Being Connected: Exploring associations between quality of life and social connectedness in middle-aged and older autistic adults

Being Connected: Exploring associations between quality of life and social connectedness in middle-aged and older autistic adults | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Being Connected: Exploring associations between quality of life and social connectedness in middle-aged and older autistic adults Hanna L. Muse, Emily Luedecke, William Mandy, Rebecca A. Charlton, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9092197/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Autistic adults report lower quality of life (QoL), but little is known about how social connectedness and ageing interact to shape QoL in middle-aged and older autistic populations. This study examined differences in QoL and social connectedness between autistic and non-autistic adults, and how age and gender influence these patterns. Methods 265 autistic adults and 167 non-autistic adults aged 40–93 completed self-report measures of social connectedness, QoL, and symptoms of poor mental health. Group and gender differences in QoL were analysed using 2x2 ANOVAs. Pearson correlations and Fisher’s r-to-z tests assessed associations between social connectedness and QoL. Post hoc analyses examined age group differences. Results When compared to the non-autistic group, the autistic group reported significantly lower social connectedness scores, as well as lower QoL across all domains. Social connectedness was positively associated with QoL in both groups but was significantly stronger for Psychological QoL and Social QoL in the autistic group. Gender and age moderated these associations, with autistic men having stronger associations compared to autistic women. Post-hoc analyses revealed interactions with autism group and age group on all four QoL domains, with autistic people in older age having significantly lower scores than autistic people in midlife, a pattern not observed in the non-autistic group. Conclusion Social connectedness may play a key role in shaping QoL for autistic adults as they age. Tailored, lifespan-focused support is needed to promote sustained social connection and foster wellbeing. Quality of Life Social Connectedness Autism Midlife Old Age Figures Figure 1 Figure 2 COMMUNITY BRIEF Why is this an important issue? Many autistic adults report a lower quality of life than non-autistic people. However, most autism research focuses on children or young adults, and we know little about autistic people in midlife and old age. Getting older comes with many changes, so understanding autistic peoples’ needs as they age is essential. Social connection, such as feeling supported and having people to rely on, may play an important role in wellbeing, but this has not been well studied in older autistic adults. What was the purpose of this study? This study examined how social connectedness relates to quality of life in autistic adults aged 40 and over. The researchers compared autistic and non-autistic adults and explored whether age and gender affected these patterns. What did the researchers do? A total of 432 adults aged 40 to 93 completed an online survey. This included 265 autistic adults and 167 non-autistic adults. Participants answered questions about their quality of life, social connectedness (how socially supported and connected they felt), and their mental health. Autistic adults helped shape the survey. What were the results and conclusions of the study? Autistic participants reported lower social connectedness and lower quality of life than non-autistic participants. In both groups, people who felt more socially connected reported better quality of life. This link was stronger for autistic adults, especially for mental and social quality of life. Age also mattered; older autistic adults reported lower quality of life than autistic people in midlife, and this pattern was not seen in the non-autistic group. Gender differences were also found, with autistic women reporting lower mental and social quality of life than autistic men. When thinking about how age and gender may interact, older autistic men showed a stronger drop in social connectedness with age. Overall, the findings suggest that social connection is especially important for wellbeing in autistic adults and that risks for poorer outcomes may increase in later life. What is new or controversial about these findings? Most autism research focuses on younger people. This study adds new evidence about autistic peoples’ experiences in midlife and old age. It shows that quality of life may decline in older autistic adults, that social connectedness may be more strongly linked to quality of life for autistic adults, and that support may need to differ by gender and age. What are potential weaknesses in the study? All data were self-reported, which may not reflect the full picture of autistic peoples’ experiences. The online format may have excluded people without internet access or people with higher support needs. Also, the social connectedness measure counted the number of contacts but not relationship quality. And finally, because the study looked at one time point, it cannot show cause and effect. How will these findings help autistic adults now or in the future? The results highlight the need for services that support meaningful social connection across adulthood, especially in later life. Policymakers and providers can use this evidence to develop long-term, age-focused support. Early and ongoing support for social connection may help improve quality of life as autistic people grow older. INTRODUCTION Autism is a lifelong neurodevelopmental condition characterised by differences in social communication and repetitive behaviours and interests (American Psychiatric Association, 2013 ). Approximately 1% of the global population are autistic, although rates of diagnosis amongst those in midlife and older age are substantially lower than this, suggesting widespread underdiagnosis in this age group (Santomauro et al., 2025 ; World Health Organization, 2023 ; O’Nions et al., 2023 ; Stewart and Happé, 2025). Research focusing on autism in midlife and older age is scarce (Mason et al., 2022 ). With an increasing number of autistic people being identified later in life, as well as ageing into older adulthood, there is a growing need for research that examines their experiences as they age, and that identifies factors associated with positive outcomes (Pellicano & Heyworth, 2023 ). One area that has been identified as a research priority by the autistic community is improving Quality of Life (QoL). While conceptualisations of QoL can vary, it often centres around hedonic (i.e., pleasure and satisfaction) and eudaimonic (i.e., meaning and purpose) well-being (Ryan & Deci, 2001 ). The World Health Organisation operationalises QoL as a multidimensional concept encompassing various domains, including physical health, psychological, social relationships, and environmental well-being (World Health Organization (WHO) 1996). Several studies indicate that autistic adults often report lower QoL than their non-autistic counterparts across these four domains. Skaletski et al., ( 2021 ) conducted a rapid review of 27 studies that included that autistic people (including those in adolescence into adulthood) consistently reported lower QoL than their non-autistic counterparts. This pattern of results has also been found in studies involving middle-aged and older autistic people; Mason et al., ( 2018 ) found that autistic adults (n = 370, aged = 17–80) had significantly lower QoL than non-autistic adults across all four domains proposed by WHO. Similar findings were reported by Yarar et al. ( 2022 ) (n = 79, aged = 19–71). However, the autistic adults aged 50 + years in Yarar et al. ( 2022 ) rated social aspects of their QoL higher than their younger autistic counterparts, highlighting the importance of considering age when examining QoL in autistic populations. Finally, subjective differences in QoL have also been described in qualitative studies; Francis et al. ( 2025 ) found that autistic and non-autistic adults in midlife and older age shared many similarities in QoL experiences but differed in the impact of mental health and access to support. While many factors have been suggested for this disparity in QoL (e.g., autistic people experiencing high rates of poor health), autistic people often report being lonely ( Grace et al., 2024 ), and their susceptibility to experiencing social isolation (i.e., having poor social connectedness) may be a driving force in the experience of lower QoL (Stewart et al., 2024 ). Social isolation refers to an objective lack of social interactions, relations and connections (Valtorta & Hanratty, 2012 ). Social isolation is viewed as a significant public health concern, particularly in older populations, and has been linked to poor physical and mental health outcomes such as depression, anxiety, and increased mortality (Fakoya et al., 2020 ; Leigh-Hunt et al., 2017 ). Autistic people may be even more vulnerable to these challenges due to barriers in forming social relationships, such as communication difficulties, social stigma, and limited opportunities for social interaction (Mason et al., 2021 ; Grace et al., 2022 ). Howlin and Moss, ( 2012 ) reviewed 23 studies and found that autistic adults, including those with average or above-average IQs, faced significant challenges in establishing meaningful social connections. Moreover, Stewart et al., ( 2024 ) using data from the AgeWellAutism study (autistic n = 265, with age/sex matched comparison group), examined social connectedness in middle-aged and older autistic adults (age = 40–91, mean age = 60.59 years). Stewart and colleagues found that middle-aged and older autistic adults reported lower levels of social connectedness compared to the non-autistic comparison group, and these experiences were cross-sectionally associated with age, suggesting that social isolation may increase with age. The relationship between being socially connected and QoL was examined by Charlton et al., ( 2023 ); using data from a study of autistic adults (n = 388, aged = 40–83), they found that subjective social support significantly predicted all QoL domains. More specifically, social interactions were associated with physical and psychological QoL, while instrumental support contributed to social, environment, and autism-specific QoL (Charlton et al., 2023 ). The importance of social connections has also been highlighted in qualitative studies, for example Hickey et al., ( 2018 ) and Francis et al., ( 2025 ). Together, social connections appear important for positive outcomes (i.e., flourishing). However, despite these findings, no study has yet directly examined how age and social connectedness jointly relate to QoL in autistic adults, representing a significant gap in the literature. The current study aims to build on previous research, particularly the findings from Stewart et al., ( 2024 ), Yarar et al., ( 2022 ) and Charlton et al. ( 2023 ). We seek to further examine the relationship between social connectedness and quality of life in middle-aged and older autistic adults, with comparisons being made to a non-autistic group. Stewart and colleagues highlighted that older autistic adults experience significantly lower levels of social connectedness compared to non-autistic people, and these issues appear to worsen with age. However, Yarar and colleagues highlighted that some aspects of QoL may improve in older age their autistic sample. Additionally, Charlton and colleagues found social support to be a strong predictor of QoL in their autistic sample. As such, this study aims to expand on those findings by examining group differences and the relationships between social connectedness, QoL and age, as well as examine potential gender interactions in these experiences. By focusing specifically on autistic adults in midlife and older age (Stewart, 2025 ), this study aims to fill a critical gap in understanding how social connectedness and QoL associate with age and how these factors interact with gender and being autistic. A better understanding of these associations could benefit how we support autistic people to flourish in midlife and older age. We hypothesise that: 1) the autistic group will report lower QoL scores across all four domains compared to the non-autistic group, and 2) social connectedness will be positively associated with QoL scores. Exploratory analyses will be conducted to examine the influence of age (midlife vs. old age) and gender (men vs. women) differences on these two hypotheses. METHODS Study Design This study uses cross-sectional data from the first wave of the ‘AgeWellAutism’ study, an online survey exploring ageing on the autism spectrum collected in early 2019. The AgeWellAutism study has been described elsewhere (Stewart et al., 2024 ). In brief, the study was steered by 12 middle-aged and older autistic adults, who were compensated for their involvement. Recruitment was conducted via established research networks (e.g., Autistica, the ReSpect Lab database), older adult residential communities, and through social media. Inclusion criteria for the study were: being 40 years of age or older, having access to an internet-enabled device, and being able to read English. The study had no specific exclusion criteria. The survey was conducted on Qualtrics. Participants reviewed an information sheet with detailed study aims and objectives, provided informed consent, and were informed of their right to withdraw at any time. Participants were then presented with a demographics form and a series of standardised questionnaires. Participants were entered into a raffle to win one of twenty £20 Amazon gift vouchers. Full ethical approval was received for this study through the PNM Research Ethics Subcommittee at King's College London (HR-18/19–10941). Participants In total, 502 completed surveys were recorded, of which 70 were removed due to suspected spam (i.e., very short completion times and/or irregular responses to open-text questions, such as repeating the question text or nonsensical text). This resulted in a final total of 432 participants aged 40–93 years completing the online survey. Participants who disclosed that they either had an autism diagnosis (n = 254) or self-identified as autistic (n = 11) formed an autistic group (total autistic n = 265). The autistic group were asked when they received their autism diagnosis/began to identify as autistic; responses ranged from the current year to 43 years ago as a child (mean years since diagnosis = 10.3 years, 17 (6.4%) of sample diagnosed under 18 years of age). The remaining participants formed a non-autistic comparison group (total non-autistic n = 167). Groups did not differ on age (autistic mean age = 60.6 years; non-autistic mean age = 60.5 years) and gender ratio (autistic group men = 46.8%; non-autistic group men = 50.3%). The groups were also comparable in education level. Some group differences were found in demographic characteristics, specifically, autistic participants reported lower rates of employment and were more likely to live with non-marital family members. Specific data on race/ethnicity and socio-economic status were not recorded. See Table 1 for demographic characteristics of the autistic and non-autistic group. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Table 1 – DEMOGRAPHICS HERE - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Materials Demographic characteristics – Participants provided detailed demographic information including age, gender, education level, employment status, and living situation. Quality of Life – Participants self-reported their QoL using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF; World Health Organization, 1996 )). The WHOQOL-BREF assesses four domains: 1) Physical Health, 2) Psychological, 3) Social Relationships, and 4) Environment. Each of the 26 items are rated on a five-point scale. Using the standard scoring method, domain scores range from 4 to 20. Higher scores indicate better QoL. The WHOQOL-BREF has been widely used in both autistic and non-autistic populations and is validated for cross-group comparisons (Mason et al., 2018 ). In the current study, internal consistency was excellent for both the autistic (Cronbach's α = .93) and non-autistic groups (Cronbach's α = .95). Social Connectedness and Isolation – Participants self-reported their experiences of social connectedness using the six-item Lubben Social Network Scale (LSNS-6; Lubben et al., 2006 ). The LSNS-6 has two subscales that explore social integration and support access availability from family members and friends. Each of the six items is rated on a six-point scale (scores ranging from ‘none’ to ‘nine or more’). Scores are totalled for each subscale (family member total, friend total), as well as an overall combined total score. High scores indicate the individual has good social integration and support access, while low scores suggest the individual may be socially isolated with poor support access. The LSNS-6 has been widely used in older non-autistic adult populations and has high internal consistency and stable factor structure (Lubben et al., 2006 ). In the current sample, the internal consistency of the LSNS was very good in the autistic group (Cronbach's α = .83) and excellent in the non-autistic group (Cronbach's α = .93). Depression – Symptoms of depression were measured using the Patient Health Questionnaire (PHQ-9; Kroenke et al., 2001 ). The PHQ-9 is a nine-item questionnaire with a 4-point scale which ask the participant to report whether they have been bothered by a range of problems over the past two weeks such as anhedonia, low mood, sleep problems, fatigue, poor appetite or weight change, concentration difficulty, psychomotor disturbance, and suicidal ideation. Using the conventional cut-off score of ≥ 10, the PHQ-9 has a sensitivity of 88% and a specificity of 88% for major depressive disorder. The PHQ-9 has been validated with autistic adults (Arnold et al., 2020 ; Robeson et al., 2024 ). Anxiety – Symptoms of anxiety were measured using the General Anxiety Disorder questionnaire (GAD-7; Spitzer et al., 2006 ) The GAD-7 is a seven-item questionnaire with a 4-point scale which asks the participant to report whether they have been bothered by a range of problems over the past two weeks such as nervousness, uncontrollability of worrying, issues relaxing, restlessness, and irritability. Using the conventional cut-off score of ≥ 10, the GAD-7 has a sensitivity of 89% and a specificity of 82% for generalised anxiety disorder. The GAD-7 has been validated with autistic adults (Robeson et al., 2024 ). Data Analysis All statistical analyses were conducted using SPSS (v29.0.2.0; IBM Corp., 2023). Group differences (autistic vs. non-autistic) in demographic characteristics were assessed using t-tests (for continuous variables) and chi-square (χ²) tests (for categorical variables). A 2x2 ANOVA examined group (autistic vs. non-autistic) and gender (men vs. women) differences in Quality of Life (QoL) scores (Hypothesis 1). A 2x2 ANCOVA was also used to account for the potential confounding effects of depression and anxiety on QoL. Bivariate correlations (with Fisher’s r-to-z transformations) examined associations between social connectedness and QoL scores within each group (autistic and non-autistic; Hypothesis 2). To explore the influence of age and gender on social connectedness and QoL, additional Pearson’s correlations and Fisher’s r-to-z transformations were performed, with comparisons across gender and group to assess potential interaction effects. To further explore age group effects on QoL domains, a post-hoc 2x2 ANOVA was conducted between autism groups and age (midlife, age 40–64 vs. old age, age 65+) groups. Multiple comparisons were corrected using the False Discovery Rate (FDR) method (Benjamini & Hochberg, 1995 ), with a final α-value of .037. RESULTS Effects of Autism group and Gender on Social Connectedness and Quality of Life domains A series of 2x2 ANOVAs were used to explore the main effects of autism group (autistic vs. non-autistic) and gender group (men vs. women) in social connectedness scores and the four QoL domain QoL scores, the results of which are presented in Table 2 . For social connectedness, a significant main effect of autism group was found; the autistic group reported significantly lower social connectedness scores compared to those in the non-autistic group, F(1,424) = 217.26, p <.001, with a large effect size (Cohen’s d=-1.43). No main effect of gender was found, F(1,424) = 2.54, p =.111. Additionally, no interaction between autism and gender group was found F(1,424) = 0.09, p =.923. For Physical QoL, a significant main effect of autism group was found; the autistic group reported significantly lower Physical QoL scores compared to those in the non-autistic group, F(1,424) = 229.52, p <.001, with a large effect size (Cohen's d=-1.50). No main effect of gender group was found, F(1,424) = 1.70, p =.193. Additionally, there was no interaction of Autism group and gender was found, F(1,424) = 0.31, p =.579. For Psychological QoL, a significant main effect of autism group was found; the autistic group reported significantly lower Psychological QoL scores compared to those in the non-autistic group, F(1,424) = 210.72, p<.001, with a large effect size (Cohen's d=-1.44). A significant main effect of gender group was also found, with men reporting higher Psychological QoL scores than women, F(1,424) = 4.99, p =.026, with a small effect size (Cohen’s d = 0.22). However, no interaction of Autism group and gender was found, F(1,424) = 0.02, p =.887. For Social QoL, a significant main effect of autism group was found; the autistic group reported significantly lower Social QoL scores compared to those in the non-autistic group, F(1,424) = 173.79, p<.001, with a large effect size (Cohen’s d=-1.41). No main effect of gender group was found, F(1,424) = 2.85, p =.092. Additionally, no interaction of Autism group and gender was found, F(1,424) = 0.001, p =.976. For Environment QoL, a significant main effect of autism status was found; the autistic group reported significantly lower Environment QoL scores compared to those in the non-autistic group, F(1,424) = 175.62, p<.001, with a large effect size (Cohen’s d=-1.33). No main effect of gender group was found, F(1,424) = 1.44, p =.231. Additionally, no interaction of Autism group and gender was found, F(1,424) = 0.064, p =.801. Across all QoL domains, the same pattern of results was found after controlling for current symptoms of depression and anxiety. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Table 2 –2x2 TABLE HERE FIGURE 1 –2x2 PLOTS HERE - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Associations between Social Connectedness and Quality of Life Domains A series of Pearson correlations were conducted to explore the association between Social Connectedness (LSNS combined score) and QoL domains in the autistic and non-autistic groups. See Table 5 for correlations by group. In the autistic group, significant positive associations were found between Social Connectedness and all four QoL domains: Physical Health QoL (r=.445, p <.001), Psychological QoL (r=.550, p <.001), Social Relationships QoL (r=.526, p <.001), and Environment QoL (r=.373, p <.001). In the non-autistic group, significant positive associations were also found between social connectedness and all four QoL domains: Physical QoL (r=.321, p <.001), Psychological QoL (r=.378, p <.001), Social QoL (r=.210, p =.007), and Environment QoL (r=.317, p <.001). To test whether the strength of these associations differed by group, Fisher’s r-to-z transformation was used. The strength of association was found to be stronger in the autistic group than the non-autistic group for Social Connectedness and Psychological QoL (z=-2.22, p =.013), as well as Social QoL (z=-3.73, p <.001). However, no significant difference in strength of association was found for Physical QoL (z=-1.46, p =.072) or Environment QoL (z=-0.64, p =.261). G ender differences within/between Autism group An additional series of Pearson’s correlations were used to explore the association between Social Connectedness and QoL domains in the autistic and non-autistic groups split by gender. See Table 4 for correlations by group and gender. Significant positive correlations between Social Connectedness and Physical QoL were found in all groups: non-autistic men (r=.268, p =.014), non-autistic women (r=.358, p <.001), autistic men (r=.435, p <.001), and autistic women (r=.447, p <.001). Fisher’s r-to-z transformation revealed no significant group differences in any of the pairwise comparisons. Similarly, significant positive correlations of social connectedness with Psychological QoL were found across all groups: non-autistic men (r=.343, p =.001), non-autistic women (r=.395, p <.001), autistic men (r=.622, p <.001), and autistic women (r=.483, p <.001). Fisher’s r-to-z transformation showed no significant difference between autistic men and women (z = 1.61, p =.054) or non-autistic men and women (z=-0.38, p =.352). However, autistic men had a significantly stronger association than non-autistic men (z = 2.58, p =.005), while no difference was found between autistic and non-autistic women (z=.77, p =.221). For Social QoL, significant positive correlations were found with social connectedness in non-autistic women (r=.274, p =.012), autistic men (r=.558, p <.001), and autistic women (r=.494, p <.001), but not in non-autistic men (r=.111, p =.315). Fisher’s r-to-z transformation showed no significant difference between autistic men and women (z = 0.71, p =.239) or non-autistic men and women (z=-1.08, p =.140). Autistic men showed a significantly stronger association than non-autistic men (z = 3.61, p <.001), and autistic women had a stronger association than non-autistic women (z = 1.84, p =.033). Lastly, significant positive correlations between Social Connectedness and Environment QoL were observed across all groups: non-autistic men (r=.318, p =.003), non-autistic women (r=.311, p =.004), autistic men (r=.355, p <.001), and autistic women (r=.384, p <.001). Fisher’s r-to-z transformation revealed no significant group differences in any of the pairwise comparisons. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - FIGURE 2 – SCATTER PLOTS HERE - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Age associations in Quality of Life A series of Pearson’s correlations were used to explore the association between age and QoL domains in the autistic and non-autistic groups. See Table 3 for correlations by group. In the autistic group, significant negative associations were found between age and Physical QoL (r=-.498, p <.001), Psychological QoL (r=-.235, p <.001), Social QoL (r=-.225, p <.001), and Environment QoL (r=-.343, p <.001). In the non-autistic group, significant positive associations were found between age and Physical QoL (r=.160, p =.039) and Social QoL (r=.241, p =.002). No associations were found between age and Psychological QoL (r=.103, p =.186) or Environment QoL (r=.083, p =.284). To test whether the strength of these associations differed by group, Fisher’s r-to-z transformation was used. The strength or direction of association was found to be significantly different in the autistic group than the non-autistic group for age and Physical QoL (z=-7.09, p <.001), Psychological QoL (z=-3.43, p =.006), Social QoL (z=-4.75, p <.001), and Environment QoL (z=-4.41, p <.001). Gender differences within/between Autism group An additional series of Pearson’s correlations were used to explore the association between age and QoL domains in the autistic and non-autistic groups split by gender. See Table 4 for correlations by group and gender. In the autistic group, significant negative associations are found between age and Physical QoL, Psychological QoL, Social QoL, and Environment QoL for the autistic men and women. In the non-autistic group, significant positive associations are found between age and physical QoL, psychological QoL, and environment QoL for the non-autistic men and women. A significant positive association was found between age and social QoL for non-autistic women, but no association was found for non-autistic men. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Table 3 – CORRELATIONS TABLE HERE - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Post-hoc effects of Autism group and Age group on Social Connectedness and Quality of Life domains To examine whether there are differences between those in midlife (i.e., aged 40–64 years) and old age (i.e., aged 65 + years), post-hoc analyses were conducted stratifying the sample into these age groups. For social connectedness, both autism status and age group had significant effects ( p <.001), with older autistic adults reporting notably lower scores than midlife autistic adults. However, no interaction between autism and age group was found. For Physical QoL, both autism status and age group had significant effects ( p <.001), with older autistic adults reporting notably lower scores than midlife autistic adults. A significant interaction was observed ( p <.001), indicating that the old age non-autistic group had comparable Physical QoL scores to the midlife non-autistic group. For Psychological QoL, there was a significant main effect of autism diagnosis ( p <.001), but no main effect of age group. However, a significant interaction was observed ( p =.001), meaning the effect of age depends on autism status. Again, older autistic adults showed lower scores than their midlife counterparts, while this pattern was not observed in the non-autistic group. For Social QoL, a similar pattern was observed. Autistic participants had significantly lower scores than non-autistic participants ( p <.001), with no main effect of age. However, the group x age interaction was significant ( p <.001), with the age effect not being observed in the non-autistic group. Finally, for Environment QoL, both group and age had significant effects ( p <.001), and a significant interaction was observed ( p <.001); Older autistic adults showed lower scores than their midlife counterparts, while this pattern was not observed in the non-autistic group. As with other QoL domains, older autistic adults reported the lowest Environment QoL scores. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Table 4 –2x2 TABLE ABOUT HERE - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - DISCUSSION Our study quantitatively examined quality of life (QoL) and social connectedness in a sample of 265 middle-aged and older autistic adults (aged 40–93), compared to an age- and gender-matched non-autistic comparison group (n = 167). As hypothesised, our sample of autistic adults in midlife and old age reported significantly and substantially lower social connectedness and QoL across all QoL domains. Additionally, better social connectedness was found to be positively associated with better QoL scores across all domains. Furthermore, both gender and age appeared to influence the relationship between QoL and social connectedness, although patterns of differences and associations varied across QoL domains. For group differences, autistic women were more likely to report lower Psychological and Social QoL than autistic men. For associations, a stronger association was observed between older age and lower social connectedness for autistic men than autistic women (as well as their non-autistic counterparts). These findings suggest that autistic adults, especially men, may be at greater risk of lower QoL and reduced social support in older age. First, when considering differences in QoL, our study found that our sample of middle-aged and older autistic adults reported significantly lower QoL