All-cause and cause-specific mortality in people with autism spectrum disorder: A systematic review

Background: The aim of this systematic review was to synthesise the current literature on all-cause and cause-specific mortality in individuals with autism spectrum disorders (ASD) to identify whether they experience an increased risk of mortality compared to the general population and to establish which specific causes of death are most prevalent in people with ASD.Method: Medline, Embase, CINAHL and PsycINFO databases were searched. The review was registered with PROSPERO (CRD42021219582).Results: 26 of the 8505 retrieved papers were included. 25 studies reported an increased risk of mortality for people with ASD. Out of 21 studies reporting the relevant statistics, 15 found autistic individuals to have at least a two times higher risk of dying when compared to the general population. 11 studies suggested that females with ASD were at an even greater risk of death when compared to their male counterparts. The most common causes of deaths were from external causes (particularly suicide) and neurological disorders.Conclusions: Recognising the increased mortality experienced by people with ASD is an important factor in how clinicians, support workers and healthcare systems in general should plan and approach care for this population. Although a significant portion of deaths in this group occurs due to intentional or unintentional external causes, the reviewed literature also indicates that many people with ASD die from underlying health conditions. As the increased mortality risk seems to be partially mediated by the co-occurrence of other conditions, it is of great importance to provide an increased level of support and care for this population.