Falls and Fall-Related Injuries and Hospitalizations in Autistic Older Adults: A Medicare Data Study / Lauren BISHOP in Autism, 30-6 (June 2026)  

Public ISBD [article]  inAutism > 30-6 (June 2026) . - p.1443-1451 Titre : Falls and Fall-Related Injuries and Hospitalizations in Autistic Older Adults: A Medicare Data Study Type de document : texte imprimé Auteurs : Lauren BISHOP, Auteur ; Madison BLAKE, Auteur ; Melica NIKAHD, Auteur ; J Madison HYER, Auteur ; Brian W. PATTERSON, Auteur ; Bethany J. WOLF, Auteur ; Brittany N. HAND, Auteur Article en page(s) : p.1443-1451 Langues : Anglais (eng) Mots-clés : aging  autism  falls  frailty  Medicare Index. décimale : PER Périodiques Résumé : Fall-related injuries are a major public health issue for older adults, contributing to mortality, morbidity, decreased functional ability, loss of independence, and increased healthcare costs. Autistic older adults may be at greater risk for falls due to motor coordination difficulties and antipsychotic medication use. This cohort study used multivariable logistic regression to compare the odds of falling and negative binomial regression to compare the rate of fall-related injuries. Data from Medicare Standard Analytical Files (2013–2021) for autistic and non-autistic older adults aged 65+ were analyzed. The sample included 13,732 autistic and 25,497 matched non-autistic older adults. Our dependent variables were (1) falls, (2) unique fall-related injuries, and (3) fall-related hospitalizations. Overall, 47.4% of autistic older adults had a fall compared to 31.5% of non-autistic older adults. Autistic older adults also had more fall-related injuries and hospitalizations. Accounting for duration of observation, autistic older adults had significantly higher odds of any fall (odds ratio = 1.99; 95% confidence interval = 1.89–2.08), rate of fall-related injuries (incidence rate ratio = 1.93; 95% confidence interval = 1.86–2.01), and rate of fall-related hospitalizations (incidence rate ratio = 1.43; 95% confidence interval = 1.35–1.51) than non-autistic older adults. These findings highlight the need for targeted fall prevention strategies for autistic older adults to reduce morbidity and mortality.Lay Abstract Falls are a big problem for older adults, often causing injuries and making it hard for them to live independently. Autistic older adults might be at higher risk of falling because of movement difficulties. However, no one has studied how often autistic older adults fall. Our study looked at the difference in fall rates, injuries, and hospitalizations between autistic and non-autistic older adults. We used Medicare data from 2013 to 2021 and included people aged 65 and older. We had 13,732 autistic older adults and 25,497 non-autistic older adults in our study. We matched them based on factors like sex, race, and health status to make sure the comparison was fair. We found that almost half (47.4%) of autistic older adults had a fall, compared to only 31.5% of non-autistic older adults. Autistic older adults also had more injuries and hospitalizations from falls. They had about double the likelihood of falling than non-autistic older adults. The rates of injuries and hospitalizations from falls were more about double for autistic older adults compared to non-autistic older adults. These results suggest that we need special programs to help prevent falls and support the health of autistic older adults. En ligne : https://dx.doi.org/10.1177/13623613261433988 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=586 [article] Falls and Fall-Related Injuries and Hospitalizations in Autistic Older Adults: A Medicare Data Study [texte imprimé] / Lauren BISHOP, Auteur ; Madison BLAKE, Auteur ; Melica NIKAHD, Auteur ; J Madison HYER, Auteur ; Brian W. PATTERSON, Auteur ; Bethany J. WOLF, Auteur ; Brittany N. HAND, Auteur . - p.1443-1451. Langues : Anglais (eng) in Autism > 30-6 (June 2026) . - p.1443-1451 Mots-clés : aging  autism  falls  frailty  Medicare Index. décimale : PER Périodiques Résumé : Fall-related injuries are a major public health issue for older adults, contributing to mortality, morbidity, decreased functional ability, loss of independence, and increased healthcare costs. Autistic older adults may be at greater risk for falls due to motor coordination difficulties and antipsychotic medication use. This cohort study used multivariable logistic regression to compare the odds of falling and negative binomial regression to compare the rate of fall-related injuries. Data from Medicare Standard Analytical Files (2013–2021) for autistic and non-autistic older adults aged 65+ were analyzed. The sample included 13,732 autistic and 25,497 matched