scores across all WHOQOL-BREF domains compared to the non-autistic comparison group. While few gender differences were found, autistic women reported significantly lower Psychological QoL than autistic men. A similar pattern of results was found when accounting for symptoms of depression and anxiety. When viewing these findings alongside existing literature examining QoL in autistic adult populations, our findings are broadly consistent with prior studies (e.g., Lin et al., 2025 ; Mason et al., 2018 ; Skaletski et al., 2021 ), with our current findings extending this pattern into midlife and old age. When considering factors associated with QoL, we found that social connectedness was positively associated with all four QoL domains. In the autistic and non-autistic groups, higher social connectedness was associated with better QoL across all domains, with notably strong associations with Psychological QoL and Social QoL in the autistic group. This pattern of results remained when examining gender differences, and when accounting for symptoms of poor depression and anxiety. These findings are comparable with previous work conducted by Charlton et al. ( 2023 ) who found that perceived social support (a construct very similar to the measure used in the current study) was a key predictor in QoL among autistic adults in midlife and older age. When considering the associations with and impact of age on QoL, the current study found that older age was associated with lower QoL in the autistic group across all domains. In contrast, age was not consistently associated with QoL in the non-autistic group. Gender further moderated these patterns, with autistic men showing stronger age-related declines in QoL, particularly in social and psychological domains. We further explored these age differences as post-hoc tests, with our analyses indicating interactions between being autistic and in old age group. While autistic (but not non-autistic) adults in old age reported lower QoL than autistic adults in midlife across all domains, this effect was particularly strong in the physical health and environment domains. While the current study is cross-section, this interaction effect suggests that ageing may uniquely impact QoL outcomes in autistic adults. When considering how this pattern fits with the existing literature, to our knowledge, no study has compared QoL in middle-aged and older autistic adults with non-autistic comparisons before. However, some studies have explored age-differences from young adulthood to older age. For example, Mason et al., ( 2018 ) reported that younger autistic adults experienced higher Environment QoL compared to autistic adults in midlife and older age (i.e., 40 + years old). Similarly, Yarar et al., ( 2022 ) found age differences in Social QoL (adults age 18–49 years > adults age 50 + years). While this presented a complex pattern of results, these findings – along with our current findings – suggest that age may negatively impact QoL in autistic populations, particularly for autistic men. However, given the inconsistency of findings and the cross-sectional nature of these findings, further longitudinal work is required to understand age-related change in QoL in autistic populations. These findings have important implications. Specifically, our findings suggest that autistic men may face increasing vulnerability to poorer QoL with age, which may reflect both increasing challenges in maintaining social connectedness and broader age-related declines in wellbeing. However, autistic women may experience persistently lower QoL across midlife and older age. Given the positive (and perhaps protective) association between social connectedness and QoL (particularly psychological and social relationships QoL), our findings suggest that promoting social integration may be important contributor to QoL for autistic adults in midlife and older age. Additionally, this association highlights that selecting social connectedness as a target for intervention, e.g. through social prescribing (Charlton et al., 2020 ) or in other ways that are wanted by autistic people, could help promote flourishing among autistic people, including those in midlife and old age. This study has several strengths and limitations that should be considered when contextualising the findings. A key strength of the current study is that it involved PPI contributions from autistic adults to help shape the survey content and language. The study also employed multiple methods to recruit a large gender- balanced sample of middle-aged and older adults. Additionally, the inclusion of an age- and gender- matched non-autistic comparison group allowed for well-powered between-group comparisons. Our study also administered widely used and well-established instruments (e.g., WHOQOL-BREF, LSNS), which have previously been used in autistic populations. Importantly, the current study contributes to a critically under-researched area: the experiences of middle-aged and older autistic adults; much of the existing autism research focuses on childhood or young adulthood, and this study provides valuable insights into social experiences and QoL in later life. However, some limitations must be acknowledged. First, the study relied entirely on self-report measures, which may be subject to response bias and differing interpretations. Second, while rigorous steps were taken to screen for spam responses, the online survey format inevitably carries some risk of compromised data integrity, which is becoming increasingly common in online research (Lo et al., 2025 ; Pellicano et al., 2024 ). The online format may have also excluded people with limited internet access or those with greater support needs, thereby reducing the representativeness of the sample. Third, the LSNS-6 captures the quantity but not the quality of or satisfaction with social relations, which may be particularly important for autistic people when considering their social experiences. Additionally, our sample only included a small number of trans and non-binary participants in the sample, precluding meaningful analysis of these subgroups, who may face distinct barriers to social connectedness and QoL. Like most ageing research, this study may also be subject to a survivor effect; older adults who participate in research may be healthier and better resourced than their peers, which could bias the findings (Golomb et al., 2012 ). Finally, as this study employed a cross-sectional design, we cannot infer causality in age-related changes in QoL and social connectedness. These limitations present valuable opportunities for future research. Longitudinal designs are needed to examine how social connectedness and QoL evolve across the ageing process in autistic populations. Future studies should also aim to include more diverse samples, particularly people with higher support needs, trans and non-binary individuals, those from varied socioeconomic backgrounds, and those from racial and ethnic backgrounds that more closely match the general population. Furthermore, future studies should consider examining the types of social connections and interactions that autistic people want, and whether these differ in middle-aged and older adult populations. Through this, we could develop a deeper understanding of what aspects of being social connectedness promotes flourishing and positive ageing outcomes in autistic adults. In conclusion, this study quantitatively examined social connectedness and quality of life in a large sample of middle-aged and older autistic adults. In line with previous literature, autistic adults in midlife and older age reported lower QoL and social connectedness than their non-autistic peers, with these differences having a strong association with older age. Additionally, the identified associations between social connectedness and QoL, particularly in psychological and social domains, highlight the critical importance of fostering supportive social networks for autistic adults in midlife and old age. These findings emphasise the need for developing tailored, evidence-based interventions aimed at strengthening social connection and enhancing quality of life for autistic adults across the lifespan. Future research should prioritise longitudinal and inclusive designs to inform interventions that can support autistic adults in building and maintaining personally meaningful social connections well into later life. Early and sustained efforts to support social connectedness may help ensure that autistic adults can thrive well into later life. Declarations AUTHOR CONTRIBUTIONS Authors WM, RAC, FH and GRS conceived the AgeWellAutism study. GRS designed the online survey and selected materials. HM and GRS conceived the current study. EL and GRS prepared the data, and HM and GRS conducted analyses. HM wrote the manuscript, with GRS reviewing and editing drafts. All authors have read and approved the final manuscript. CONFLICTS OF INTEREST None to declare. ACKNOWLEDGEMENTS The authors are grateful to the 12 autistic people who offered suggestions on content and provided feedback on the language-use and accessibility of the study materials. At the time of data collection, GRS was funded by an UKRI/ESRC LISS-DTP PhD studentship (ES/P000703/1). GRS is currently funded by a British Academy Postdoctoral Research Fellowship (PFSS23\230043). FH is part-funded by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre and King’s College London (KCL). The funders have had no role in the data collection, analysis, interpretation, or any other aspect pertinent to the study. The authors have not been paid to write this paper by any agency. This paper represents independent research conducted by the authors, and the views expressed are those of the author(s) and not necessarily those of the ESRC, BA, NIHR or KCL. 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Autistic group (n=265) non-Autistic group (n=167) Group Difference Effect Size Age (years) M(SD) 60.59 (12.89) 60.53 (13.54) t(430)= -.05, p =.960 d =0.01 [-0.19-0.19] [95%CI] [59.03-62.15] [58.46-62.60] Range 40-91 40-93 Gender male:female:nb/t 124 : 137 : 4 84 : 83 : 0 χ2=2.86, p =.239 d =0.10 [-0.09-0.29] % 46.8% : 51.7% : 1.5% 50.3% : 49.7% : 0% Living situation Spouse or Partner 98 (37.0%) 79 (47.3%) χ2=4.52, p =.034* v=.102 Children 71 (26.8%) 39 (23.4%) χ2=.64, p =.424 v=.038 Sibling 34 (12.8%) 0 - χ2=23.26, p<. 001*** v=.232 Parent 22 (8.3%) 7 (4.2%) χ2=2.76, p =.096 v=.0.80 Other Family Member 10 (3.8%) 0 - χ2=6.45, p =.011* v=.122 Roommate/Friend 21 (7.9%) 12 (7.2%) χ2=.08, p =.778 v=.014 Supported Housing 44 (16.6%) 20 (12.0%) χ2=1.74, p =.187 v=.063 Alone independently 52 (19.6%) 58 (34.7%) χ2=12.32, p<. 001*** v=.169 Education history No formal qualifications 28 (10.6%) 4 (2.4%) χ2=1.05, p =.310 v=.209 School to 16 62 (23.40%) 27 (16.2%) School to 18 77 (29.10%) 66 (39.5%) Undergraduate 59 (22.3%) 51 (30.5%) Postgraduate 39 (14.7%) 19 (11.4%) Current employment status Employed 75 (28.3%) 88 (52.7%) χ2=45.65, p<. 001*** v=.325 Retired 125 (47.2%) 74 (44.3%) Unemployed 65 (24.5%) 5 (3.0%) Autism Diagnosis Diagnosed 254 (95.8%) 0 - - - Self-identified 11 (4.2%) 0 Years since Autism Diagnosis/Identity M(SD) 10.26 (8.22) - - - Min/Max 0-43 Note: Effect size calculated by Cohen’s d and Cramer’s v. * p<. 05, ** p<. 01, *** p<. 001 Table 2. Descriptive statistics and group differences for social connectedness and QoL domains, split by autism group and gender. Autistic Men (n=124) Autistic Women (n=137) non-Autistic Men (n=84) non-Autistic Women (n=83) Autism Main Effect Gender Main Effect Autism x Gender Interaction Social connectedness (scores=0-25) M(SD) 9.91 (5.21) 9.10 (4.88) 17.84 (5.54) 16.93 (6.24) F(1,424)=217.26, p<. 001*** F(1,424)=2.54, p= .111 F(1,424)=0.09, p =.923 [95%CI] [8.98-10.83] [8.28-9.93] [16.64-19.04] [15.57-18.30] Min-Max 0-20 0-24 3-25 0-25 D1: Physical Health (scores=4-20) M(SD) 11.05 (3.15) 10.46 (3.16) 15.68 (2.99) 15.44 (3.52) F(1,424)=229.52, p<. 001*** F(1,424)=1.70, p =.193 F(1,424)=0.31, p =.579 [95%CI] [10.49-11.61] [9.93-11.00] [15.03-16.33] [14.67-16.21] Min-Max 4.00-18.29 5.14-18.29 8.57-19.43 8.57-19.43 D2: Psychological Health (scores=4-20) M(SD) 11.05 (2.75) 10.38 (3.04) 15.10 (2.39) 14.51 (3.05) F(1,424)=210.72, p<. 001*** F(1,424)=4.98, p =.026* F(1,424)=0.02, p =.887 [95%CI] [10.56-11.54] [9.12-10.98] [14.59-15.62] [13.85-15.18] Min-Max 5.33-16.00 5.33-16.00 8.00-18.67 8.00-18.67 D3: Social Relationships (scores=4-20) M(SD) 11.29 (3.35) 10.73 (3.64) 15.76 (2.95) 15.18 (3.56) F(1,424)=173.79, p<. 001*** F(1,424)=2.85, p =.092 F(1,424)=0.001, p =.976 [95%CI] [10.70-11.89] [10.12-11.34] [15.12-16.40] [14.40-15.96] Min-Max 4.00-20.00 4.00-20.00 8.00-18.00 4.00-18.00 D4: Environment (scores=4-20) M(SD) 12.08 (2.80) 11.70 (2.80) 15.48 (2.27) 15.23 (2.43) F(1,424)=175.62, p<. 