As awareness of Autism rises and the population ages, it is no surprise that more seniors find themselves suspecting they may have Autism, presenting for assessment, and being diagnosed.
Autism is a lifelong, neurodevelopmental condition, usually identified in childhood. Many adults, including older adults, have faced the challenges of Autism their whole lives, such as difficulties with their communication, behavior, sensory challenges, focused interests, and relationships. Many older adults are living with undiagnosed Autism without knowing the cause of their challenges, having grown up in a time when Autism was generally not well understood. Autism is now much better understood by health care providers. However, traits of Autism in older adults still may be mistaken for other conditions or situations such as anxiety, depression, shyness, social withdrawal due to aging, and cognitive changes associated with aging or dementia. When undiagnosed Autism is present in an older adult, receiving a correct diagnosis can help individuals further their understanding of themselves and access support and care, making improvements in their quality of life possible.
Signs of Autism in Older Adults
An article posted on elder.org in March of 2026 describes the signs of Autism in older adults, which can vary widely from one individual to another:
- Difficulty understanding how others are feeling
- Struggling to communicate emotions or thoughts clearly
- Preferring to spend time alone rather than in social groups
- Difficulty making or keeping friendships
- Relying on routines and becoming anxious when plans change
- Experiencing sensory sensitivities, such as sensitivity to noise, bright lights, or strong smells
- Developing very strong interests in specific topics
- Focusing closely on patterns, details, or systems
- Finding eye contact uncomfortable
- Feeling socially exhausted after interactions with others
- Experiencing anxiety, depression, or burnout, particularly if they have spent years masking their traits.
Elder.org further notes differences in symptoms of Autism in older men vs. older women (these trends are described by gender, though individual differences are certainly present, and these signs may be present across genders):
Signs of Autism in Older Men
- Strong interest in technical, structured, or specialized topics
- Preference for predictable routines
- Difficulty interpreting social cues
- Challenges with emotional communication
Signs of Autism in Older Women
- Copying or mirroring other people’s behavior in social situations
- Maintaining a small number of very close friendships
- Strong emotional sensitivity
- Intense interests that appear socially typical, such as literature, animals, or hobbies
- Internalized anxiety or exhaustion from social interactions
Diagnosis of Autism in Older Adults
An article published in Health Psychology and Behavioral Medicine in 2019 notes that adults over the age of 50 recently diagnosed with Autism felt that diagnosis was a positive step in their lives. Prior to diagnosis, they reported feeling alienated from others, feeling like “a stranger in a strange land.” Symptoms of Autism in older adults can be missed, as over time these individuals may have developed strategies to mask or deal with primary markers of Autism. The authors argue that when older adults experience anxiety related to changes in routines, anxiety related to the anticipation of change, anxiety caused by sensory issues, depression, other mental health issues, and failure to achieve, they should be screened for Autism. The authors further noted that diagnosis, accompanied by appropriate services and supports, allows for reconfiguration of the identity of older adults, redefining narratives of their lives and their future possibilities, and an appreciation of their individual needs.
Dr. Blackmon’s practice has included assessment of cognitive changes in the aging population and assessment of Autism in adults for many years. As more older adults become aware of their symptoms of Autism, often after the diagnosis of their child or grandchild, many are presenting for their own Autism assessment. If you wish to discuss Autism assessment, please reach out to Dr. Blackmon at amy@amyblackmonphd.com.