RESUMEN
OBJECTIVES: In geriatric psychiatry Autism Spectrum Disorders (ASD) are increasingly recognized. This study explores what clinicians know about diagnostic and/or therapeutic aspects of autistic older adults and how aging plays a role in the course of ASD. METHODS: A Delphi study outlines the point of view of 11 clinical experts in the Netherlands and Belgium (Flanders). RESULTS: Regarding diagnostics, age-specific aspects need to be considered. Age-related characteristics (cognitive differences, life events, co-occurring conditions) influence detecting autistic features in older adults. Regarding treatment, counseling methods need to be adapted. Psychoeducation, family therapy, couples therapy, behavioral counseling and psychopharmaca can be helpful in meeting the needs of autistic older adults. There was no consensus on the effects of aging on autistic older adults. CONCLUSIONS: Diagnosis and treatment of ASD need adaptation for autistic older adults. Further research is needed on the validation of measurement tools, recorded treatment, therapy, psychoeducation, and the effects of aging among people on the autism spectrum. CLINICAL IMPLICATIONS: Available knowledge helps clinicians to detect ASD in older adults and adapt to the specific features and needs of autistic older adults. The effects of aging on the course of ASD are unclear yet.
RESUMEN
BACKGROUND: Empirical research into the diagnostics and treatment of older adults with autism spectrum disorders (ASD) is very limited; so far, only 17 studies have been published. ASD, however, is not confined to child and adult psychiatry. Increasingly, ASD is being identified and treated within the domain of geriatric psychiatry.
AIM: To investigate diagnostic and therapeutic aspects of ASD in older adults, and to obtain insight into how these aspects are related to ageing.
METHOD: Delphi techniques were employed via rounds of questionnaires put to experts; consensus was considered to have been achieved when a minimum of two-thirds of the experts 'agreed' or 'fully agreed' to a statement on a five-point scale.
RESULTS: Consensus was achieved for 10 of the 17 statements. According to the experts, older patients with ASD, form a specific group in psychiatry. With regard to diagnosis, there was a consensus that increased attention needs to be given to age-related aspects by linking symptoms more specifically to the patient's phase of life and to the ageing process. In the treatment of older adults with ASD, adjustments need to be made in relation to ageing.
CONCLUSION: This study by experts provides additional starting points for more research into specific topics relating to diagnostic and therapeutic aspects of ASD in geriatric psychiatry; these topics include validation of screening and diagnostic instruments, the adjustment of protocols for treatment, psycho-education and the effects of ageing in patients with ASD.