The dynamic trajectory of autistic life and its changing challenges: a scoping review

Abstract

Background

There is a noticeable knowledge vacuum on the ways in which autism interacts with the difficulties associated with aging, even though in recent decades there has been a growing recognition of the different needs and experiences of those on the autistic spectrum. Importantly, experiences across earlier life stages such as youth and young adulthood also influence later outcomes and warrant consideration within this dynamic trajectory, meaning the ongoing and evolving developmental path individuals follow throughout life.

Objectives

This study aimed to review the existing literature on the unique needs, challenges, and experiences of autistic adults as they progress into later stages of life.

Methodology

The scoping review was carried out by following a structure that included defining the research topic, finding pertinent studies, choosing studies, charting data, and ultimately compiling, summarizing, and synthesizing the findings, the scoping review was carried out. PubMed, PsycINFO, Google Scholar, and ScienceDirect are the databases that were used to perform an exhaustive search of the literature from 2010 to 2023. Studies were screened for inclusion based on predefined criteria.

Results

Despite an initially large dataset, only a limited number of studies directly addressed the intersection of autism and aging in sufficient depth. This review yielded only two themes: (1) Challenges experienced by adults with autism when aging; (2) interventions and support strategies.

Conclusion

The important need for greater comprehension of the relationship between autism and aging was highlighted by this study. It exposed a wide range of difficulties that autistic adults encounter as they age, such as inequalities in healthcare and problems integrating into society. This review will contribute to a deeper understanding by highlighting the evolving challenges, unmet needs, and support mechanisms required by autistic adults as they age, offering insights for research, policy, and practice.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12888-025-07212-5.

Introduction

The term “dynamic trajectory” refers to a path or course that is constantly evolving or changing over time due to various influencing factors [1]. Research on aging and adult autism is lacking, and, much more so, information on the supports and interventions that are most likely to help adults with autism live fulfilling lives [2]. Autism is a neurodevelopmental disorder that affects a person’s interactions, communication, and perception of their environment throughout their lives [2]. Compared to women, men are diagnosed with autism spectrum disorder (ASD) about four times more commonly [3]. Nonetheless, both autistic men and autistic women have unique needs as well as difficulties.

A wide range of physical and mental healthcare services, including social services to support work efforts, are frequently needed by autistic people [4]. The study conducted by Miller et al.’s study (2022) revealed that most autistic adults require services throughout their lives [5]. These services encompass physical, mental, and behavioural health care as well as community-based programs such as one-on-one support and supported employment [5]. Similarly, Turcotte et al. (2016) found that autistic individuals had the highest need for occupational treatment, speech and language therapy, one-on-one support, and social skills education, compared to individuals with other developmental disorders or the general population [6]. As per the recently released Lancet Commission on the future of care and clinical research in autism, this is in accordance with their emphasis on the necessity of creating and executing a high-quality, evidence-based, and economical healthcare model that is customized to meet the specific requirements of adults with autism [7, 8].

Research found that many necessary supports, like those for self-care, education or employment, mental health, and social skills, are usually not given [9]. As such, individuals with autism spectrum disorders (ASDs) encounter difficulties and obstacles in accessing prompt and suitable services, perhaps exacerbating their life paths and consequences as they mature [10]. Research found that adults diagnosed with autism spectrum disorders frequently report having several medical conditions, significant difficulties with daily living skills, and a significant need for assistance [11, 12]. In contrast, Manson et al. (2021) alluded to the fact that the general population too frequently has trouble accessing appropriate health services [13]. Consequently, adults with autism spectrum disorders indicated an increased likelihood of unfulfilled medical demands, worse general healthcare, and inefficient use of resources [14–16]. These then contribute to a vicious cycle that is linked to increases in comorbidity, chronicity, and suicidality as well as decreases in psychosocial functioning or health-related quality of life [17, 18].

In comparison to the general population, research indicates that persons with autism experience greater rates of trauma and post-traumatic stress disorder (PTSD) [19]. In addition, adults with autism and high autism traits report greater rates of emotional and domestic abuse, sexual and physical violence, and victimization [19]. These findings highlight the heightened susceptibility to traumatic experiences in adulthood [20, 21]. As a result, there is a greater chance of mental health issues, which includes an increase in the frequency of suicidal thoughts [22]. When compared to neurotypical individuals, several clinical and population-based studies have shown that adults with autism face higher rates of nearly all mental health issues [23–25].

According to recent research conducted on the health of autistic people, the prevalence of physical ailments and other health issues rises with age [19, 26, 27]. Significantly, Rydzewska et al.’s (2019) Scottish epidemiological study revealed that autistic men and women 65 years of age or older had twice the rate of physical disabilities including mobility impairments and neurological impairments [28]. Furthermore, according to several studies, adults with autism experience difficulties in assessing or characterizing their health, difficulties in receiving treatment, and a lack of understanding of individuals with autism in both physical and mental health care [29–31]. This is likely due to communication challenges, sensory sensitivities and a lack of autism specific training among healthcare providers which hinder effective understanding and accommodation of their needs. Conversely, research involving medical professionals and individuals with autism has revealed challenges related to communication between patients and providers, sensitivity to stimuli, executive functioning, and bodily awareness [8]. Additionally, they reported experiencing a great deal of stigma related to their autism and the need for mental health services [8, 29]. Healthcare access was hampered by alignment concerns, systemic problems, and other factors [8, 13].

However, families and partners of adults with autism typically make up for the lack of support: in addition to the financial burden, they frequently dealing with high levels of stress and responsibility that exacts extra time and increases the emotional burden, anxiety, and results in depression [32]. Adults with autism frequently find it difficult to be independent in self-care to work, to manage their finances, and to complete all the other tasks necessary to live independently as an adult should [33]. As a result, they frequently live in supported living arrangements or, more frequently, with family [23, 32]. According to Orsmond et al. (2013) many adults with autism experience social isolation and have limited possibilities for social connection [34].

While there is increasing recognition of the diverse needs and experiences of individuals on the autistic spectrum, a noticeable knowledge vacuum remains regarding how autism intersects with the challenges of aging. Existing literature has largely focused on autism in childhood or early adulthood, with limited attention paid to how needs evolve across the lifespan, particularly in later life. This review seeks to address that gap by examining not only aging-related challenges but also how earlier life experiences may shape outcomes in older age. Therefore, the study aimed to review the existing literature on the intersection of autism and aging and examine its impact on the needs and challenges of autistic adults. Furthermore, the primary goal of informing research, clinical practice, and policy development to better support this population.

