Aging and autism spectrum disorder: Evidence from the broad autism phenotype
Gregory L. Wallace
Department of Speech and Hearing Sciences, The George Washington University, Washington, DC
Search for more papers by this authorJessica Budgett
Department of Psychology, Goldsmiths University of London, London, UK
Search for more papers by this authorCorresponding Author
Rebecca A. Charlton
Department of Psychology, Goldsmiths University of London, London, UK
Address for correspondence and reprints: Rebecca A. Charlton, Department of Psychology, Goldsmiths University of London, London, SE14 6NW, UK. E-mail: [email protected]Search for more papers by this authorGregory L. Wallace
Department of Speech and Hearing Sciences, The George Washington University, Washington, DC
Search for more papers by this authorJessica Budgett
Department of Psychology, Goldsmiths University of London, London, UK
Search for more papers by this authorCorresponding Author
Rebecca A. Charlton
Department of Psychology, Goldsmiths University of London, London, UK
Address for correspondence and reprints: Rebecca A. Charlton, Department of Psychology, Goldsmiths University of London, London, SE14 6NW, UK. E-mail: [email protected]Search for more papers by this authorAbstract
This study investigated for the first time the broad autism phenotype (BAP) in the context of older adulthood and its associations with real-world executive function, social support, and both depression and anxiety symptomatology. Based on self-ratings of autistic traits, 66 older adults (60+ years old, range = 61–88) were split into BAP (n = 20) and control (n = 46) groups. Individuals in the BAP group, even after controlling for age, education level, sex, and health problems, exhibited more real-world executive function problems in multiple domains, reported lower levels of social support, and self-rated increased depression and anxiety symptomatology compared to the control group. Regression analysis revealed that level of social support was the strongest predictor of BAP traits across both groups, although real-world executive function problems and depression symptomatology were also significant predictors. Moreover, when predicting anxiety and depression symptomatology, BAP traits were the strongest predictors above and beyond the effects of demographic factors, real-world executive function problems, and social support levels. These findings suggest that the BAP in older adulthood imparts additional risks to areas of functioning that are known to be crucial to aging-related outcomes in the context of typical development. These results might in turn inform aging in autism spectrum disorder, which has been largely unexplored to date. Autism Res 2016, 9: 1294–1303. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.
References
- Anstey, K.J., von Sanden, C., Sargent-Cox, K., & Luszcz, M.A. (2007). Prevalence and risk factors for depression in a longitudinal, population-based study including individuals in the community and residential care. American Journal of Geriatric Psychiatry, 15, 497–505.
- Bancroft, K., Batten, A., Lambert, S., & Madders, T. (2012). The way we are: Autism in 2012. London, UK: The National Autistic Society.
- Beck, A.T., Epstein, N., Brown, G., & Steer, R.A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897.
- Bolton, P., Macdonald, H., Pickles, A., Rios, P., Goode, S., Crowson, M., Bailey, A., & Rutter, M. (1994). A case-control family history study of autism. Journal of Child Psychology and Psychiatry, 35, 877–900.
- Bölte, S., & Poustka, F. (2006). The broader cognitive phenotype of autism in parents: how specific is the tendency for local processing and executive dysfunction? Journal of Child Psychology and Psychiatry, 47, 639–645.
- Constantino, J.N., & Todd, R.D. (2003). Autistic traits in the general population: A twin study. Archives of General Psychiatry, 60, 524–530.
- Croen, L.A., Zerbo, O., Qian, Y., Massolo, M.L., Rich, S., Sidney, S., & Kripke, C. (2015). The health status of adults on the autism spectrum. Autism 19, 814–823.
- Dawson, G., Estes, A., Munson, J., Schellenberg, G.D., Bernier, R., & Abbott, R. (2007). Quantitative assessment of autism symptoms in autism probands and parents: Broader phenotype autism symptom scale. Journal of Autism and Developmental Disorders, 37, 523–536.
