The Association between Autistic Traits and Trajectories of Anxiety in Middle-Aged and Older Adults: An 8-year Growth Mixture Model Analysis
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Anxiety is common in autistic people, yet little is known about its course beyond midlife due to limited longitudinal research. We analysed data from 5,270 adults aged 50–91 (median 62; 75% female) in the PROTECT study. Participants completed the Autistic Spectrum Traits questionnaire and GAD-7. Sixty-six (~1.3%, 72.3% female) had high autistic traits (AST group), while 3,874 (~73.5%, 77.8% female) reported none (Control Older Adults; COA). Growth mixture modelling (GMM) identified anxiety trajectories over eight years. Associations between AST status and trajectory membership were examined using multinomial logistic regression.GMM revealed three trajectories: persistently minimal symptoms (‘lower-range minimal’ 85.6%; ‘upper-range minimal’ 12.4%), and a third showing rising anxiety from mild to clinical levels (1.9%). Regressions showed AST individuals were more likely than COA to follow the mild-to-clinical trajectory (RR 4.41, 95% CI 1.70–11.44). Elevated autistic traits increase risk of worsening anxiety with age, highlighting the need for tailored support.