Methodology

The present researchers decided that a scoping review would be the most appropriate study design for this research due to the gaps in the understanding of the requirements and challenges of autistic persons as they age. Researchers working in the field can obtain study findings through the scoping review, which also detects gaps in the literature and gathers, summarizes, and disseminates research findings [35]. Furthermore, scoping reviews apply rigorous techniques to find and evaluate pertinent research from a variety of methodologically and heterogeneous sources of information. Given the dearth of well-defined studies and standardized outcomes in this field, this technique is crucial for detecting gaps and guiding future research directions. To accomplish the goal of the study, we only used the first five steps of the Arksey and O’Malley framework [35]. The five steps are as follows: (1) identifying the research question; (2) searching strategy; (3) Study selection; (4) data extraction and analysis; and (5) collating, summarizing, and reporting results.

Research question

This scoping review’s guiding question was: what are the specific needs and challenges encountered by autistic adults as they age, and how can tailored support and interventions be developed to enhance their wellbeing and quality of life in later stages of adulthood?

Identifying relevant literature and selection of search terms

Using a search syntax, a comprehensive examination of the literature using electronic databases, including PubMed, PsycINFO, Scopus, Google Scholar, and Science Direct, was initiated in January 2023. To ensure a comprehensive and systematic search of the literature, we enlisted the expertise of a professional librarian with special training in conducting systematic reviews. The librarian assisted in developing and refining our search strategy, which included selecting appropriate databases, determining relevant search terms, and applying Boolean operators to optimize the search. The search terms included variations related to the population (e.g., “Autistic,” “Asperger,” “ASD”), age group (e.g., “Adulthood,” “Older Age,” “Midlife”), and needs or challenges (e.g., “Needs,” “Challenges,” “Difficulties,” “Weaknesses”). This approach yielded an estimated total of 9,500 articles, with 1,200 from PubMed, 800 from PsycINFO, 1,500 from Scopus, 5,000 from Google Scholar, and 1,000 from Science Direct. Despite the large number of initial results, many articles were excluded due to irrelevance, duplication, or not meeting the inclusion criteria focused on studies directly addressing the intersection of autism and aging. After a rigorous screening process, we included 60 studies that provided relevant and high-quality insights into the needs and challenges faced by autistic adults in later life. This final selection reflects a targeted focus on studies that best contribute to understanding the scope and depth of the research in this emerging area. Table 1 below shows the exact search strategy, including the databases searched, keywords used, and any filters applied. This table will facilitate replication of the study. Our search yielded several thousand articles, and we employed rigorous inclusion and exclusion criteria to narrow down the results. We reviewed each of the relevant articles that met our criteria. Summary of selected studies is shown in Fig. 1.

Table 1.

Search strategy table

Database	Search String	Number of articles
PubMed	(“Autistic” OR “Asperger” OR “ASD” OR “autism spectrum disorder”) AND (“Adulthood” OR “Older Age” OR “Midlife” OR “Later-Life” OR “Aging”) AND (“Needs” OR “Challenges” OR “Difficulties” OR “Weaknesses” OR “Barriers” OR “Experiences”)	1200
PsycINFO	(“Autistic” OR “Asperger” OR “ASD” OR “autism spectrum disorder”) AND (“Adulthood” OR “Older Age” OR “Midlife” OR “Later-Life” OR “Aging”) AND (“Needs” OR “Challenges” OR “Difficulties” OR “Weaknesses” OR “Barriers” OR “Experiences”)	800
Scopus	(“Autistic” OR “Asperger” OR “ASD” OR “autism spectrum disorder”) AND (“Adulthood” OR “Older Age” OR “Midlife” OR “Later-Life” OR “Aging”) AND (“Needs” OR “Challenges” OR “Difficulties” OR “Weaknesses” OR “Barriers” OR “Experiences”)	1500
Google Scholar	(“Autistic” OR “Asperger” OR “ASD” OR “autism spectrum disorder”) AND (“Adulthood” OR “Older Age” OR “Midlife” OR “Later-Life” OR “Aging”) AND (“Needs” OR “Challenges” OR “Difficulties” OR “Weaknesses” OR “Barriers” OR “Experiences”)	5000
Science Direct	(“Autistic” OR “Asperger” OR “ASD” OR “autism spectrum disorder”) AND (“Adulthood” OR “Older Age” OR “Midlife” OR “Later-Life” OR “Aging”) AND (“Needs” OR “Challenges” OR “Difficulties” OR “Weaknesses” OR “Barriers” OR “Experiences”)	1000

Fig. 1.

A Prisma diagram of the selection of articles [36]

The articles written in English language were included and span the years 2010 through 2023. The decision to include articles published between 2010 and 2023 was based on the evolution of research in the field of autism and aging. Research on the aging experiences of autistic individuals began to gain more attention around 2010, coinciding with a broader recognition of autism as a lifelong condition, not just a childhood disorder. This period marks the emergence of significant studies that focus on the needs and challenges of autistic adults, particularly as they age, and reflects the growing understanding of autism across the lifespan. Selecting 2010 as the starting point allows us to capture this critical period of development in the literature, while also ensuring that the review includes the most up-to-date research.

For this scoping review, we employed the Population, Concept, and Context (PCC) framework, which is well-suited to the exploratory nature of scoping reviews [35]. This approach guided our inclusion and exclusion criteria, ensuring a focused yet comprehensive review of the literature.

Inclusion criteria

• Population (P): We included studies that specifically addressed autistic individuals, encompassing those diagnosed with autism spectrum disorder (ASD), Asperger’s Syndrome, or other related conditions. Our primary interest was in adults, particularly those in midlife (ages 40–64) or older age (65+), as the focus of this review was to understand the experiences of aging within the autistic population at the intersection of autism and aging. However, a considerable number of included studies also involved adolescents (ages 14–18) and young autistic adults (ages 18–39), reflecting the broader context of challenges encountered across life stages. To ensure clarity and consistency, we defined “aging” as the progression into midlife and later life, emphasizing transitions in health, social roles, and independence. Support studies were defined as those providing empirical or theoretical insights into the challenges and needs of autistic individuals related to aging. These definitions guided the selection of studies and allowed us to assess their relevance to the review’s objectives.

• Concept ©: Studies were selected based on their exploration of the needs, challenges, and experiences of autistic adults as they age. This included, but was not limited to, research on physical and mental health, social support, employment, and quality of life. We also considered studies addressing difficulties and barriers faced by this population in later life.

• Context ©: We focused on studies conducted in various social and cultural contexts, without geographic limitations, to capture a wide range of experiences. However, the studies needed to be published in peer-reviewed journals, available in English, and relevant to the intersection of autism and aging.

Exclusion criteria

• Population: Studies focusing on children or adolescents were excluded, as our interest was in understanding the challenges faced by autistic individuals as they age.

