"Utterly Overwhelming"-A Mixed-Methods Exploration of Sensory Processing Differences and Mental Health Experiences in Middle-Aged and Older Autistic Adults.

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 (i.e., aged 40 and older) across their midlife and older adulthood. Methods: A total of 432 participants (autistic 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 of SPDs and associated poorer mental health. This study extends previous understanding of SPDs with mainly younger autism populations and highlights the necessity of exploring sensory difficulties in autistic adults in midlife and older adulthood. Community Brief: