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Epidemiology of autism in adults across age groups and ability levels
Open accessAbstract
Background: The epidemiology of autism in adults has relied on untested projections using childhood research. Aims: To derive representative estimates of the prevalence of autism and key associations in adults of all ages and ability levels. Method: Comparable clinical diagnostic assessments of 7274 Adult Psychiatric Morbidity Survey participants combined with a population case-register survey of 290 adults with intellectual disability. Results: The combined prevalence of autism in adults of all ages in England was 11/1000 (95% CI 3–19/1000). It was higher in those with moderate to profound intellectual disability (odds ratio (OR) = 63.5, 95% CI 27.4–147.2). Male gender was a strong predictor of autism only in those with no or mild intellectual disability (adjusted OR = 8.5, 95% CI 2.0–34.9; interaction with gender, P = 0.03). Conclusions: Few adults with autism have intellectual disability; however, autism is more prevalent in this population. Autism measures may miss more women with autism.
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“Epidemiological studies indicate that ASD is more common among males than females, with a ratio estimate from the 2010 Global Burden of Disease study revealing a ratio of 4:1 (Brugha et al. 2016; Loomes et al. 2017).”
From The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond (2021) · cites this paper as Brugha et al. 2016
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“Epidemiological administrative and community-based [Au:OK?YES] studies have suggested that ASD is more common in males than in females, with reported ratios [Au:OK to add 'with reported ratios' here?] ranging from 2.1 -5. 1, with an estimate of 4.1 in the 2010 [Au:OK?] Global Burden of Disease study 3,4 .”
From Autism spectrum disorder (2020) · cites this paper as [4]
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“Given that most people in the world who are autistic are adults , and as many of these individuals have not received a diagnosis of autism 4,15”
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“The large increase in the estimated prevalence of the autism spectrum reflects necessary improvements in its epidemiological modelling and aligns global estimates with estimates derived from high-quality epidemiological surveys.11, 12, 13”
From The global epidemiology and health burden of the autism spectrum: findings from the Global Burden of Disease Study 2021. (2025) · cites this paper as [11]
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“A large UK epidemiological study estimated autism prevalence among adults living in the community to be 9.8 per 1000 (Brugha et al., 2011), adjusted to 11 per 1000 following inclusion of a sample with intellectual disability (Brugha et al., 2016).”
From Diagnosis of autism in adulthood: A scoping review (2020) · cites this paper as Brugha et al., 2016
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“Gender ratio (1.2:1) was close to equal in studies assessing autism in adults with intellectual disability (Brugha et al., 2016; Rutherford, McKenzie, Johnson, et al., 2016).”
From Diagnosis of autism in adulthood: A scoping review (2020) · cites this paper as Brugha et al., 2016
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“Prevalence of autism in populations with moderate to profound intellectual disability was high (21% to 42.3%) (Brugha et al., 2016; Saemundsen et al., 2010), including some cases of first diagnosis in adulthood (Saemundsen et al., 2010).”
From Diagnosis of autism in adulthood: A scoping review (2020) · cites this paper as Brugha et al., 2016
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“Despite the frequent co-occurrence of autism and intellectual disability in adults (Brugha et al., 2016; Saemundsen et al., 2010), only a small proportion of studies intentionally included these individuals.”
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“Lower sex ratios have also been noted among community-identified individuals with moderate to profound intellectual disability (Brugha et al. 2016).”
From The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond (2021) · cites this paper as Brugha et al. 2016
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“Active case-finding that does not rely on administrative records has demonstrated an equivalent community rate of ASD in men and women with moderate to profound .”
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“which was relatively low compared with the prevalence of autism spectrum disorder from active case-finding methods (in which prevalence is estimated using a diagnostic instrument in a general population survey supplemented by a search in case registries or special education facilities).11, 12, 13”
From The global epidemiology and health burden of the autism spectrum: findings from the Global Burden of Disease Study 2021. (2025) · cites this paper as [11]
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“Prevalence of autism in the combined sample was 1.1%”
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“Gender difference was found only in the mild/no ID group.”
From Diagnosis of autism in adulthood: A scoping review (2020) · cites this paper as Brugha et al. (2016)
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Aging Well on the Autism Spectrum: An Examination of the Dominant Model of Successful Aging
Hwang, Y. I., Foley, K., & Trollor, J. N. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3596-8 · Cited by 33
Autism Spectrum Disorder May Be Highly Prevalent in People with Functional Neurological Disorders
González‐Herrero, B., Morgante, F., Pagonabarraga, J., Stanton, B. R., & Edwards, M. J. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm12010299 · Cited by 28
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Tyrer, F., Kiani, R., & Rutherford, M. J. (2020) · Journal of Intellectual & Developmental Disability · doi:10.3109/13668250.2020.1834946 · Cited by 26
Self-citationMetabolic interventions in Autism Spectrum Disorder
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Characters with autism spectrum disorder in fiction: where are the women and girls?
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Face processing in autism spectrum disorder re-evaluated through diffusion models.
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Mentalizing and narrative coherence in autistic adults: Cerebellar sequencing and prediction
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Autistic Traits, Empathizing–Systemizing, and Gender Diversity
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“…impair the ability to cope with daily hassles and reach long-term goals (Bednarz et al., 2020; Uddin, 2021; Wallace et al., 2016) and affect essential life areas, such as social relationships, work, and independent living (Bishop-Fitzpatrick et al., 2017; Brugha et al., 2016; Lai et al., 2020).”
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Transparent deep learning to identify autism spectrum disorders (ASD) in EHR using clinical notes
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The Prevalence of Diabetes in Autistic Persons: A Systematic Review
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Dental experiences of a group of autistic adults based in the United Kingdom
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Metadata
- Authors
- Brugha, T. S., Spiers, N., Bankart, J., Cooper, S.-A., McManus, S., Scott, F. J., Smith, J., & Tyrer, F.
- Affiliations
- University of Leicester (GB)
- Corresponding author
- Brugha, Traolach S.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2016-12
- Volume
- 209
- Issue
- 6
- Pages
- 498-503
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2400322275
- Cited by
- 299
- References
- 44
- Citations by year
- 2026: 19 · 2025: 28 · 2024: 54 · 2023: 33 · 2022: 45 · 2021: 32 · 2020: 31 · 2019: 28 · 2018: 18 · 2017: 7 · 2016: 3
- FWCI
- 12.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- Figshare (submittedVersion, cc-by)
- Leicester Research Archive (University of Leicester) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- National Institute for Health and Care Research
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
- Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
- Keywords
- autism spectrum disorder, adults, prevalence, intellectual disability, gender differences, underdiagnosis in women, age groups, Adult Psychiatric Morbidity Survey, England
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Adult, Aged, Autistic Disorder, England, Female, Humans, Male, Intellectual Disability, Middle Aged, Registries, Comorbidity, Prevalence, Young Adult
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