The Ability to Understand What Others Are Thinking Diminishes with Age, But Not for Autistic People

People with autism often struggle to read expressions and have trouble knowing what other people are feeling and thinking without being told. However, new research suggests that the ability to “read” others’ thoughts does not deteriorate with age for people with autism the way it does for neurotypical people.

Researchers evaluated 29 people with autism and 20 without to determine how good they were at the “theory of mind” skill—the ability to infer another person’s mental state. Both these groups of people were between the ages of 18 and 50. They also evaluated 29 individuals with autism over the age of 50, and 19 non-autistic people over 50.

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Questionnaires were used to determine the participants’ abilities to identify their own emotions and practice empathy. Then participants completed four tests aimed at determining how well they could infer people’s thoughts, feelings, and motivations. Participants were judged both on their accuracy and how descriptive they were able to be concerning the thoughts and emotions at play in each scenario they were presented with.

Hilde Geurts, professor of clinical neuropsychology at the University of Amsterdam in the Netherlands, who was not involved in this work, says the variety of tests and tasks in this study is important. “It’s more about an underlying construct that you are measuring, and not just the individual task, because people can have a problem with a specific task.”

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Younger people without autism showed the strongest performance with the theory of mind skill, outperforming their older counterparts and both young and old people with autism. However, younger people with ASD and older people with ASD showed very little difference in their theory of mind skills. It would appear that the brains of people with autism do not age in the same way as those of people without the disorder—they retain most of the theory of mind skill they had as young people as they get older.

“Our results show that there seems to be no significant decline in understanding others’ minds with age in autism,” says study investigator Esra Zıvralı Yarar, assistant professor of psychology at the Social Sciences University of Ankara in Turkey.

The study is an important one, not only because it demonstrates a key difference between the brains of autistic and neurotypical people, but also because it reports on older autistic people, which is rare. It’s so important that we work hard to learn more about autism in older individuals.

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“This paper is a well-designed experimental investigation,” says Uta Frith, emeritus professor of cognitive development at University College London in the United Kingdom, who was not involved in the study. “Any paper that reports on older people with autism is welcome, because we are so ignorant about cognitive changes that come with age.”

Researchers are unsure whether their discoveries are due to differences in brain maturation between autistic and neurotypical people or whether autistic people have to exercise their brains more in social situations, causing them to lose less of their mental capacities over time.

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“Autistic people often say that working out what others think is like doing mental arithmetic, so maybe a lifetime of this sort of compensation equips them well to offset the effects of aging,” Yarar says.

“This is one possibility,” Frith adds. “Another possibility is that the performance on [theory of mind] tests is governed by different underlying processes in the two groups.”

The results of this small study are far from definitive, but they seem to show that autistic and non-autistic brains age differently, for whatever reason. The data also shows that many people with autism likely suffer from alexithymia, or difficulty in naming and reflecting on their own emotions.

Yarar and her colleagues intend to follow up on the study by investigating the relationship between psychiatric health and quality of life in older adults with autism.

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