Racial and ethnic disparities among older adults with autism spectrum disorder: a scoping review

Although more older adults are living with autism spectrum disorder (ASD), research has focused mainly on younger individuals. Emerging evidence suggests that racial/ethnic disparities may further hinder timely diagnosis and care for older adults with ASD. This scoping review maps existing research on these disparities among older adults with ASD.

A systematic database search was conducted from 01/15/2025 to 01/30/2025 across PubMed, PsycINFO, and Scopus. The PCC (Population, Concept, Context) framework was used to identify peer-reviewed, data-based studies published in English that focused on adults aged 60 years and older with ASD and explicitly addressed racial/ethnic disparities.

Eight of 4,179 articles met the inclusion criteria. All included studies were observational, with the majority (n = 7) conducted in the United States. Racial/ethnic minority older adults with ASD face persistent disparities across the ASD care continuum. Black, Hispanic, and Asian/Pacific Islander older adults were less likely to be dually eligible for Medicare and Medicaid compared to their White counterparts. Additionally, racial/ethnic minority older adults with ASD showed a higher burden of physical and psychological comorbidities but lower likelihood of receiving treatment for their comorbidities. Racial/ethnic minority older adults with ASD had lower rates of outpatient service utilization and reduced access to supportive accommodations compared to their White counterparts.

Current research on racial/ethnic disparities among older adults with ASD remains limited; this research gap highlights an urgent need for more inclusive, population-specific studies to advance understanding and promote equity at the intersection of aging, autism, and healthcare access.