• Concept: We excluded studies that did not directly address the specific needs or challenges of aging autistic individuals. For instance, studies solely focused on early interventions or childhood development were not considered relevant to our review.

• Context: Articles not published in peer-reviewed journals, or those not available in English, were excluded. Additionally, studies that were purely theoretical or lacked empirical data were not included, as we prioritized research with substantive findings applicable to real-world scenarios.

Quality appraisal

To assess the methodological rigor of the included studies, a quality appraisal was conducted. Each study was independently evaluated by two reviewers against criteria such as clarity of aims, appropriateness of methodology, recruitment strategy, data collection and analysis, consideration of researcher bias, ethical issues, and clarity of findings. Studies were scored based on how well they met these criteria, with scores categorized as high, moderate, or low quality. Any discrepancies between reviewers were resolved through discussion or consultation with a third reviewer. The quality appraisal ensured that the synthesis was informed by studies with acceptable methodological standards, enhancing the credibility of the review findings. Studies were rated High if most criteria were clearly addressed (Yes), Moderate if some criteria were partially addressed (Moderate), and Low if several criteria were inadequately addressed (No). The quality appraisal tool is show in the Table 2.

Table 2.

A summary quality appraisal

Author/Year	Geographical area	Objectives Clear	Methodology Appropriate	Recruitment Strategy	Ethics Addressed	Findings Clear	Overall Quality Rating
Nicolaidis et al.,2015 [8]	USA	yes	yes	yes	yes	yes	High
Nicolaidis et al.,2013 [16]	USA	yes	yes	yes	yes	yes	High
Mason et al.,2021 [32]	USA	yes	yes	yes	no	yes	High
Vohra et al.,2016 [39]	USA	yes	yes	yes	yes	yes	High
Vohra et al.,2016 [40]	USA	yes	yes	yes	yes	yes	High
Zerbo et al.,2019 [41]	USA	yes	yes	yes	yes	yes	High
Zerbo et al.,2015 [42]	USA	yes	yes	yes	yes	yes	High
Unigwe et al.,2017 [43]	UK	yes	no	yes	yes	no	Moderate
Vogan et al.,2017 [44]	CANADA	yes	yes	yes	no	yes	High
Raymaker et al.,2017 [45]	USA	yes	yes	yes	yes	yes	High
Saqr et al.,2018 [46]	USA	yes	yes	yes	yes	yes	High
Nicolaidis et al.,2016 [47]	USA	yes	yes	yes	yes	yes	High
Vohra & Rini (2016) [48]	USA	yes	yes	yes	yes	yes	High
Au-Yeung et al.,2019 [49]	UK	yes	no	yes	no	yes	Moderate
Hedley et al.,2018 [50]	AUSTRALIA	yes	yes	yes	no	yes	High
Pelton et al.,2017 [51]	UK	yes	no		no		Moderate
Lever et al.,2016 [52]	NETHERLANDS	yes	no	yes	no	yes	Moderate
Kerns et al.,2015 [53]	USA	yes	no	yes	no	yes	Moderate
Stewart et al.,2023 [54]	UK	yes	yes	yes	yes	yes	High
Stewart et al.,2020 [55]	UK	yes	yes	yes	yes	yes	High
Cassidy et al.,2014 [56]	UK	yes	yes	yes	yes	yes	High
Jadav et al.,2022 [57]	USA	yes	yes	yes	yes	yes	High
Howlin & Iliana (2017) [58]	USA	yes	yes	yes	yes	yes	High
Happé et al.,2016 [60]	UK	yes	yes	yes	yes	yes	High
Russell et al.,2016 [61]	UK	yes	yes	yes	yes	yes	High
Baker et al.,2015 [62]	AUSTRALIA	yes	yes	yes	yes	yes	High
Jovevska et al.,2020 [63]	USA	yes	yes	yes	yes	yes	High
MacLennan et al.,2022 [64]	UK	yes	yes	yes	yes	yes	High
Sala et al.,2023 [65]	AUSTRALIA	yes	yes	yes	yes	yes	High
Barnett et al.,2015 [68]	CANADA	yes	yes	yes	yes	yes	High
Brown-Lavoie et al.,2014 [69]	CANADA & USA	yes	yes	yes	yes	yes	High
Pecora et al.,2020 [71]	USA	yes	yes	yes	yes	yes	High
Douglas et al.,2023 [72]	UK	yes	yes	yes	yes	yes	High
Gibbs et al.,2023 [73]	AUSTRALIA	yes	yes	yes	yes	yes	High
Weiss et al.,2018 [74]	CANADA	yes	yes	yes	yes	yes	High
Vaiouli et al.,2021 [78]	CYPRUS	yes	yes	yes	yes	yes	High
Rapp et al.,2018 [79]	USA	yes	yes	yes	yes	yes	High
Radev et al.,2023 [81]	UK	yes	no	yes	no	yes	Moderate
Bagatell et al.,2023 [85]	USA	yes	no	yes	no	yes	Moderate
Muniandy et al.,2022 [87]	AUSTRALIA	yes	no	no	yes	yes	Moderate
Turner & Neil (2016) [89]	USA	yes	no	yes	no	no	Low
Pavlopoulou et al.,2019 [93]	LONDON	yes	no	yes	yes	no	Moderate

Data extraction and data analysis

Critical data from included studies was compiled, and their attributes were quantified by the authors. The study findings were then thematically synthesized. Using Cresswell’s Tesch method of data analysis, this was accomplished [37]. The writers created a conceptual framework by talking about the thematic codes, which L.W. then applied to the remaining pieces. G.O. then verified that all the articles had accurate coding. Using NVIVO word clouds, L.W., G.O., and M.W. quantified codes to provide an understanding of the requirements and difficulties faced by adults with autism. After that, we created themes that all the authors approved of.

Results

This scoping review aimed to give an overview of the relationship between aging and autism to better understand the demands and difficulties faced by autistic adults as they age. The themes and subthemes of the findings were developed by the authors using a thematic coding approach [37], as shown in Table 3 below. In this investigation, two themes and nine subthemes surfaced. In some cases, conceptually related subthemes were integrated into broader overarching themes to provide a clearer and more coherent synthesis of the findings. This approach was taken when distinct but closely connected experiences shared a common underlying issue or developmental trajectory. By collapsing these subthemes, we aimed to reveal the broader patterns and key challenges faced by autistic adults, while still preserving the nuance of individual findings within each theme.

Table 3.