- Delorme, R., Goussé, V., Roy, I., Trandafir, A., Mathieu, F., Mouren-Siméoni, M. C., Betancur, C., & Leboyer, M. (2007). Shared executive dysfunctions in unaffected relatives of patients with autism and obsessive compulsive disorder. European Psychiatry, 22, 32–38.
- Gerdts, J., & Bernier, R. (2011). The broader autism phenotype and its implications on the etiology and treatment of autism spectrum disorders. Autism Research and Treatment, Article ID 545901, doi:10.1155/2011/545901.
- Geurts, H.M., & Vissers, M.E. (2012). Elderly with autism: Executive functions and memory. Journal of Autism and Developmental Disorders, 42, 665–675.
- Granader, Y., Wallace, G.L., Hardy, K.K., Yerys, B.E., Lawson, R.A., Rosenthal, M., Wills, M.C., Dixon, E., Pandey, J., Penna, R., Schultz, R.T., & Kenworthy, L. (2014). Characterizing the factor structure of parent reported executive function in autism spectrum disorders: The impact of cognitive inflexibility. Journal of Autism and Developmental Disorders, 44, 3056–3062.
- Happé, F., & Charlton, R.A. (2011). Ageing in autism spectrum disorders: A mini-review. Gerontology, 58, 70–78.
- Hawkley, L.C., Thisted, R.A., Masi, C.M., & Cacioppo, J.T. (2010). Loneliness predicts increased blood pressure: Five-year cross-lagged analyses in middle-aged and older adults. Psychology & Aging, 25, 132–141.
- Hill, E.L. (2004). Executive dysfunction in autism. Trends in Cognitive Sciences, 8, 26–32.
- Hughes, C., Leboyer, M., & Bouvard, M. (1997). Executive function in parents of children with autism. Psychological Medicine, 27, 209–220.
- Hurley, R.S.E., Losh, M., Parlier, M., Reznick, J.S., & Piven, J. (2007). The broad autism phenotype questionnaire. Journal of Autism and Developmental Disorders, 37, 1679–1690.
- Ingersoll, B., Meyer, K., & Becker, M.W. (2011). Increased rates of depressed mood in mothers of children with ASD associated with the presence of the broader autism phenotype. Autism Research, 4, 143–148.
- Isaac, V., Stewart, R., Artero, S., Ancelin, M.L., & Ritchie, K. (2009). Social activity and improvement in depressive symptoms in older people: A prospective community cohort study. American Journal of Geriatric Psychiatry, 17, 688–696.
- James, I.A., Mukaetova-Ladinska, E., Reichelt, F.K., Briel, R., & Scully, A. (2006). Diagnosing Aspergers syndrome in the elderly: A series of case presentations. International Journal of Geriatric Psychiatry, 21, 951–960.
- Jobe, L.E., & White, S.W. (2007). Loneliness, social relationships, and a broader autism phenotype in college students. Personality and Individual Differences, 42, 1479–1489.
- Jurado, M.B., & Rosselli, M. (2007). The elusive nature of executive functions: A review of our current understanding. Neuropsychology Review, 17, 213–233.
- Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–249.
- Kenworthy, L., Yerys, B.E., Anthony, L.G., & Wallace, G.L. (2008). Understanding executive control in autism spectrum disorders in the lab and in the real world. Neuropsychology Review, 18, 320–338.
- Klusek, J., Losh, M., & Martin, G.E. (2014). Sex differences and within-family associations in the broad autism phenotype. Autism, 18, 106–166.
- Koenig, H.G., Westlund, R.E, George, L.K, Hughes, D.C., Blazer, D.G., & Hybels, M.P.H. (1993). Abbreviating the duke social support index for use in chronically Ill elderly individuals. Psychosomatics, 34, 61–69.
- Landa, R., Piven, J., Wzorek, M.M., Gayle, J.O., Chase, G.A., & Folstein, S.E. (1992). Social language use in parents of autistic individuals. Psychological Medicine, 22, 245–254.
- Lever, A.G., & Geurts, H.M. (2015). Age-related differences in cognition across the adult lifespan in autism spectrum disorder. Autism Research. DOI:10.1002/aur.1545.
