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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0164

Unrecognized autism in older adults across generations: implications for late-life psychiatry

UNDERIDENTIFICATION OF AUTISM IN OLDER ADULTS ACROSS GENERATIONS: IMPLICATIONS FOR LATE-LIFE PSYCHIATRY

More than 90% of autistic individuals aged 50 and over may be unrecognized, creating a clinically significant gap in late-life psychiatry.

The study aimed to examine the clinical consequences of unrecognized autism in older adults and its significance for late-life psychiatry. The methodology combined a narrative analysis informed by clinical experience with a structured, focused review of the literature on autism in older adults, supplemented by observations from psychiatric practice. The evidence indicates that a substantial proportion of autistic adults over 50 remain unrecognized, with estimates suggesting that up to 90% may remain undiagnosed or have been mischaracterized. In modeled estimates for birth cohorts in England (O'Nions et al., 2023), the proportion of unrecognized cases was 99.8% among those born between 1930 and 1939, 97.1% among those born between 1940 and 1949, 89.8% among those born between 1950 and 1959, 70.8% among those born between 1960 and 1969, and 38.8% among those born between 1970 and 1979; the proportions diagnosed were 0.2%, 2.9%, 10.2%, 29.2%, and 61.2%, respectively. Although prevalence appears relatively stable across birth cohorts, recognition rates are markedly lower in older generations. Autistic individuals have higher rates of co-occurring medical and psychiatric conditions and reduced life expectancy; social outcomes are also adversely affected, with greater isolation and unemployment and reduced independence. Contributing factors included lifelong compensatory strategies, masking, diagnostic overshadowing, fragmented diagnostic trajectories, cumulative lifetime burden, cohort effects, and limited clinician awareness. The study concluded that a person-centered, integrated approach grounded in a lifespan perspective is necessary to improve recognition and reduce mischaracterization.

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