non-autistic older adults. Our dependent variables were (1) falls, (2) unique fall-related injuries, and (3) fall-related hospitalizations. Overall, 47.4% of autistic older adults had a fall compared to 31.5% of non-autistic older adults. Autistic older adults also had more fall-related injuries and hospitalizations. Accounting for duration of observation, autistic older adults had significantly higher odds of any fall (odds ratio = 1.99; 95% confidence interval = 1.89–2.08), rate of fall-related injuries (incidence rate ratio = 1.93; 95% confidence interval = 1.86–2.01), and rate of fall-related hospitalizations (incidence rate ratio = 1.43; 95% confidence interval = 1.35–1.51) than non-autistic older adults. These findings highlight the need for targeted fall prevention strategies for autistic older adults to reduce morbidity and mortality.Lay Abstract Falls are a big problem for older adults, often causing injuries and making it hard for them to live independently. Autistic older adults might be at higher risk of falling because of movement difficulties. However, no one has studied how often autistic older adults fall. Our study looked at the difference in fall rates, injuries, and hospitalizations between autistic and non-autistic older adults. We used Medicare data from 2013 to 2021 and included people aged 65 and older. We had 13,732 autistic older adults and 25,497 non-autistic older adults in our study. We matched them based on factors like sex, race, and health status to make sure the comparison was fair. We found that almost half (47.4%) of autistic older adults had a fall, compared to only 31.5% of non-autistic older adults. Autistic older adults also had more injuries and hospitalizations from falls. They had about double the likelihood of falling than non-autistic older adults. The rates of injuries and hospitalizations from falls were more about double for autistic older adults compared to non-autistic older adults. These results suggest that we need special programs to help prevent falls and support the health of autistic older adults. En ligne : https://dx.doi.org/10.1177/13623613261433988 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=586

Mental health outcomes associated with applied behavior analysis in a US national sample of privately insured autistic youth / Nahime G. AGUIRRE MTANOUS in Autism, 30-2 (February 2026)  

Public ISBD [article]  inAutism > 30-2 (February 2026) . - p.484-494 Titre : Mental health outcomes associated with applied behavior analysis in a US national sample of privately insured autistic youth Type de document : texte imprimé Auteurs : Nahime G. AGUIRRE MTANOUS, Auteur ; Jamie KOENIG, Auteur ; Melica NIKAHD, Auteur ; Sarah E. EFFERTZ, Auteur ; Sal SILINONTE, Auteur ; J. Madison HYER, Auteur ; Brittany N. HAND, Auteur ; Lauren BISHOP, Auteur Article en page(s) : p.484-494 Langues : Anglais (eng) Mots-clés : adolescents  applied behavior analysis  autism  health services  medical claims data  mental health  outcome measurement  school-age children Index. décimale : PER Périodiques Résumé : Applied behavior analysis is a widely used intervention for autistic youth, though its mental health impacts remain under-researched. This study aims to investigate the association between applied behavior analysis therapy and post-traumatic stress disorder, suicidality, mental health hospitalization rates, and length of mental health hospitalizations using a national database of privately insured youth under 18. We matched 17,120 autistic youth who received applied behavior analysis with a control group of autistic youth with no record of applied behavior analysis and clustered them into four applied behavior analysis dose groups using two-stage bisecting k-medians clustering. Then, we used negative binomial regression and logistic regression to compare outcomes for the applied behavior analysis and non-applied behavior analysis groups. Overall, applied behavior analysis receipt was associated with 30% higher odds of experiencing a mental health hospitalization (odds ratio = 1.30, p < 0.001) and a 32% higher incidence rate of these hospitalizations (incidence rate ratio = 1.32, p < 0.001). Our analysis found no relationship between applied behavior analysis dosing and the other tracked mental health outcomes. These results indicate the need for more quantitative analysis with more comprehensive records of applied behavior analysis receipt to fully investigate claims of ABA resulting in adverse adult mental health outcomes.Lay abstract Autistic youth often receive applied behavior analysis (ABA) therapy, but some autistic adults who had ABA as youth say it harmed their mental health as adults. We looked at the