“Bigger lows, but higher highs”: A qualitative exploration of the similarities and differences in quality of life of middle-aged and older autistic and non-autistic adults

Background: Autistic adults often report lower subjective quality of life (QoL) than non-autistic adults. Despite older age also often being associated with lower QoL, little is known about the first-hand experiences of, and influences on, QoL for middle-aged and older autistic adults compared with their non-autistic peers.

Method: Thirty-three participants (autistic n=15, non-autistic n=18) aged 50-89 years completed semi-structured interviewed that explored their QoL. Responses were thematically analysed, and themes were compared to identify similarities and differences between groups.

Results: Both autistic and non-autistic groups reported similar QoL experiences, but with subtle differences. Social support from family and friends was important for both groups. Both noted shrinking social networks with age, but the non-autistic group was often less satisfied with their social lives. Concerns about health and sleep changes were common, but autistic participants often mentioned persistent mental health issues affecting their wellbeing. Autistic individuals also highlighted sensory sensitivities and difficulties with change. Receiving their autism diagnosis was significant for autistic participants, aiding self-acceptance. Acceptance of age-related changes was common in both groups, but the autistic group was more willing to seek support, while the non-autistic group often saw asking for help as losing their independence.

Conclusions: These findings highlight similarities and differences in aspects relevant to QoL for middle-aged and older autistic and non-autistic adults. While many similarities were found, the autistic group reported subtle differences in their experiences. Experiences such as social connectedness and coping with change could be targeted to improve the QoL of ageing autistic adults.