Characteristics of the studies

Author/Year	Research Design	Research methodology	Population (n)	Data Collection	Results	Age-Range
Nicolaidis et al.,2015 [8]	Experimental Research Design	Qualitative study	55	Semi-structured, open-ended interviews	Satisfaction with care varied by multiple factors.	19–64
Nicolaidis et al.,2013 [16].	Descriptive research design	Qualitative study	437	Online survey	Autistic individuals reported lower patient-provider communication satisfaction.	18 or older
Mason et al.,2021 [32]	Cross-sectional	Quantitative study	6	Online survey	Increased Barriers to healthcare services	Above 18
Vohra et al.,2016 [39]	Cross-sectional research design	Quantitative study	25,527	Online survey	Adults with ASD use ED for injuries, non-psychiatric, and mental needs.	22–64
Vohra et al.,2016 [40]	Retrospective cohort	Qualitative study	1772	Open ended interviews	There were high reported rates of mental health issues	22–64
Zerbo et al.,2019 [41]	Case control study	Qualitative study	1507	Open ended interviews	Adults with ASD had higher healthcare utilization rates.	Above 18
Zerbo et al.,2015 [42]	Exploratory-descriptive	Qualitative study	922	Open-ended interviews	Many practitioners misidentified or overlooked adult ASD cases.	Above 18
Unigwe et al.,2017 [43]	Cross-sectional research design	Quantitative study	304	Online survey	Increased barriers to access healthcare services	18 or above
Vogan et al.,2017 [44]	Cross-sectional research design	Quantitative study	40	Online survey	Increased medical obstacles among autistic adults	18–61
Raymaker et al.,2017 [45]	Cross-sectional research design	Quantitative study	209	Online survey	Top barriers were fear and difficulty processing information for healthcare discussions.	18 or above
Saqr et al.,2018 [46]	Retrospective cross-sectional research design	Quantitative study	10	Online closed-open questionnaire	ASD patients and health providers face communication challenges.	18–30
Nicolaidis et al.,2016 [47]	Descriptive exploratory and cross-section research design	Qualitative and quantitative study	259	open-ended questions.	High access to healthcare were reported	18 or above
Vohra & Rini (2016) [48]	Retrospective cohort	Quantitative Study	1772	Online survey	High rates of psychiatric comorbidity were reported	22–64
Au-Yeung et al.,2019 [49]	Descriptive design	Qualitative study	420	Open-ended- questions	Autistic participants received more diagnoses but disagreed.	18–67
Hedley et al.,2018 [50]	Cross-sectional	Quantitative study	185	Closed-ended questions	High increased rates of mental issues were reported	18–80
Pelton et al.,2017 [51]	Descriptive design	Quantitative study	163	Online survey	Burdensomeness and thwarted belonging mediated autistic traits’ suicidality.	18–30
Lever et al.,2016 [52]	Cross-sectional design	Quantitative study	247	Online survey	Lower incidence of psychopathology, particularly social phobia, in late adulthood.	19–79
Kerns et al.,2015 [53]	Descriptive design	Quantitative study	54	Online survey	No consensus on measuring anxiety and ASD.	17 or older
Stewart et al.,2023 [54]	Cross sectional design	Quantitative study	276	Online survey	High rates of suicidal ideation were reported.	50 and above
Stewart et al.,2020 [55]	Cross-sectional design	Quantitative study	13,897	Online survey	Autistic adults reported difficulty in sleeping.	50–81
Cassidy et al.,2014 [56]	Cross-sectional design	Quantitative study	374	Closed-ended questionnaire	There are increased rates of suicidal ideation in adults with Asperger’s syndrome	17–67
Jadav et al.,2022 [57]	Descriptive and cross-sectional design	Quantitative study	4857	Online survey	The study reported more lifetime psychiatric diagnoses	18–85
Howlin & Iliana (2017) [58]	Cross-sectional	Quantitative study	20	Online survey	Limited social integration, poor job prospects, mental health issues.	18 and above
Happé et al.,2016 [60]	Longitudinal design	Quantitative study	100	Closed-ended questions	Increased age was associated with higher ASD traits and better cognition.	Over 18
Russell et al.,2016 [61]	Retrospective cohort	Quantitative study	937	Closed-ended questions	Anxiety disorders, especially OCD, were prevalent in autism.	Over 18
Baker et al.,2015 [62]	Cross-sectional design	Quantitative study	36	Online survey	Adults with ASD had significantly more general sleep disturbances	36
Jovevska et al.,2020 [63]	Cross-sectional	Quantitative study	297	Closed-ended questions	Autistic participants experienced more frequent sleep problems.	15–80
MacLennan et al.,2022 [64]	Mixed method design	Qualitative and quantitative study	49	Both closed and open-ended questions	Content analysis explored sensory reactions; thematic analysis identified outcomes, control, tolerance themes.	20–55
Sala et al.,2023 [65]	Experimental exploratory design	Qualitative	57	online survey	Autistic individuals showed higher rates of non-binary, non-heterosexual identities.	Above 16
Barnett et al.,2015 [68]	Exploratory design	Qualitative study	24	Open-ended questions	Participants’ concerns included courtship difficulties and sensory dysregulation.	18–61
Brown-Lavoie et al.,2014 [69]	Cross sectional, longitudinal	Quantitative study	212	Online survey	ASD individuals experienced sexual victimization, limited sexual knowledge.	19–43
Pecora et al.,2020 [71]	Longitudinal design	Quantitative study	295	Online Survey	Autistic females report higher non-heterosexuality, sexual victimization.	Above 16
Douglas et al.,2023 [72]	Experimental exploratory design	Qualitative study	24	semi-structured interviews online	Participants experienced recurring assault, violence, with shared themes.	25–61
Gibbs et al.,2023 [73]	Cros-sectional design	Quantitative study	250	Online survey	Autistic adults reported higher rates of all violence types.	Above 15
Weiss et al.,2018 [74]	Cross-sectional design	Quantitative study	42	Online survey	ASC individuals reported higher childhood victimization, including assault.	18–53
Vaiouli et al.,2021 [78]	Cross-sectional design	Quantitative study	275	Online survey	Alexithymia significantly impacted participants’ interpersonal skills model.	18 or above
Rapp et al.,2018 [79]	Exploratory design	Qualitative study	12	Semi-structured interviews	Three spaces identified; design supports spatial needs.	Above 18
Radev et al.,2023 [81]	Experimental design	Qualitative study	10	Semi-structured interview	Autistic moms faced service challenges affecting well-being.	Above 18
Bagatell et al.,2023 [85]	Descriptive design	Qualitative study	31	Semi-structured interview	Roles persisted regardless of autistic adults’ demographics.	Above 30
Muniandy et al.,2022 [87]	Descriptive design	Qualitative study	420	Open-ended interview	Insights on coping, mental health in autism were identified.	15–80
Turner & Neil (2016) [89]	Descriptive exploratory design	Qualitative single case study	1	Open-ended interview	Therapy improved anxiety, distress, depression, self-esteem.	47
Pavlopoulou et al.,2019 [93]	Descriptive design	Qualitative study	9	semi-structured interviews	Good maintenance of sister relationship identified.	14 and above

Charting of data

In this study, forty-two studies were included. It is very important to note that the researchers primarily focused on the intersection of autism and aging to understand the needs and challenges among autistic population when they age. The characteristics of the forty-two studies included in the review are tabulated in Table 4 below. The table will include author, publication year, research design, research methodology, population, data collection, results, and age range.

