A new review found around 90% of adults over the age of 40 with autism are undiagnosed as a psychologist reveals the symptoms to look out for
A fresh study from King’s College London revealed that roughly 90% of autistic adults aged over 40 remain undiagnosed, with limited research and understanding about the condition amongst older generations. To bridge this knowledge void, Dr Lisa Williams, a clinical psychologist and founder of The Autism Service, outlined seven subtle indicators of autism in adults that frequently slip under the radar.
Routines, habits and predictability
Adults on the autism spectrum may find themselves locked into inflexible daily patterns and rituals that provide them with security, especially if they’ve gone undiagnosed for most of their existence. This might involve requiring detailed advance planning and maintaining their everyday customs without deviation.
When arrangements alter or their established patterns face disruption, they could encounter heightened stress and worry. Unexpected spontaneity can also leave them feeling deeply uncomfortable.
Workplace difficulties
Autistic adults may demonstrate exceptional ability in their core responsibilities and duties, yet when confronting the interpersonal and adaptable elements of office life, they might find it more challenging than their peers to manage.
Speaking to PA, Dr Williams explained: “They may struggle with aspects of workplace integration, such as adapting to frequent changes, navigating office politics, or participating in group meetings that feel overwhelming.
“However, supportive managers who provide reasonable adjustments, like clear communication or flexibility in work routines, can help them succeed. Without this understanding, autistic employees may face unnecessary stress, conflict, or even unfair disciplinary action.”
Social difficulties
Dr Williams explained: “Unwritten social norms, such as eye contact, small talk, respect for personal space, body language and understanding subtle humour, as just a few examples, can be more difficult to understand for older adults with autism.
“People with autism often think differently from neurotypical people and can interpret things much more literally or struggle to pick up on subtle social cues. This may result in feeling out of step in social settings or needing extra time to process interactions, even with years of life experience.”
Romantic difficulties
Just like the social challenges experienced by adults with autism, forming and maintaining romantic relationships can prove more complex. This becomes particularly apparent when attempting to express feelings or decode signs of affection.
Dr Williams observed that they might feel uncomfortable with physical closeness or favour living independently rather than sharing a home. She added: “They often thrive in relationships with partners who are understanding of their needs, communicate openly, and are willing to adapt to their preferred ways of connecting.”
Sensory sensitivities
Light, noise, odours and textures can leave an autistic adult feeling distressed or overwhelmed. This indicator is typically most apparent in busy and noisy settings or when donning certain materials that activate the sensory processing distinctions experienced by people with autism.
Change
Whilst it’s commonly said that nobody enjoys change, for elderly adults with undiagnosed autism, alterations may prove considerably more challenging to handle. Dr Williams explained: “Moving house, starting a new job or adapting to new technology can draw out natural anxieties about a lack of predictability and familiarity.
“Consistent signs of this can be a hallmark of autism.”
Interests
Dr Williams noted: “It’s not uncommon for anyone with autism to develop deep interests in particular subjects or hobbies, but this can be especially the case for older adults. This can appear to be a lifelong passion, but if it dominates their free time and tends to be something they talk about almost obsessively, it could be a sign that the person falls somewhere on the autistic spectrum.”
Fresh research published in the Annual Review of Developmental Psychology revealed that approximately 96% of people with autism over 60 remain undiagnosed, in contrast to 23% of those under 19 with autism who lack a diagnosis. Older adults exhibiting high levels of autistic traits were found to be six times more likely to grapple with suicidal thoughts, self-harm ideation and actual self-harm.
The study also indicated that these people were four times more likely to receive an early diagnosis of dementia compared to those without autism. Autistic adults often encounter poorer outcomes in areas such as employment prior to retirement, relationships, and overall quality of life, largely due to heightened social isolation.
The review further revealed that they face obstacles in accessing healthcare support owing to autistic characteristics like communication differences, sensory sensitivities, uncertainty about service access, and a lack of understanding about adult autism among medical professionals.