it’s helpful to go beyond primary care and see a specialist who has vast experience with autism. Ask your primary care physician for a referral.

Finally, keep a close eye on someone with autism. Ask about how the person feels, both physically and emotionally. Address bullying at the source, when you can. Change environments if you need to do so to keep the person safe. You can't keep your community from bullying, but you can advocate for someone you love, and this can help to keep them safe.

References

Premature Mortality in Autism Spectrum Disorder. (2016). The British Journal of Psychiatry.

Large Swedish Study Ties Autism to Early Death. (December 2015). Spectrum.

Study Identifies Predictors of Early Death Among Autistic People. (April 2019). Spectrum.

Primary Care for Adults on the Autism Spectrum. (September 2014). Medical Clinics of North America.

People on Autism Spectrum Die 18 Years Younger Than Average. (March 2016). Science.

Autism and Health: A Special Report by Autism Speaks. (2017). Autism Speaks.

The Three Main Causes of Early Death in Autism. (April 2016). Autism Awareness Centre.

Autism and Safety Facts. National Autism Association.

Tackling Early Death in Autism. (October 2016). Autistica.

Study Identifies Predictors of Early Death Among Autistic People. (April 2019). Spectrum.