Table 4.

Themes and subthemes of the review

Themes	Subthemes
1. Challenges faced by adult with autism when aging.	1.1. Access challenges to Healthcare Services. 1.2. Communication Barriers in Healthcare Settings. 1.3. Sensory Sensitivities and Healthcare Environments. 1.4. Mental Health Challenges. 1.5. Sexual Desire Challenges and Sexual Victimization. 1.6. Marital and Relationship Challenges. 1.7. Parenting Challenges and Death of Caregivers.
2. The Interventions and support Strategies	2.1. Psycho-social Interventions and Therapies. 2.2. Support Systems and Networks.

To provide a clearer overview of the scope, a map and chart illustrating the geographical distribution and types of studies are included as Figs. 2 and 3.

Fig. 2.

Geographic distribution of the studies included in the review, highlighting the countries where research on autism and aging has been conducted

Fig. 3.

Breakdown of study types included in the review to illustrate the methodological diversity

Collating, summarizing, and reporting the results

The authors followed the Creswell Tesch technique to formulate themes and sub-themes [37].

Theme 1: challenges faced by adults with autism when aging

The review highlights the challenges faced by older autistic adults in their daily lives.

Subtheme 1.1: access challenges to healthcare services

Autistic adults often face significant barriers when accessing healthcare services. Many report difficulties in finding healthcare providers who are knowledgeable about autism, which can lead to suboptimal care and increased frustration. Research indicates that compared to the general population, individuals with autism are more likely to use certain healthcare services [13]. Similarly, a study conducted in 2016 by Vohra et al. found that individuals with autism visited emergency rooms considerably more frequently for mental and physical health issues than the general population (who visited less frequently for alcohol and drug abuse disorders [38]. Yet, compared to the general population, persons with autism are noticeably more likely to report unmet healthcare needs and weaker healthcare self-efficacy [16, 39]. Significant variations in the ways that services are accessed still exist. For instance, compared to the general population, autistic adults may be more likely to use a diabetes screening service, but not a cervical, breast, or prostate cancer screening program [40]. Nevertheless, data from interviews and surveys indicates that many medical professionals lack the knowledge and resources needed to manage autistic patients [41]. It’s possible that healthcare professionals won’t get official training on autism [42].

A qualitative study by Vogan et al. found that over 25% of individuals with autism reported being afraid of being stigmatized or given a label [43]. Similarly, qualitative studies examined the attitudes of healthcare professionals toward people with autism [8]. Additionally, system-level determinants influencing healthcare access were discovered [8]. The availability of official or informal help for the intricacies of the healthcare systems was one of these aspects [8]. Moreover, Nicolaidis et al. revealed that several adults with autism felt that they required assistance to successfully navigate the healthcare system [8]. Findings from Vogan et al. show that just over 50% of participants said that the process of asking for help was a barrier, and nearly 70% said that not knowing where to look for help was a barrier to getting health care [43].

Subtheme 1.2: communication barriers in healthcare settings

Autistic adults frequently encounter communication barriers in healthcare settings, often feeling misunderstood due to differences in communication styles and sensory sensitivities. Adults with autism spectrum disorders expressed far less satisfaction with patient provider communication, according to a recent large survey [13]. Manson et al. systematic review found that five studies reported communication with healthcare providers as a barrier to healthcare [13]. The following were examples of communication challenges: scheduling an appointment, speaking with the primary care physician, or the healthcare practitioner not honouring the autistic patient’s preferred mode of communication [13, 44–46]. Certain healthcare practitioners, for instance, do not accept the use of augmented communication because they believe an autistic patient cannot attend an appointment without the assistance of a relative or caregiver [13]. Healthcare access issues or a lack of effort in reporting medical conditions can be caused by general communication problems, both verbal and nonverbal [46]. It has been reported, for instance, that literal interpretation of language hinders some autistic people’s capacity to respond to queries regarding, say, quantifying pain [13]. According to Nicolaidis et al., a related study also revealed that certain individuals with autism who utilize alternative communication technologies expressed uncertainty about their healthcare providers’ ability to support them [8, 13].

Subtheme 1.3: sensory sensitivities and healthcare environments

Autistic adults often report that sensory sensitivities in healthcare environments, such as bright lights and loud noises, make it difficult for them to focus and effectively communicate with healthcare providers. Enhanced sensory sensitivity is one of the distinct issues that adults with autism frequently face [45]. These sensitivities can show up as enhanced sensitivity to touch, light, sound, or even certain textures, among other manifestations [45]. This can cause older persons with autism distress and discomfort in healthcare settings. Hospitals and clinics sometimes have startling bright lights, loud noises, and strange sensations that can exacerbate anxiety or tension that already exists [45, 46]. The sound of medical equipment, the antiseptic scent of disinfectants, and waiting rooms full of strangers can all aggravate sensory sensitivity [45]. The discomfort and uneasiness that elderly people on the spectrum experience can also be exacerbated by healthcare institutions’ ignorance about autism and their inability to make modifications for it [47]. Furthermore, it is important for healthcare professionals to be aware of and understanding of the fact that some medical treatments or tests may be difficult for a patient to tolerate due to sensory sensitivity.

Subtheme 1.4: mental health challenges

According to recent research, people with autism spectrum disorders may be more susceptible to exposure to risk factors for mental health disorders [48–50]. Consequently, there was a higher chance of depression and suicidality. In fact, Lever and Geurts (2016) found that 79% of adult autistic individuals satisfied the criteria for a mental co-occurring disease at some point in their lives, with mood and anxiety disorders being the most prevalent and happening at a much higher rate than in non-autistic adults [23].

First, it may be challenging for individuals with autism to recognize that they are suffering from depression and anxiety due to the overlap of many characteristics of autism (e.g., social disengagement, sleep issues) with these diseases [51, 52]. Second, traits linked to autism may influence how individuals with autism express mental health issues [53]. For instance, autism is linked to alexithymia, which is a problem identifying and characterizing feelings and emotions [53]. This may influence how depression manifests in individuals with autism [48, 53, 54].

