Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Autism Res. 2022 Aug;15(8):1550-1559. doi: 10.1002/aur.2741. Epub 2022 May 28.
Research from different countries suggests that autistic adults are more likely to die prematurely than non-autistic adults, but these studies do not always investigate male and female individuals separately and do not consider whether this pattern is unique to autistic people or is also an issue for people with other developmental disabilities. We examined premature mortality in autistic males and females (assigned at birth) in a population-based cohort, compared to males and females with and without other developmental disabilities. Using linked administrative health and social services population data from Ontario, Canada, age-matched males and females aged 19-65 years were followed between 2010 and 2016, and causes of death were determined. Over the 6-year observation period, 330 of 42,607 persons (0.77%) in the group without developmental disabilities had died compared to 259 of 10,646 persons (2.43%) in the autism group and 419 of 10,615 persons (3.95%) in the other developmental disabilities group. Autistic males and females were more likely to die than non-autistic males (adjusted risk ratio, RR 3.13, 95%CI 2.58-3.79) and non-autistic females (adjusted RR 3.12, 95%CI 2.35-4.13) without developmental disabilities, but were less likely to die than adults with other developmental disabilities (males: adjusted RR 0.66, 95%CI 0.55-0.79; females: adjusted RR 0.55, 95%CI 0.43-0.71). Most common causes of death varied depending on a person's sex and diagnosis. Given the greater likelihood of premature mortality in adults with developmental disabilities including autism, greater attention and resources directed toward their health and social care are needed, tailored to their sex and diagnosis-informed needs. LAY SUMMARY: This study looked at how many autistic men and women died over 6 years (2010-2016), along with how they died, and compared this to adults who did not have autism living in Ontario, Canada. It found that autistic men and women were more than three times as likely to die as people of the same age who did not have a developmental disability. However, adults with other developmental disabilities besides autism were even more likely to die than autistic adults. This means that we have to pay more attention and invest in better social and health care for autistic people, along with people who have other types of developmental disabilities.
研究表明，与非自闭症成年人相比，自闭症成年人更有可能过早死亡，但这些研究并不总是分别对男性和女性进行调查，也不考虑这种模式是否仅适用于自闭症患者，或者是否也是其他发育障碍患者的一个问题。我们在一个基于人群的队列中检查了自闭症男性和女性（出生时分配）的过早死亡情况，并与有和没有其他发育障碍的男性和女性进行了比较。使用来自加拿大安大略省的链接行政健康和社会服务人群数据，我们对 2010 年至 2016 年间年龄在 19-65 岁之间的男性和女性进行了随访，并确定了死亡原因。在 6 年的观察期内，在没有发育障碍的人群中，有 330 人（0.77%）死亡，而自闭症组中有 259 人（2.43%），其他发育障碍组中有 419 人（3.95%）。自闭症男性和女性比非自闭症男性（调整后的风险比，RR 3.13，95%CI 2.58-3.79）和非自闭症女性（调整后的 RR 3.12，95%CI 2.35-4.13）更容易死亡，但比患有其他发育障碍的成年人（男性：调整后的 RR 0.66，95%CI 0.55-0.79；女性：调整后的 RR 0.55，95%CI 0.43-0.71）更不容易死亡。死亡的最常见原因因性别和诊断而异。鉴于包括自闭症在内的发育障碍成年人过早死亡的可能性更大，因此需要更加关注他们的健康和社会护理，并提供有针对性的资源，以满足他们的性别和诊断需求。
