Mortality characteristics in individuals with autism spectrum disorder across the lifespan: a narrative review

Abstract

This narrative review provides a comprehensive synthesis of mortality rates and associated risk factors among individuals with autism spectrum disorder (ASD) across the lifespan. Following a search across PubMed, Scopus, and Google Scholar, 31 peer-reviewed studies were identified for synthesis. The findings consistently demonstrate that individuals with ASD experience significantly higher mortality rates compared to neurotypical controls. Analysis shows a distinct developmental shift: in childhood and adolescence, external causes are predominant, with accidents—particularly drowning—accounting for a substantial portion of fatalities, estimated between 70% and 90% in some reports. In contrast, adult mortality is increasingly driven by natural causes. The evidence indicates a reduced life expectancy, with some studies reporting average ages of death as low as 36 years, depending on comorbid conditions. Furthermore, standardized mortality ratios appear notably higher in individuals with co-occurring intellectual disabilities and epilepsy, with some cohorts showing risks several times higher than the general population. A substantial proportion of ASD-related mortality is potentially preventable through targeted safety training, early metabolic screening, and ASD-friendly healthcare practices. Addressing communication barriers and sensory sensitivities in clinical settings is essential for early diagnosis and effective management of chronic conditions to reduce the mortality gap.