Recent years have seen a massive improvement in neurodiversity awareness, including better school provisions and higher detection rates among middle-aged women. However, adults over 60 remain significantly underserved. A recent study estimates that between 89% and 97% of autistic people in this age bracket are undiagnosed, leading experts like Dr. Louise Rutter—who co-authored a report for the British Psychological Society—to categorize them as a “neglected generation.” This presents a challenge for adult children caring for parents while recognizing potential signs of autism or ADHD.
Later life often introduces disruptive changes that make neurodivergent traits harder to manage. While retirement offers freedom for many, Dr. Rutter notes it can be destabilizing for autistic individuals who rely on routines for protection. Transitions such as health issues, bereavement, or moving into care reduce control and predictability, which can intersect with autistic traits. Furthermore, chartered clinical psychologist Dr. Neil Drew warns that for those with ADHD, the loss of dopamine associated with leaving the workforce can sometimes lead to depression.
Experts suggest that identifying neurodivergence should focus on whether traits cause significant life impairment rather than just personal habits. Dr. Gavin Stewart, head of ageing and autism at King’s College London’s ReSpect Lab, clarifies that it is not about a preference for morning routines, but the intense distress caused if those routines are broken. Dr. Emilie Moorhead highlights that caregivers should look for difficulties with social communication, extreme isolation, or the need for extensive recovery time following large gatherings.
These traits often become more apparent with age. According to Dr. Georgia Pavlopoulou, director of Autism Central at Anna Freud, older adults may appear more rigid, stressed, or forgetful because their nervous systems have less capacity to mask after decades of effort. Dr. Lisa Williams, founder of the Autism Service, notes that masking can involve scripted conversations and social interactions that are cut short due to deep fatigue.
Despite the challenges, experts encourage seeking a diagnosis for older adults, even those in their 80s. Dr. Rutter explains that a diagnosis helps people make sense of their life history. Dr. Drew notes that if an individual has spent decades masking, a diagnosis can help them finally live more authentically. When starting these conversations, experts suggest avoiding overwhelming information. Instead, parents might relate to shared sensory struggles, such as using earplugs for loud noises or discussing neurodivergent celebrities to dispel myths.
Clinical data shows 70-80% of autistic people live with at least one other coexisting condition, such as depression or anxiety, and up to 40% have two or more. Dr. Moorhead notes that adults with undiagnosed ADHD often struggle with organization and brain fog, sometimes worrying that these symptoms signal early-onset dementia. Professionals recommend discussing these concerns with a doctor.
While private providers are often used to bypass NHS wait times, Dr. Williams advises that patients ensure their clinician is regulated by bodies like the General Medical Council or the Health and Care Professions Council. Face-to-face assessments are considered the gold standard for accuracy.
A diagnosis can also be vital for physical health. Dr. Pavlopoulou points out that the chronic stress of masking for decades can increase risks for high blood pressure and cardiovascular disease. Furthermore, ADHD medication may help mitigate accident risks. Even without a formal diagnosis, families can improve a parent’s life by simplifying routines and using literal communication. As they age, many people in their 50s and 60s find the freedom to unmask, allowing their true values and strengths to be recognized and appreciated by their loved ones.
