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Background: Sensory processing differences (SPDs) and mental health symptoms are not limited to young autistic people but continue to occur into adulthood. However, existing quantitative research has predominantly focused on younger autistic people. Less work has been done to investigate SPDs and relationships with mental health conditions in older autistic adults (ie, aged 40 and above) across their midlife and older adulthood.

Methods: 432 participants (autistic n= 265; non-autistic n= 167) aged 40-93 years completed online questionnaires related to SPDs and mental health (ie, anxiety and depression symptoms). Neurotype and gender differences, age associations, and associations between SPDs and mental health were examined. Participants’ contextualization of their lived experiences of SPDs was analyzed qualitatively.

Results: Overall, SPDs and mental health symptoms were more apparent in the autistic group than the non-autistic group, with autistic women showing higher levels of SPDs and poorer mental health than autistic men. SPDs were more often reported to worsen across adulthood by those in the autistic group than those in the non-autistic group, with older autistic people more often reporting worse coping abilities. Furthermore, positive associations between SPDs and anxiety/depression symptoms were observed in the autistic group, with the strength of associations increasing with age. From the qualitative data, we developed six topics reflecting participants’ lived experience of SPDs.

Conclusion: Quantitative and qualitative evidence suggest that autistic adults in older age may be more likely to have a heightened risk …