Autism in later life

Autism is not something a person catches in later life. It is a lifelong difference in how a brain develops, and it begins very early.³ But many older adults grew up at a time when few doctors looked for it. Some only learn they are autistic at 50, 60 or 70.

This page is for autistic older adults, people who wonder if they might be autistic, and families who care for them. It covers late diagnosis, aging with autism, how autism differs from dementia, and planning ahead. Research on autism in later life is still small, so we say so where the answers are not yet clear.

Can you be diagnosed with autism after 50?

Yes. The NIMH says autism can be diagnosed at any age, and the CDC says some people are not diagnosed until they are teens or adults.^2,3 The National Institute of Mental Health (NIMH) says adults can ask a health care provider for a referral to a specialist who knows autism, such as a psychologist, neuropsychologist or psychiatrist.¹

Why do so many people go unnoticed until later life?

• Few were checked as children. Many older adults grew up when autism was seen mostly as a childhood condition.
• Masking. Masking means hiding or copying behaviors to fit in. Many autistic adults mask, and it can make daily life very tiring.⁵
• Other conditions can cover it up. Anxiety, depression and ADHD can make autism harder to spot.⁵ The NIMH says some signs overlap with anxiety and ADHD, which is part of why adult diagnosis is often harder than in children.¹
• Women are often missed. Autistic women may mask more, seem to cope well in social settings, and show fewer repetitive behaviors.⁵

For more on what the signs look like, see signs of autism in adults.

What a late diagnosis can mean

Many people feel relief. A diagnosis can explain why some things were always hard and help a person see their own strengths.^1,6 Others feel grief for the years spent without support. A diagnosis can shake a person's sense of identity, and it can take time to adjust.⁶ It may also help with insurance coverage for some therapies and open the door to support groups.⁶

There are hurdles too. Few clinicians diagnose adults, waits can last months or longer than a year, and evaluations can be costly.⁶ Our page on getting an autism diagnosis as an adult walks through the steps.

Aging with autism: what we know and what we do not

Researchers are still learning. Autistica, a UK autism research charity, notes that autistic people, families and professionals report having limited information when dementia affects an autistic person.⁹ The same gaps exist for many other parts of later life.

Here is what is known from the sources we checked.

• Autism lasts throughout life. Symptoms can change over time, and some people need a lot of daily help while others need little.³ Stress and big life changes can make symptoms harder to manage.⁶
• Mental health matters. About 8 in 10 autistic people have a mental health difficulty, according to Autistica.¹⁰ One review of adult diagnosis says autistic people are about four times as likely to have depression.⁶ Adults diagnosed later in life were almost three times as likely to have a mood, anxiety or personality disorder as people diagnosed in childhood.⁶ Read more in autism and other health conditions.
• Suicide risk is higher. Autistica reports that autistic people are more likely to die by suicide than other people, and that masking and other mental health problems may add to the risk.¹⁰ This is not meant to alarm you. Suicide is preventable, and help works. See the help box below.

Everyday health, loneliness and routines

Older adults of any kind face changes: retirement, hearing or vision loss, new medicines, the death of a spouse, a move. For many autistic people these changes hit hard, because routines and familiar places do a lot of work. Distress over small changes in routine and strong reactions to light, sound or touch are common features of autism.¹

Loneliness is a risk for anyone in later life. Autistic people may have had a harder time making friends,⁵ and loss of work or family contact can shrink their world further. Small, steady ways to connect often fit best, such as a shared-interest group or a regular quiet visit. See ways to feel more connected and loneliness in later life.

Sleep problems, stomach trouble and anxiety are common with autism,^1,4 and sleep often changes with age. Tell your doctor about them. Treatable problems should not be written off as part of being autistic or part of being old. See sleep in later life and anxiety in later life.

