A Lifespan Approach to Neurodivergence

I am a year older.( birthday is at the start of the year).. and so ageing interests me more and more...

When I try to explore the research relating to ageing and neurodivergent traits and conditions there is very little. The main focus till the 90s was on children and it is only in the last 20 years or so have we even considered adults but this has predominantly focused on up to 40 years.

As I am getting older and consider myself and others it has made me become increasingly interested in the ...what next... and what do we need to do..

It is also becoming a discussion about ageing in our workforce and the need to consider this...another intersection!

Our brains and our bodies change throughout our life and ageing well doesn't just start when you retire- if we can ever do so! The chance of gaining a diagnosis of a neurodivergent condition declines with age.Chung and colleagues showed an age-dependent decline in the diagnosis of ADHD for example.

Neurodivergent conditions bring unique strengths but also lifelong challenges that can compound with age. We need to always remember the traits and conditions often co-occur.

For instance:

• ADHD: Associated with difficulties in attention, impulsivity, and emotional regulation, ADHD contributes to heightened risks of physical health issues, depression, and social isolation in later life. Higher rates of smoking may have long term impact on health outcomes.Surman wrote about the challenge about diagnosing ADHD in older adults. Thorell and colleagues have also written about quality of life in ADHD people age 60 years.

Also see:https://www.adhdevidence.org/blog/understanding-adhd-in-older-adults-an-overlooked-concern

• Autism Spectrum Disorder (ASD): Adults with ASD may experience challenges managing different sensory sensitivities, communication with others, and maintaining social relationships, which can lead to isolation, reduced access to healthcare, and mental health challenges.People with Autism who are 65 years and over can have a 2.6 times greater risk of dementia.
• Developmental Coordination Disorder (DCD): DCD often leads to physical coordination difficulties, increasing the risk of falls, reduced physical activity, and related health issues such as obesity or cardiovascular disease.

The cumulative impact of these challenges, alongside barriers like poverty, homelessness, and lack of access to education, creates significant disparities for older neurodivergent adults. These conditions often coexist, amplifying the difficulties individuals face as they age. We also know there is inequity in systems and so those who have been social disadvantaged, and/or been in the justice systems, are less likely to have needs identified or addressed in earlier years.

Shared Challenges Across Neurodivergent Conditions

Older neurodivergent adults face similar difficulties to younger people but they may worsen with age:

• Reduced social connections: Isolation and loneliness are particularly common, stemming from lifelong difficulties in communication, sensory sensitivities, or reduced mobility.
• Mental health struggles: Depression and anxiety are prevalent in neurodivergent populations, often exacerbated by social isolation, stigma, and lack of tailored mental health support.
• Physical health difficulties: Neurodivergent adults may be at higher risk of obesity, cardiovascular issues, and other chronic conditions due to reduced physical activity, sensory challenges, or difficulty accessing healthcare. There may be greater risk of accidents and falls.
• Daily functioning challenges: Executive functioning difficulties can make managing daily tasks harder, from finances to household management, and these challenges can intensify with age especially if living alone.

These shared challenges contribute to poorer quality of life, increased healthcare needs, and greater dependency on informal carers or inadequate support systems.

Key Protective Factors for Neurodivergent Adults

While neurodivergence can amplify ageing-related challenges, certain factors can mitigate risks and promote healthier outcomes:

• Education: Access to quality education early in life helps build resilience and offers protective effects throughout ageing by improving job opportunities, financial independence, and access to healthcare. There is extensive evidence this is a protective factor.. meaning early identification and support has lifelong impact.
• Employment: Workplaces that provide accommodations and foster inclusion enable neurodivergent adults to maintain financial stability and social connections, both of which are vital for healthy ageing. We also need to plan ahead for ageing well in retirement .
• Community and support networks: Social inclusion initiatives, peer support groups, and tailored community services can combat isolation and improve mental health.
• Healthcare access: Integrated health and social care tailored to neurodivergent needs ensures better outcomes for physical and mental health. This means not delivering siloed services but thinking of delivery how we have models of practice in multisystem conditions like Diabetes where someone may have heart, kidney, circulation, vision challenges as a secondary consequence of Diabetes.
• Lifestyle factors: Exercise, good nutrition, and mental health care tailored to sensory or behavioural needs are critical for overall wellbeing. This is not something that can just start at 65!

"Those who think they have no time for bodily exercise will sooner or later have to find time for illness." Edward Stanley (1826-1893)

Implications for Policy and Practice

To better support neurodivergent individuals across the lifespan, there are key areas that need urgent attention:

1. Integrated Care Models

Healthcare and social care services must adopt an integrated approach to address the intersection of physical health, mental health, and social needs. I think this is not only in ageing populations but really needs to be considered across age spans.

We need to have:

• ND-informed healthcare - this can reduce the stress of engaging in a range of medical environments and make services more accessible for all.
• ADHD-tailored smoking cessation programmes with an understanding of the challenges of withdrawal.Withdrawal from nicotine may be more complicated by re-emergence of ADHD symptoms.
• Fall prevention and mobility support programmes can benefit individuals particularly with DCD where balance may have always been a problem. Maintaining core stability and improving balance is going to be important. We know the increased risk of mortality from falls and hip fractures.

2. Inclusive Policies

Policymakers must consider the unique challenges neurodivergent adults face when accessing social services, healthcare, and housing. Tailored support for financial independence, employment, and accessible transport can reduce inequity. This challenges the real need to consider inclusive approaches built in to design processes.

3. Education and Advocacy

Raising awareness about neurodivergence in later life among healthcare providers, carers, and policymakers can improve understanding and reduce stigma. Training carers and professionals to recognise and support neurodivergent needs is essential.

4. Research and Data Collection

Research on ageing in neurodivergent populations is sparse. Longitudinal studies are urgently needed to understand how conditions like ADHD, ASD, and DCD impact ageing and to identify effective interventions.

5. Social Inclusion Initiatives

Programs that promote social connections and community involvement can combat isolation. Tailored activities, peer groups, and neurodivergent-friendly spaces can create opportunities for meaningful engagement.

A Lifespan Approach to Neurodivergence

Managing neurodivergent conditions like ADHD, ASD, and DCD requires a lifespan approach. These conditions share challenges that do not diminish with age but can be mitigated through proactive support and inclusion. Just as we’ve developed long-term strategies for conditions like diabetes or heart disease, we must extend similar frameworks to neurodivergent conditions.

By understanding the lifelong impacts of neurodivergence and addressing the unique needs of older adults, we can foster a society where everyone has the opportunity to age well. With the right interventions, older neurodivergent adults can experience healthier, more fulfilling lives—and contribute to a more inclusive and equitable future for all. I do feel very strongly we need to start today!

Blog Author

I am Amanda Kirby, CEO of Do-IT Solutions a tech-for-good company that delivers consultancy and guidance, consultancy, training and web-based screening tools that have helped 10s of 1000s of people.

Contact us and we can discuss how we can help.

We strive to deliver person-centered solutions relating to neurodiversity and wellbeing.I am a mixed bag of experiences and skills and have 25+ years of working in the field of neurodiversity.

I am a medical doctor, Professor, and have a Ph.D. in the field of neurodiversity; most important of all I am a parent and grandparent to neurodivergent wonderful kids and am neurodivergent myself.I am getting older too!

I have written 10 books so far.Theo Smith and I wrote the UK award-winning book?Neurodiversity at Work Drive Innovation, Performance, and Productivity with a Neurodiverse Workforce. My 11th book came out in 2023 Neurodiversity and Education. We have a new one (Theo and myself ) coming out in 2025... watch this space.... perhaps I will write one about ageing and being ND!