Ask the Expert: Adults with Autism and Health Problems
Adults with Autism and Health Problems
An Interview with Lisa Croen
Lisa Croen, Ph.D., led a Kaiser Permanente research team that analyzed medical records to compare rates of diseases and conditions between adults with autism and the general population. This is an excerpt from an interview with Dr. Croen that will appear in the July edition of the Autism Advocate.
Autism Advocate: How did your team determine the rates of disorders in the population of adults with autism?
Lisa Croen: We recognized that there was really very little data on adults with autism, so we wanted to take a look at our system at Kaiser Permanente and use it to get a lay of the land. We just did a study looking at the adult membership of Kaiser Permanente in northern California, and that’s out of about two-and-a-half million adult members. We identified all of those with a diagnosis of autism that was recorded in the medical record, and then we pulled from the rest of the membership without autism – so, ten controls for every adult with autism – and it’s just pretty straightforward descriptive epidemiologic study.
We’re in a situation where we have a big patient population and a really great record of the people’s health status and their health care utilization, being members of Kaiser, so we were in a really good position to take a look at this in a big, very diverse population, and with really good data.
Advocate: What did you discover about the health of adults on the spectrum?
Croen: Almost every medical and psychiatric diagnosis or condition occurred at a much higher rate in the adults with autism than the adults without autism. This included things that we thought we might see, like depression and anxiety and other conditions that we see in kids with autism occurring at a higher frequency than kids without autism, like sleep disturbances and [gastrointestinal] disorders. We also see some major chronic medical conditions occurring much more frequently, like hypertension, obesity, diabetes, other cardiovascular disease and metabolic conditions.
The other surprising result, and very alarming result, was that we found suicide attempts to be significantly more frequent in the adults with autism. Fortunately, the rate is not very high, but compared to adults without autism, that was four or five times higher. And that’s really something, I think, that needs immediate action, and it goes along with the depression and the anxiety and the social isolation of the other chronic conditions, and not feeling good physically and emotionally.
Advocate: What do your findings mean for people with autism and their families and caregivers?
Croen: It’s really critical for people with autism to learn from a very young age [about] healthy lifestyles and healthy habits. If you want to prevent some of these chronic diseases like obesity and hypertension and heart disease, diabetes in adulthood, you’ve got to start very early and have all your ducks in a row as you approach adulthood. So I think it’s really critical for parents to be aware that even given the challenges, it’s really important to do whatever they can and to work with their teachers and health care providers to figure out ways for their kids to have healthy nutrition and exercise.
[For adults with autism], it’s trying to do the best they can and to seek medical attention if they’re noticing things that aren’t feeling good to them. Prevention is always better than intervention, I think, so if they can do whatever they can and work with their networks to help them get the care that they need, that would be really good.