-
Liu, L.,
Gou, Z., &
Zuo, J. (2014). Social support mediates loneliness and depression in elderly people. Journal of Health Psychology. DOI:10.1177/1359105314536941.
10.1177/1359105314536941 Google Scholar
- Losh, M., Childress, D., Lam, K., & Piven, J. (2008). Defining key features of the broad autism phenotype: A comparison across parents of multiple- and single-incidence autism families. American Journal of Medical Genetics, Part B, Neuropsychiatric Genetics, 147, 424–433.
- Losh, M., Adolphs, R., Poe, M.D., Couture, S., Penn, D., Baranek, G.T., & Piven, J. (2009). Neuropsychological profile of autism and the broad autism phenotype. Archives of General Psychiatry, 66, 518–526.
- Luijendijk, H., van den Berg, J.F., Dekker, M.J., van Tuijl, H.R., Otte, W., Smit, F., Hofman, A., Stricker, B.H., & Tiemeier, H. (2008). Incidence and recurrence of late-life depression. Archive of General Psychiatry, 65, 1394–1401.
- Lund, R., Nilsson, C.J., & Avlund, K. (2010). Can the higher risk of disability onset among older people who live alone be alleviated by strong social relations? A longitudinal study of non-disabled men and women. Age & Ageing, 39, 319–326.
- Mukaetova-Ladinska, E.B., Perry, E., Baron, M., Povey, C., & Autism Ageing Writing Group (2012). Ageing in people with autistic spectrum disorder. International Journal of Geriatric Psychiatry, 27, 109–118.
- Piven, J., Gayle, J., Chase, G.A., Fink B., Landa, R., Wzorek, M.M., & Folstein, S.E. (1990). A family history study of neuropsychiatric disorders in the adult siblings of autistic individuals. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 177–183.
-
Piven, J.,
Palmer, P.,
Landa, R.,
Santangelo, S.,
Jacobi, D., &
Childress, D. (1997). Personality and language characteristics in parents from multiple-incidence autism families. American Journal of Medical Genetics, 74, 398–411.
10.1002/(SICI)1096-8628(19970725)74:4<398::AID-AJMG11>3.0.CO;2-D CAS PubMed Web of Science® Google Scholar
- Piven, J., Rabins, P., & Autism-in-Older Adults Working Group (2011). Autism spectrum disorders in older adults: Toward defining a research agenda. Journal of the American Geriatrics Society, 59, 2151–2155.
- Robinson, E., Koenen, K.C., McCormick, M.C., Munir, K., Hallett, V., Happé, F., Plomin, R., & Ronald, A. (2011). Evidence that autistic traits show the same etiology in the general population and at the quantitative extremes (5%, 2.5% and 1%). Archives of General Psychiatry, 68, 1113–1121.
- Ronald, A., & Hoekstra, R.A. (2011). Autism spectrum disorders and autistic traits: A decade of new twin studies. American Journal of Medical Genetics, Part B, Neuropsychiatric Genetics, 156, 255–274.
- Ronald, A., Happé, F., & Plomin, R. (2005). The genetic relationship between individual differences in social and nonsocial behaviours characteristic of autism. Developmental Science, 8, 444–458.
- Rosbrook, A., & Whittingham, K. (2010). Autistic traits in the general population: What mediates the link with depressive and anxious symptomology? Research in Autism Spectrum Disorders, 4, 415–424.
- Rosenblatt, M. (2008). I Exist: The message from adults with autism in England. London, UK: The National Autistic Society.
- Roth, R.M., Isquith, P.K., & Gioia, G.A. (2005). Behavioral rating inventory of executive function-adult version. Lutz, FL: Psychological Assessment Resources, Inc.
- Ruzich, E., Allison, C., Smith, P., Watson, P., Auyeung, B., Ring, H., & Baron-Cohen, S. (2015). Measuring autistic traits in the general population: A systematic review of the autism-spectrum quotient (AQ) in a nonclinical population of 6,900 typical adult males and females. Molecular Autism, 6: 2. DOI: 10.1002/aur.1545.