Similarly, high rates of psychiatric problems are typically observed in adults with autism, according to a study by Jadav and Bal (2022) examining mental health outcomes [55]. Alarmingly high rates of depression, anxiety, and obsessive-compulsive disorder (OCD) have been observed in adult autistic individuals [55–57]. A related study conducted by Happe et al. discovered that the frequencies of co-occurring disorders in 100 persons with ASD diagnosis were comparable to those of 46 adults without ASD [58]. In contrast to a non-ASD group, 474 adults with an ASD diagnosis were found to have a considerably higher clinical diagnostic of obsessive-compulsive disorder (OCD) in another study of 859 people who were referred for an autism diagnosis [59]. In contrast to the UK general population, it is observed that persons with autism who were diagnosed as adults had higher odds of being diagnosed with a phobia, generalized anxiety disorder, OCD, or depressive episode [59].

A multi-method approach was used by Baker and Richdale (2015) to investigate sleep issues in a group of individuals with autism who were between the ages of 21 and 44 [60]. In comparison to an age- and gender-matched comparison group, the authors found that autistic adults had longer sleep onsets and more fragmented sleeps through actigraphy (a device that measures sleep/wake patterns objectively through movement recordings); they also reported more sleep disturbances, lower sleep quality, and poorer sleep efficiency through self-report measures with a moderate-to-large effect [60]. While the prevalence of sleep issues in midlife and older age has not been thoroughly studied, Jovevska et al., found that throughout their lives, autistic individuals had trouble in sleeping at a higher rate (64%), compared to the 46% in the reference group [61].

Subtheme 1.5: sexual desires challenges and sexual victimization

Being more sensitive to physical touch can result in sex-related issues. According to MacLennan et al., many adults with autism are highly sensitive to tactile experiences and react more strongly than others to even mild stimulation [62]. Touch sensitivity experienced by autistic adults may be linked to higher rates of painful sex and premature ejaculation problems in men [63]. Conversely, Tunner et al. contend that hypersensitivity to bodily sensations and social skill deficits may increase the likelihood of hypersexuality in certain autistic individuals [64]. Sometimes, individuals could use inappropriate social behaviors to convey their sexual feelings. When people struggle to discover ways to meet their needs, they may end up adopting risky or aberrant sexual activities that violate social standards [64].

The study by Solomon et al., 2019 found that people with autism may have trouble ex-pressing their sexual demands, which can lead to problems in close relationships. Rather than discussing these desires with their partner, they can try to satiate them on their own, which could lead to resentment [65]. Sexual coercion can occasionally result from communication breakdowns about sex [66]. This happens when someone emphasizes their need for sex so much and inappropriately that it gets harder and harder for the other person to say no [65]. According to Barnett et al., (2015) partners with autism may find it difficult to recognize when expressing interest in sex becomes demanding [66]. This is because social cues from other people play a major role in determining what is and is not appropriate [65].

According to Brown-Lavoie et al., (2014) there may be a greater risk of sexual victimization for people with autism [67]. This encompasses being forced or duped into engaging in sexual activity with someone who might seem to be interested in them [67]. Adults with autism may be more vulnerable to sexual abuse due to difficulties interpreting social cues [68]. Results from a study matched for intellectual ability between 95 autistic adults and 117 non-autistic adults showed that there was a higher incidence of sexual victimization among autistic men and women [67]. The Brown-Lavoie et al. (2014) study also revealed that, in comparison to students without disabilities, American college students with autism were twice as likely to report unwelcome sexual contact [67].

Similarly, Pecora et al. (2020) observed that a sample of 135 autistic women, whose ages ranged from 18 to 56, also exhibited higher rates of unwelcome social advances [69]. Of these women, 78% reported having been the subject of unwanted sexual advances in the past, compared to 57% of non-autistic women [69]. Furthermore, a bigger worldwide study with 425 persons with autism and 268 adults without autism discovered that the autism group reported substantially greater rates of forced and coercive sexual engagement [69]. This is corroborated by research done by Douglas et al. (2023) which discovered that compared to non-autistic individuals in partnerships, autistic adults who had been in relationships were more likely to have experienced sexual abuse at the hands of a partner [70].

Emerging research indicates that adult autistic people experience high rates of physical violence, much like they do sexual violence [71]. Weiss et al. (2018) looked into the victimization experiences that 45 adults with autism and 42 non-autistic adults with similar IQs, educational backgrounds, gender distributions, and ethnic backgrounds had as children and adults [72]. They discovered that adults with autism had a 4.4 times higher likelihood of reporting having been the victim of a weapon attack than adults [72]. According to Yew et al. (2021) slightly more than one-third of 426 individuals with autism stated that they have experienced severe physical harm as an adult from someone, which has left them with physical scars [73].

Subtheme 1.6: marital and relationship challenges

Adults with autism experience communication difficulties, which can have a big effect on a marriage’s dynamics [74, 75]. Misunderstandings can occur frequently because of the difficulties autistic people have comprehending implicit communication [74]. For example, a partner’s use of irony or reliance on nonverbal clues might not be understood as intended, which could cause misunderstanding or annoyance [74, 75]. Both partners may feel disconnected because of their inability to accommodate one another’s communication preferences. Notably, emotional management presents additional difficulty when it comes to causing serious stress in a marriage for persons with autism [74, 75].

Strong emotional reactions are common among autistic people, which can make it difficult for them to handle conflict or emotionally charged situations [76, 77]. It could be difficult for spouses to comprehend or react to these intensely felt emotions. The emotional health of both may be impacted by this cycle of tension [77]. Another difficulty is lack of flexibility and high need for routine. Routines can provide comfort to those with autism, and sudden alterations might be upsetting [78]. When normal demands conflict with the flexibility and spontaneity that are frequently required in partnerships, this difficulty might cause conflict [78].

Subtheme 1.7: parenting challenges and death of caregivers

Parenting presents unique obstacles for many adults with autism, especially when it comes to communication and parenting approaches [79]. Parent-child relationships may be impacted by variations in communication styles and how they read social cues [79]. For example, a parent with autism may find it difficult to implicitly interpret nonverbal clues from their child, which may have an impact on how well the youngster feels supported and guided by their parents [80]. Furthermore, due to their routines and sensory sensitivity, parents with autism may have distinct parenting methods [80]. Another important factor determining parenting difficulties for adults with autism is emotional management [81]. Parenting-related stressors combined with possible emotional regulation issues can lead to strains [81]. Moreover, parents with autism may face societal obstacles and discrimination because of their parenting skills [82]. According to research, prejudice, and discrimination against parents of autistic children might be exacerbated by societal misconceptions regarding autism [83].