Care settings and health visits

Doctor offices, hospitals, rehab centers and care homes are loud, bright and unpredictable. For an autistic person, that can make care harder to receive. These steps can help:

• Write a one-page "about me" sheet. List sensory triggers (noise, scratchy fabric, strong smells), how you or your relative communicate best, what calms you, and what upsets you.
• Ask for what helps. Examples: a quiet room, written instructions, extra time, a warning before touch, or the same staff member each visit.
• Bring a trusted person to appointments.
• Say what is changing and why. Sudden moves or new routines can cause great stress. Give notice, and keep favorite objects and daily rhythms where you can.
• Ask how staff will read distress. An autistic person in pain or overwhelmed may not look upset in the usual ways, or may show it through shutting down or a meltdown. Staff need to know this.

For work and home tips, see daily life, work and autistic burnout.

Autism or dementia? How they differ

Autism and dementia can look alike on the surface. Both can involve trouble with social situations, routines or language. But they are very different.

The key question is: has something changed from this person's usual self? Someone who has always lined up their items, avoided eye contact or needed a strict routine is not showing dementia just because of those habits. But someone who now cannot follow a familiar routine, gets lost on a well-known route, loses track of bills, or has new confusion needs a check-up.⁸

Warning signs listed by the Alzheimer's Association include forgetting recent information, trouble with planning or bills, and pulling back from favorite activities.⁸ Some are easy to mistake for autism. That is why change over time matters more than any single behavior.

Other problems can look like dementia and may improve with treatment, such as thyroid problems, vitamin shortages, depression, medicine side effects and too much alcohol.⁷ A doctor can check for these. See treatable conditions that look like dementia.

Autistica worked with Dementia UK and King's College London on guides for autistic people and families about dementia, because social, communication and sensory needs may interact with dementia in complicated ways.⁹ They are a good place to learn more.

Support and treatment in later life

There is no "cure" to chase, and autism does not need one. The goal is support that fits: a good daily rhythm, a calm home, and people who understand how you communicate.

The CDC says no medicine treats the core features of autism. Medicines may help with co-occurring problems such as anxiety, depression, seizures, sleep or stomach problems. Work with a doctor who knows autism, including for over-the-counter products.⁴ Talk with your doctor or pharmacist before changing anything.

Therapies named by the CDC include speech-language and occupational therapy, social skills groups and cognitive behavioral therapy (CBT).⁴ Peer groups help many people too. See support and therapy.

Planning for the future

Planning ahead is good for everyone. For an autistic person, it helps protect their choices and comfort.

1. Name a trusted person to speak for you. In an advance directive, you can name a health care proxy (someone to make decisions if you cannot) and write a living will (the care you do or do not want).¹² Medicare Part B covers voluntary advance care planning during the Welcome to Medicare visit and yearly Wellness visits.¹² See advance directives.
2. Write down what matters. Include sensory needs, food and routine, communication style, and what helps in a crisis. Share it with family and care teams.
3. Think about where you want to live. Look at housing and care options early, so a move is not a sudden shock. Ask how staff handle noise and sensory needs.
4. Find local services. The Eldercare Locator, from the federal Administration for Community Living, connects older adults and families to local services. You can call or text 1-800-677-1116.¹³
5. Build a circle of support. A few people who know you well can notice changes early. The care circle tool can help you organize it.

If you are helping a relative, see supporting an autistic family member and caregiver burnout.

Frequently asked questions

Can autism start in old age?

No. Autism begins early in life.³ What can start late is the diagnosis, or the time when masking and coping stop working because of retirement, loss or stress.⁶

Is it worth getting diagnosed this late?

Many people say yes, because it explains their life and helps them find support and community.^1,6 Others decide they do not need a formal label. Both choices are fine. It is your decision.

What words should I use?

Many autistic people prefer "autistic person," and others prefer "person with autism." Ask what the person likes. Avoid language that treats autism as a disease to fix. Stigma and the way others react can hurt more than the traits themselves.¹¹

When to get help

See a doctor soon for:

• New memory loss, confusion or getting lost in familiar places
• Sudden changes in sleep, eating, mood or behavior
• Signs of depression or anxiety that last for weeks
• Pain, illness or a new medicine that seems to cause trouble

The safety plan tool can help you prepare ahead of time. You can also read our pages on depression in later life and getting help.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.