Risk of death from natural causes as well as unnatural causes is significantly increased for people on the autism spectrum, according to researchers.
A systematic review and meta-analysis published in JAMA Pediatrics claims the mortality risk is significantly increased for people with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD).
Ferrán Catalá-López, PhD, from the Ottawa Hospital Research Institute in Ontario, Canada, and colleagues, conducted the review, and included data from 27 studies involving 642,260 individuals.
The key question the authors were looking to answer was: Are persons with autism or ADHD at a higher risk of dying compared with the general population?
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When causes of death were examined, ASD and ADHD were associated with higher mortality than the general population due to unnatural causes (e.g. injury or poisoning), and only persons with ASD had an increased risk of mortality from natural causes of death (e.g. neurologic, respiratory system, and cancer).
All-cause mortality was more than doubled in people with ASD (rate ratio [RR] 2.37, 95% CI 1.97-2.85, I2 89%) and in those with ADHD (RR 2.13, 95% CI 1.13-4.02, I2 98%). As mentioned above, among those with ASD, deaths from natural causes were increased (RR 3.80, 95% CI 2.06-7.01, I2 96%), as well as deaths from unnatural causes (RR 2.50, 95% CI 1.49-4.18, I2 95%). For people with ADHD, deaths from unnatural causes were higher than expected (RR 2.81, 95% CI 1.73-4.55, I2 92%).
ASD and ADHD associated with higher risk of mortality
“We found suggestive evidence that ASD and ADHD are associated with a significantly increased risk of mortality. Understanding the mechanisms of these associations may lead to targeted strategies to prevent avoidable deaths in high-risk groups of children and young people as an approach to improve public health,” the researchers commented.
“For example, clinicians and health care professionals can be encouraged to routinely collect information on behavioral, medical conditions, and health outcomes related to ASD/ADHD, emphasizing the need to recognize and address modifiable vulnerability factors and prevent delays in health care provision. Additionally, we hope that these estimates can shed some light for future studies related to examining mortality-related health estimates in persons with ASD or ADHD.”
Several authors involved in the review disclosed they have financial ties to the pharmaceutical industry.