relationship between ABA and post-traumatic stress disorder (PTSD), suicidality, mental health hospitalization rates, and length of mental health hospitalizations among autistic youth. We used private health insurance claims data to look at how ABA receipt was related to those mental health outcomes. We divided autistic youth into groups based on how much ABA they received, so we could see if different amounts of ABA had different associations with mental health. There were 17,120 autistic youth in the group that did not receive ABA, and 17,120 autistic youth in the group that did receive ABA. In this sample, ABA therapy was associated with a greater use of acute mental health services; autistic youth in the ABA group had an overall risk that was 30% higher for mental health hospitalizations; and a 32% greater frequency of mental health hospitalizations. These results suggest that there may be a relationship between mental health hospitalizations and getting ABA. However, more work is needed to fully understand the impact of ABA therapy on mental health outcomes. En ligne : https://dx.doi.org/10.1177/13623613251390604 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=579 [article] Mental health outcomes associated with applied behavior analysis in a US national sample of privately insured autistic youth [texte imprimé] / Nahime G. AGUIRRE MTANOUS, Auteur ; Jamie KOENIG, Auteur ; Melica NIKAHD, Auteur ; Sarah E. EFFERTZ, Auteur ; Sal SILINONTE, Auteur ; J. Madison HYER, Auteur ; Brittany N. HAND, Auteur ; Lauren BISHOP, Auteur . - p.484-494. Langues : Anglais (eng) in Autism > 30-2 (February 2026) . - p.484-494 Mots-clés : adolescents  applied behavior analysis  autism  health services  medical claims data  mental health  outcome measurement  school-age children Index. décimale : PER Périodiques Résumé : Applied behavior analysis is a widely used intervention for autistic youth, though its mental health impacts remain under-researched. This study aims to investigate the association between applied behavior analysis therapy and post-traumatic stress disorder, suicidality, mental health hospitalization rates, and length of mental health hospitalizations using a national database of privately insured youth under 18. We matched 17,120 autistic youth who received applied behavior analysis with a control group of autistic youth with no record of applied behavior analysis and clustered them into four applied behavior analysis dose groups using two-stage bisecting k-medians clustering. Then, we used negative binomial regression and logistic regression to compare outcomes for the applied behavior analysis and non-applied behavior analysis groups. Overall, applied behavior analysis receipt was associated with 30% higher odds of experiencing a mental health hospitalization (odds ratio = 1.30, p < 0.001) and a 32% higher incidence rate of these hospitalizations (incidence rate ratio = 1.32, p < 0.001). Our analysis found no relationship between applied behavior analysis dosing and the other tracked mental health outcomes. These results indicate the need for more quantitative analysis with more comprehensive records of applied behavior analysis receipt to fully investigate claims of ABA resulting in adverse adult mental health outcomes.Lay abstract Autistic youth often receive applied behavior analysis (ABA) therapy, but some autistic adults who had ABA as youth say it harmed their mental health as adults. We looked at the relationship between ABA and post-traumatic stress disorder (PTSD), suicidality, mental health hospitalization rates, and length of mental health hospitalizations among autistic youth. We used private health insurance claims data to look at how ABA receipt was related to those mental health outcomes. We divided autistic youth into groups based on how much ABA they received, so we could see if different amounts of ABA had different associations with mental health. There were 17,120 autistic youth in the group that did not receive ABA, and 17,120 autistic youth in the group that did receive ABA. In this sample, ABA therapy was associated with a greater use of acute mental health services; autistic youth in the ABA group had an overall risk that was 30% higher for mental health hospitalizations; and a 32% greater frequency of mental health hospitalizations. These results suggest that there may be a relationship between mental health hospitalizations and getting ABA. However, more work is needed to fully understand the impact of ABA therapy on mental health outcomes. En ligne : https://dx.doi.org/10.1177/13623613251390604 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=579

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