- Sasson, N.J., Lam, K.S., Parlier, M., Daniels, J.L., & Piven, J. (2013a). Autism and the broad autism phenotype: Familial patterns and intergenerational transmission. Journal of Neurodevelopmental Disorders, 5, 11.
- Sasson, N.J., Lam, K.S.L., Childress, D., Parlier, M., Daniels, J.L., & Piven, J. (2013b). The broad autism phenotype questionnaire: Prevalence and diagnostic classification. Autism Research, 6, 134–143.
- Shankar, A., Hamer, M., McMunn, A., & Steptoe, A. (2013). Social isolation and loneliness: Relationships with cognitive function during 4 years of follow-up in the English longitudinal study of ageing. Psychosomatic Medicine, 75, 161–170.
- Shiovitz-Ezra, S., & Ayalon, L. (2010). Situational versus chronic loneliness as risk factors for all-cause mortality. International Psychogeriatrics, 22, 455–462.
- Skuse, D.H., Mandy, W.P., & Scourfield, J. (2005). Measuring autistic traits: heritability, reliability and validity of the social and communication disorders checklist. British Journal of Psychiatry, 187, 568–572.
- Spinhoven, P., Ormel, J., Sloekers, P.P.A., Kempen, G.I.J.M., Speckens, A.E.M., & Van Hemert, A.M. (1997). A validation study of the hospital anxiety and depression scale (HADS) in different groups of Dutch subjects. Psychological Medicine, 27, 363–370.
- Stuart-Hamilton, I., Griffith, G., Totsika, V., Nash, S., Hastings, R.P., Felce, D., & Kerr, M. (2009). The circumstances and support needs of older people with Autism. Report for the Welsh Assembly Government. Cardiff, Welsh Assembly. http://wales.gov.uk/docs/dhss/report100622olderpeoplewithautismreporten.pdf.
- Taylor, M.G., & Lynch, S.M. (2004). Trajectories of impairment, social support and depressive symptoms in later life. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 59, 238–246.
- Tun, P.A., Miller-Martinez, D., Lachman, M.E., & Seeman, T. (2013). Social strain and executive function across the lifespan: The dark (and light) sides of social engagement. Neuropsychology, Development, and Cognition, Section B, Aging, Neuropsychology, and Cognition, 20, 320–338.
- van Heijst, B.F.C., & Geurts, H.M. (2015). Quality of life in autism across the lifespan: A meta-analysis. Autism, 19, 158–167.
- van Niekerk, M.E., Groen, W., Vissers, C.T., van Driel-de Jong, D., Kan, C.C., & Oude Voshaar, R.C. (2011). Diagnosing autism spectrum disorders in elderly people. International Psychogeriatrics, 23, 700–710.
- Wainer, A.L., Block, N., Donnellan, M.B., & Ingersoll, B. (2013). The broader autism phenotype and friendships in non-clinical dyads. Journal of Autism and Developmental Disorders, 43, 2418–2425.
- Wallace, G.L., Kenworthy, L., Pugliese, C.E., Popal, H.S., White, E.I., Brodsky, E., & Martin, A. (2016). Real-world executive functions in adults with autism spectrum disorder: Profiles of impairment and associations with adaptive functioning and co-morbid anxiety and depression. Journal of Autism and Developmental Disorders, 46, 1071–1083.
- Wheelwright, S., Auyeung, B., Allison, C., & Baron-Cohen, S. (2010). Defining the broader, medium and narrow autism phenotype among parents using the autism spectrum quotient (AQ). Molecular Autism, 1, 1–10.
- Wilcox, J.A., Tsuang, M.T., Schnurr, T., & Baida-Fragoso, N. (2003). Case-control family study of lesser variant traits in autism. Neuropsychobiology, 47, 171–177.
- Woods, R.T. (1999). Mental health problems in later life. In R.T. Woods (ed.) Psychological Problems of Ageing. Chichester: John Wiley, pp. 73–110.
- Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M., & Leirer, V.O. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 37–49.