Overview of Proposed Research

As the first diagnosed autism spectrum disorder (ASD) individuals are now reaching old age, it is imperative that we understand the impact of aging on individuals with ASD. Yet, there is a dearth of current published data on the social, psychological, cognitive, and biological profiles of individuals aging with ASD to guide development of models of care or intervention strategies. We propose a research project that focuses on neurobiological aspects of aging in ASD that has promise of an immediate and direct impact on several of critical issues for this group. We have developed a model of aging in ASD based on striking parallels of the types of cognitive dysfunction observed in young adult ASD individuals and the pattern of cognitive changes associated with aging in typically developing individuals. Young adult ASD individuals have deficits in executive function, which is subserved by the frontal lobe, and the frontal lobe is susceptible to typical age-related changes; therefore, there may be an exacerbation of deficits beyond normal aging in ASD.

This project is possible through the combined efforts of Dr. Christopher Smith, Research Director of the Southwest Autism Resource and Research Center (SARRC), and Dr. Leslie Baxter, Clinical Neuropsychologist and imaging researcher at the Barrow Neurological Institute (BNI) who studies brain-behavior relationships in aging and Alzheimer's disease. The SARRC and BNI have recently combined their efforts to better address issues of the older ASD cohort. The team also includes two collaborators who are within the Phoenix research community, Dr. Kewei Chen, a biostatistician and imaging researcher at Banner Alzheimer's Institute, who is a world-renown expert in statistical models and imaging, and Dr. Jieping Ye, an Associate Professor in Arizona State University's Computing, Informatics and Decision System Engineering who will be able to use advanced mathematical methods to detect even subtle changes that may be seen when combining cognitive and imaging data.

Although we hope to expand this study to a wide range of ASD individuals in terms of age and intellectual ability, we are focusing on high-functioning ASDs, mostly because it is they who may benefit from new information regarding support needs, care plans, and medical interventions. By producing a comprehensive cognitive, behavioral, and neuroimaging data on a set of well-characterized older ASD individuals, we can use these data as a reference for clinical diagnosis, therapeutics, and care plans.

Impact: Our research describing the cognitive and brain changes that happen during aging in ASD, directly addresses the Autism Research Program (ARP) Idea Development Award goals to better understand mechanisms underlying conditions co-occurring with ASD and promote success in a key transition to independence for individuals living with ASD, namely, the time during aging when the support system of many ASDs may be dramatically changing. Our neuroimaging data will allow us to localize areas of vulnerability of accelerated or exacerbated brain aging in ASD with the goal of targeting future prevention trials. We will produce cognitive and behavioral data on older adults with ASD for the purpose of guiding therapeutic and plans of care. We will have normative data for high-functioning older ASD patients, who represent an at-risk group for being misdiagnosed as having a dementia syndrome, which may be of immediate help to this community.

Innovation: To our knowledge, we are among the first to systematically study the neurobiological aspects of aging in ASD with a focus on longitudinal assessment of cognition and neuroimaging. Our study addresses the ARP Idea Development Award goal by presenting a new paradigm for ASD aging research with a unique model of how the anterior-to-posterior gradient of ASD pathology may interact with the anterior-to-posterior gradient of atrophy in aging. This project will use innovative and sophisticated data analytic techniques to combine structure, function, cognition, and symptom profiles to specifically address contributions to accelerated aging in ASD.