Most adults with autism rely on their carers [83]. For autistic adults, who frequently depend on the support and direction of their caregivers, the death of a caregiver presents serious issues [84]. A significant obstacle is the sudden disruption of structure and routine, which are essential for people with autism [84]. Because autistic people frequently depend on consistency, the loss of a caregiver can cause heightened anxiety and make it more difficult for them to adjust to new situations [85]. The possible effect on autistic people’s general well-being, particularly in terms of mental health, is another noteworthy challenge [85].

The loss can cause emotions of loneliness, grief, and heightened vulnerability because of the special emotional bond and understanding that develops between the caregiver and the autistic person [86]. According to Lipskt et al. (2013)the lack of this emotional anchor may make pre-existing mental health issues worse or lead to new difficulties controlling emotions [86]. The practical features of daily life also present significant challenges. When it comes to self-care, work, and interacting with others, adults with autism may find it difficult to manage without the help and support of their prior caregivers [85].

Theme 2: interventions and support strategies

The review highlights the importance of developing tailored interventions and support systems to enhance the well-being and quality of life for aging autistic adults.

Subtheme 2.1: Psycho-social interventions and therapies

One well-known strategy is Cognitive Behavioural Therapy (CBT), which can be customized to address difficulties that individuals with autism spectrum disorders encounter [87]. This could involve social interaction techniques, anxiety management techniques, and sensory sensitivity techniques [87]. CBT provides useful skills for improving emotional well-being by recognizing and changing harmful thought patterns and behaviours [87]. Social skills training is another essential component that is crucial in helping persons with autism improve their social communication skills [88]. Individuals can practice and enhance their relationships in a supportive setting by engaging in structured activities such as role-playing, video modelling, and supervised group interactions [88]. Furthermore, mindfulness and stress-reduction methods work wonders for handling anxiety and sensory overload [89]. Adults with autism can attain a state of emotional balance and relaxation by engaging in techniques such as progressive muscle relaxation, deep breathing, and mindfulness meditation [89].

Art and expressive treatments provide a potent outlet for people who are naturally creative. Adults with autism can express themselves and manage their emotions nonverbally through the arts, music, and dance [90]. It has been demonstrated that these treatments enhance self-expression, emotional control, and self-assurance [89]. When it comes to treating emotional and psychological well-being, counselling and psychotherapy are essential [89]. It’s critical to look for therapists that specialize in autism and who can establish a secure environment for learning, coping, and personal development [89]. Transition planning and life coaching become even more important when helping adults with autism deal with significant life crises [89]. Expert coaching and preparation offer priceless direction when it comes to changing living situations or entering the workforce [89].

Subtheme 2.2: support systems and networks

A variety of connections, relationships, and groups that offer comprehension, help, and chances for individual development make up support systems. They have a crucial role in enhancing the general quality of life and assisting persons with autism in over-coming obstacles [91]. Family and familial-type friendships are an essential part of sup-port networks. For adults with autism, family members including parents, siblings, and extended relatives often serve as a rock of support [92]. They can provide advocacy, useful help, and emotional support in a variety of facets of life [92]. A nurturing atmosphere that promotes an individual’s well-being can be created by comprehending and welcoming families.

Therapists, educators, and medical professionals are examples of professionals who offer crucial support [93]. They can provide specific advice in areas including communication, social skills, and sensory integration. An autistic adult’s capacity to overcome obstacles and capitalize on their abilities can be significantly impacted by their access to skilled specialists [93]. Communities and peer support groups specifically for people with autism can be helpful [94]. These networks offer a sense of understanding and community that can be hard to come from otherwise [94]. They provide an environment where people can exchange stories, counsel, and coping mechanisms [94]. A sense of empowerment and a reduction in emotions of loneliness can also be obtained by joining a group of people who have gone through similar things.

Discussion

This review aimed to explore the needs and challenges faced by older autistic people. According to the report, adults with autism have difficulty accessing healthcare treatments. This is consistent with Nicolaidis et al.‘s 2015 study, in which the authors found that individuals with autism experienced unmet healthcare needs [8]. It is noteworthy that most persons with autism reported being mismanaged because healthcare workers lacked information regarding autism. According to Manson et al. (2021) most of the research also revealed several barriers associated with stigma or stereotyping, healthcare providers’ ignorance of autism, healthcare providers’ receptivity to various forms of communication, and professionals’ lack of trust [13]. Access to healthcare systems has been reported to be hampered by stigmatization by healthcare professionals [8, 13]. This is consistent with research by Vogan et al., (2017) which discovered that over 25% of autistic individuals expressed a fear of being stigmatized or given a label [41]. One type of impediment to receiving healthcare was communication challenges. Individuals with ASD struggle with communication. Several studies found that when autistic persons attended healthcare institutions, they were unable to describe their healthcare problems due to communication impairments [11]. In addition, alexithymia too impedes communication as they lack the emotive vocabulary to describe their feelings and their symptoms [11]. Our study has shown that sensory sensitivity occurs in individuals with autism. Most individuals with autism experience anxiety because of their sensory sensitivity, which makes it difficult for them to get healthcare services. Their anxiety is also high when their routines are disturbed and when they need to meet situations that are unpredictable as when going to medical appointments.

It is very important to note that autistic individuals often exhibit a range of behaviours that reflect unique ways of processing the world, and these behaviours can vary widely depending on the individual’s age, environment and social support. Common behaviours include repetitive movements or speech, sensory sensitivities, and social communication differences [5, 11]. For example, repetitive behaviours such as hand flapping or repeating phrases often referred to as stimming, can serve as self-regulatory mechanisms, helping individuals manage sensory overload or anxiety. Research suggests that these behaviours are not inherently problematic but are coping strategies to help maintain emotional and sensory equilibrium [95]. Similar, sensory sensitivities whether to light, sound, texture, or smell can significantly impact daily functioning. For instance, in adolescence and young adulthood, these sensitivities may manifest in more subtle ways, such as avoiding crowded places [5, 11, 95].

Adults with autism experience more significant issues in their relationships and marriages, as well as in their parental roles, including sexual challenges and sexual victimization [62, 63, 65]. This is a result of a failure to uphold appropriate connections, inadequate communication abilities, and a failure to recognize social cues [65]. They face problems with both verbal and nonverbal cues, often misinterpreting others due to a poor theory of mind, which, when not remediated, can persist into adulthood. Importantly, trauma often accumulates across different life stages, compounding its impact over time. For autistic adults, the effects of repeated or chronic trauma may become more pronounced in later life, exacerbating challenges related to emotional regulation, social isolation, and access to support [64, 65]. This cumulative burden can increase vulnerability during aging, making it essential to recognize and address trauma histories in both research and practice [65]. A life-course perspective that acknowledges how earlier adverse experiences intersect with the complexities of aging can inform more sensitive and effective interventions tailored to the needs of older autistic adults. These issues increase the need for extra support systems to assure the well-being of the individuals affected.

