title: High rates of parkinsonism in adults with autism.
abstract: BACKGROUND
  While it is now recognized that autism spectrum disorder (ASD) is typically a life-long condition, there exist only a handful of systematic studies on middle-aged and older adults with this condition.
  
  
  METHODS
  We first performed a structured examination of parkinsonian motor signs in a hypothesis-generating, pilot study (study I) of 19 adults with ASD over 49 years of age. Observing high rates of parkinsonism in those off atypical neuroleptics (2/12, 17 %) in comparison to published population rates for Parkinson's disease and parkinsonism, we examined a second sample of 37 adults with ASD, over 39 years of age, using a structured neurological assessment for parkinsonism.
  
  
  RESULTS
  Twelve of the 37 subjects (32 %) met the diagnostic criteria for parkinsonism; however, of these, 29 subjects were on atypical neuroleptics, complicating interpretation of the findings. Two of eight (25 %) subjects not taking atypical neuroleptic medications met the criteria for parkinsonism. Combining subjects who were not currently taking atypical neuroleptic medications, across both studies, we conservatively classified 4/20 (20 %) with parkinsonism.
  
  
  CONCLUSIONS
  We find a high frequency of parkinsonism among ASD individuals older than 39 years. If high rates of parkinsonism and potentially Parkinson's disease are confirmed in subsequent studies of ASD, this observation has important implications for understanding the neurobiology of autism and treatment of manifestations in older adults. Given the prevalence of autism in school-age children, the recognition of its life-long natural history, and the recognition of the aging of western societies, these findings also support the importance of further systematic study of other aspects of older adults with autism.
authors: Fremantle Hospital, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia Australia ; Autism Association of Western Australia, Western Australia, WA 6008 Australia ; School of Psychiatry, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia Australia.
authors: Sergio
authors: S
authors: Starkstein
authors: Fremantle Hospital, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia Australia.
authors: Scott
authors: S
authors: Gellar
authors: Carolina Institute for Developmental Disabilities, School of Medicine, University of North Carolina at Chapel Hill, CB# 3367, Chapel Hill, NC 27599 USA.
authors: Morgan
authors: M
authors: Parlier
authors: Carolina Institute for Developmental Disabilities, School of Medicine, University of North Carolina at Chapel Hill, CB# 3367, Chapel Hill, NC 27599 USA.
authors: Leslie
authors: L
authors: Payne
authors: Fremantle Hospital, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia Australia ; Carolina Institute for Developmental Disabilities, School of Medicine, University of North Carolina at Chapel Hill, CB# 3367, Chapel Hill, NC 27599 USA.
authors: Joseph
authors: J
authors: Piven
keywords: adults; autism; movement disorders; parkinsonism; parkinson’s disease