Authors used the Convoy and Roy models because they offer complementary frameworks for understanding how evolving social support networks (Convoy model) and adaptive coping mechanisms (Roy model) shape the experiences of autistic adults as they age. The Convoy Model of Social Relations posits that social networks function as a “convoy” that accompanies individuals throughout life, offering emotional, instrumental, and informational support as they navigate challenges [96]. For adults with autism, who often struggle to establish and maintain these supportive networks, the absence of such relationships can exacerbate feelings of isolation and vulnerability [96]. According to the model, individuals with more robust and functional social convoys are better equipped to cope with life’s demands, including the relational and.

psychological challenges associated with autism [96]. These convoys are dynamic, evolving over time to reflect changing needs and circumstances, and they can play a critical role in mitigating the risks of social disconnection and mental health challenges in autistic adults [96]. For instance, many autistic individuals face a gradual narrowing of their social circles, leading to increased dependence on close family members or formal support services. Conversely, some develop new connections through engagement with community programs or peer support groups. These examples illustrate the fluid and dynamic nature of support networks highlighted by the Convoy Model, underscoring the importance of flexible, personalized support strategies that adapt to the evolving social needs of autistic adults throughout their lifespan.

It becomes essential to implement interventions and support techniques to deal with these issues. This study can also be strengthened by Roy’s adaptation theory. According to the theory, people try to stay in a state of balance by adjusting to both internal and external cues [97]. This adaptation pertains to aging autistic people and addresses changes in social relationships, sensory sensitivity, and communication challenges as they age. For example, consider an autistic adult who experiences the loss of a primary caregiver a significant event that can disrupt established routines and support systems. According to the model, adaptation may involve the individual developing new coping strategies, such as establishing alternative daily routines, engaging with new social supports, or seeking professional assistance [97]. This process reflects the dynamic interaction between the person and their environment, illustrating resilience in the face of adversity. The theory’s focus on stress management techniques and coping strategies fits with the diverse experiences of elderly autistic people, providing insights into how they deal with shifting expectations and surroundings [97]. By incorporating Roy’s adaptation theory, researchers can explore interventions and support strategies that enhance the adaptive capacity of aging autistic adults, fostering a more comprehensive and tailored approach to their unique needs.

The research question guiding this review focused on understanding the unique needs, challenges, and experiences of autistic adults as they age. The two main themes identified challenges in aging and support strategies directly respond to this question by revealing the specific difficulties autistic adults face, such as healthcare disparities and social isolation, as well as the existing supports and gaps in services designed to address these issues. This thematic synthesis allowed us to comprehensively capture the evolving landscape of aging with autism, thereby providing clear answers to the research question and highlighting areas that require further attention from researchers and policymakers. Overall, the findings directly address the research question by revealing the specific challenges autistic adults face as they age and the current gaps in support systems, emphasizing the urgent need for more targeted research, interventions, and policies.

Policy implications

One actionable recommendation is the implementation of mandatory autism-specific training for healthcare and aging service providers to ensure more responsive and informed care. Additionally, improved coordination between disability services and aging support systems could help bridge service gaps and ensure continuity of care throughout the lifespan.

Implementing a comprehensive policy that centres on understanding the changing needs and problems individuals confront as they age is necessary to address the nexus of autism and aging. First and foremost, healthcare systems must be modified to acknowledge and handle the special difficulties experienced by elderly autistic people. To enable early detection and interventions, this entails providing healthcare workers with specialized training and integrating autism-specific concerns into routine health check-ups. Second, it’s critical to create inclusive spaces. To meet the varied requirements of this population, this includes social support networks, community programs, and accessible housing. To support a lifelong learning strategy, policy measures should also emphasize caregiver training, independence promotion, and expanding educational and employment possibilities that acknowledge the abilities and talents of elderly people with autism.

Limitations

One major limitation is that the review may be restricted by the inclusion of studies published only between 2010 and 2023, potentially omitting relevant older research or recent emerging studies. Furthermore, the scarcity of studies focusing specifically on autistic adults in later life, particularly in certain geographic or cultural contexts, could result in an incomplete representation of the topic. Another limitation is the exclusion of grey literature, policy documents, and personal narratives, which might offer valuable insights into the lived experiences of autistic adults. Moreover, the review does not assess the quality of the included studies, meaning that the findings are descriptive rather than evaluative. The methodological diversity across studies may also limit the ability to synthesize findings comprehensively, making it challenging to draw definitive conclusions. Furthermore, Additionally, while efforts were made to ensure objectivity, the interpretive nature of thematic coding introduces the potential for author bias, despite independent coding and consensus discussions. Language bias may further limit the review’s scope if studies published in languages other than English are excluded.

Conclusion

To sum up, this study’s results shed light on the complex requirements and obstacles encountered by older people with autism. Together, specialized support groups, job training, housing aid, counselling services, and community engagement provide a strong foundation for improving their well-being. Addressing these gaps through interdisciplinary collaboration may be key to improving the lives of autistic adults as they grow older.

Supplementary Information

Below is the link to the electronic supplementary material.

Abbreviations

ASD

Autism spectrum disorder

PTD

Post-Traumatic Stress Disorder

OCD

Obsessive-compulsive disorder

CBT

Cognitive Behavioural Therapy

Author contributions

Conceptualization: Mokhwelepa Leshata Winter; Methodology: Mokhwelepa Leshata Winter; Validation: Sumbane Gsakani Olivia, Ngwenya Mxolisi Welcome and Mokhwelepa Leshata Winter; Formal Analysis: Mokhwelepa Leshata Winter, Sumbane Gsakani Olivia and Ngwenya Gsakani Olivia; Investigation: Mokhwelepa Leshata Winter, Resources: Mokhwelepa Leshata Winter; Writing-original draft preparation: Mokhwelepa Leshata Winter. All the authors have contributed to the work and approved the manuscript.

Funding

This research received no external funding.

Data availability

No datasets were generated or analysed during the current study.

Declarations

Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Institutional review board statement

Not applicable.

Informed consent Statement

Not applicable.

Conflict of interest

The authors declare no conflict of interest.

Supplementary Information

Table 1. Serves as a supplementary material of included studies.

Disclaimer

The views and opinions expressed in review article are those of the authors and does nor necessarily reflect the official policy or position of any affiliated agency of the authors.