001*** F(1,424)=1.44, p =.064 F(1,424)=0.06, p =.801 [95%CI] [11.59-12.58] [11.23-12.18] [14.98-15.97] [14.70-15.76] Min-Max 5.14-20.00 5.14-18.29 9.71-18.86 9.71-18.86 Note: * p<. 05, ** p<. 01, *** p<. 001 Table 3. Correlations and Fisher’s r-to-z Comparisons of Social Connectedness, Age, and QoL domains by Autism and Gender. Autistic group (n=265) non-Autistic group (n=167) Fisher's r-to-z Autistic Men (n=124) Autistic Women (n=137) non-Autistic Men (n=84) non-Autistic Women (n=83) Within-group Fisher's r-to-z Between-group Fisher's r-to-z Social Connectedness D1: Physical Health r =.445*** r =.321*** z=1.46, p= .072 r =.435*** r =.447*** r =.268* r =.358*** Aut: z=-0.12, p =.452 non-Aut: z=-0.63, p =.264 Men: z=1.33, p= .092 Women: z=0.75, p =.227 D2: Psychological Health r =.550*** r =.378*** z= 2.22, p =.013* r =.622*** r =.483*** r =.343*** r =.395*** Aut: z=1.61, p =.054 non-Aut: z=-0.38, p =.352 Men: z=2.58, p =.005** Women: z=0.77, p =.221 D3: Social Relationships r =.526*** r =.210** z=3.73, p<. 001*** r =.558*** r =.494*** r =.122 r =.274* Aut: z=0.71, p =.239 non-Aut: z=-1.01, p =.156 Men: z=3.53, p<. 001*** Women: z=1.84, p =.034* D4: Environment r =.373*** r =.317*** z=0.64, p= .261 r =.355*** r =.384*** r =.318** r =.311** Aut: z=-0.27, p =.394 non-Aut: z=0.05, p =.480 Men: z=0.29, p =.386 Women: z=0.59, p =.278 Age D1: Physical Health r =-.498*** r =.160* z=-7.09, p<. 001*** r =-.550*** r =-.441*** r =.068 r =.250* Aut: z=-1.16, p =.123 non-Aut: z=-1.19, p =.234 Men: z=-4.78, p<. 001*** Women: z=-5.16, p<. 001*** D2: Psychological Health r =-.235*** r =.103 z= 3.43, p =.006** r =-.348*** r =-.124 r =-.039 r =.223** Aut: z=-1.90, p=.029* non-Aut: z=-1.69, p =.046* Men: z=-2.26, p =.012* Women: z=-2.49, p =.006** D3: Social Relationships r =-.225*** r= .241** z=-4.75, p<. 001*** r =-.293*** r =-.157 r =.154 r =.322** Aut: z=-1.14, p =.127 non-Aut: z=-1.13, p =.129 Men: z=-3.18, p<. 001*** Women: z=-3.48, p<. 001*** D4: Environment r =-.343*** r =.083 z=-4.41, p<. 001*** r =-.344*** r =-.334*** r =-.077 r =.252** Aut: z=-0.09, p =.464 non-Aut: z=-2.12, p =.017* Men: z=-1.96, p =.025* Women: z=-4.28, p<. 001*** Note: * p<. 05, ** p<. 01, *** p<. 001 Table 4. Descriptive statistics and group differences for social connectedness and QoL domains, split by autism group and age group. Autistic group non-Autistic group Autism Main Effect Age Main Effect Autism x Age Interaction Midlife (n=159) Old Age (n=106) Midlife (n=106) Old Age (n=61) Social connectedness (scores=0-25) M(SD) 9.98 (5.17) 7.56 (4.18) 19.48 (4.74) 13.77 (6.00) F(1,428)=214.57, p<. 001*** F(1,428)=77.65, p<. 001*** F(1,428)=5.91, p=. 055 [95%CI] [9.98-11.62] [6.76-8.37] [18.56-20.39] [12.23-15.30] Min-Max 0-24 0-18 3-25 0-25 D1: Physical Health (scores=4-20) M(SD) 11.96 (2.84) 8.89 (2.81) 15.28 (3.66) 16.06 (2.35) F(1,428)=294.57, p<. 001*** F(1,428)=14.03, p<. 001*** F(1,428)=39.65, p<. 001*** [95%CI] [11.52-12.41] [8.35-9.44] [14.57-15.98] [15.45-16.66] Min-Max 4.00-18.29 4.00-18.29 8.57-19.43 11.43-19.43 D2: Psychological Health (scores=4-20) M(SD) 11.21 (2.90) 9.90 (2.84) 14.60 (3.15) 15.18 (1.79) F(1,428)=226.85, p<. 001*** F(1,428)=1.61, p =.206 F(1,428)=10.85, p<. 001*** [95%CI] [10.76-11.67] [9.35-10.45] [13.99-15.20] [14.72-15.64] Min-Max 5.33-16.00 5.33-16.00 8.00-18.67 12.67-18.67 D3: Social Relationships (scores=4-20) M(SD) 11.47 (3.71) 10.21 (3.05) 14.96 (3.71) 16.36 (2.08) F(1,428)=197.24, p<. 001*** F(1,428)=0.04, p =.845 F(1,428)=15.04, p<. 001*** [95%CI] [109-12.05] [9.62-10.79] [14.25-15.68] [15.83-16.89] Min-Max 4.00-20.00 4.00-20.00 4.00-18.00 12.00-18.00 D4: Environment (scores=4-20) M(SD) 12.72 (2.52) 10.62 (2.79) 15.29 (2.60) 15.47 (1.86) F(1,428)=207.06, p<. 001*** F(1,428)=13.96, p<. 001*** F(1,428)=19.59, p<. 001*** [95%CI] [12.33-13.17] [10.08-11.16] [14.79-15.79] [14.99-15.94] Min-Max 6.86-20.00 5.14-18.29 9.71-18.86 12.00-18.86 Note: * p<. 05, ** p<. 01, *** p<. 001 Additional Declarations The authors declare no competing interests. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9092197","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":605626840,"identity":"44144792-5c54-4c5e-86d6-13b46ce6c5f4","order_by":0,"name":"Hanna L. Muse","email":"","orcid":"","institution":"King’s College London","correspondingAuthor":false,"prefix":"","firstName":"Hanna","middleName":"L.","lastName":"Muse","suffix":""},{"id":605626841,"identity":"6c3a3500-179f-4785-a54c-cb8d20587b51","order_by":1,"name":"Emily Luedecke","email":"","orcid":"","institution":"King’s College London","correspondingAuthor":false,"prefix":"","firstName":"Emily","middleName":"","lastName":"Luedecke","suffix":""},{"id":605626842,"identity":"2523f6d3-4e8b-4a3e-8d02-94c799f543c4","order_by":2,"name":"William Mandy","email":"","orcid":"https://orcid.org/0000-0002-3564-5808","institution":"University College London","correspondingAuthor":false,"prefix":"","firstName":"William","middleName":"","lastName":"Mandy","suffix":""},{"id":605626843,"identity":"925aedae-5740-46c7-856b-a3e858310faf","order_by":3,"name":"Rebecca A. Charlton","email":"","orcid":"https://orcid.org/0000-0002-3326-8762","institution":"Goldsmith University of London","correspondingAuthor":false,"prefix":"","firstName":"Rebecca","middleName":"A.","lastName":"Charlton","suffix":""},{"id":605626844,"identity":"9af4f881-5638-4951-b8e4-22433610fc34","order_by":4,"name":"Francesca Happé","email":"","orcid":"https://orcid.org/0000-0001-9226-4000","institution":"King's College London","correspondingAuthor":false,"prefix":"","firstName":"Francesca","middleName":"","lastName":"Happé","suffix":""},{"id":605626845,"identity":"f9fa3544-2ba4-42c8-95cb-56aa69b9bc7a","order_by":5,"name":"Gavin R. Stewart","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/ElEQVRIiWNgGAWjYJCCAwhmRQIDH4SVQFCLBIR1JoGBjRgtDHAtB9uI0CLvfsbwcAFDXR2/RPKzzx/npcmzMTA//MDYloZTi+GZHIPDMxgOS0jOSDOecXBbjmEbA5uxBGNbDm4tDWkJh3kYDkgY3E4wZji4rSIB6DAzBsa2Ctxa+p+BtNRJ2N9O/8xwcA5IC/s3vFrkJZIPALUwSxhI5wBtacgBauEB2YLbYQYSj4FaDA5Lzrj/ppjhzLE0wzZmnmKJhHO4vS/fn9j8maeijp+/5/hmhoqaZHl+9vaNHz6UJeO25QCYRBZiZsAfkfINeCRHwSgYBaNgFIABAA9bTUokG2C4AAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0001-9262-888X","institution":"King's College London","correspondingAuthor":true,"prefix":"","firstName":"Gavin","middleName":"R.","lastName":"Stewart","suffix":""}],"badges":[],"createdAt":"2026-03-11 08:51:20","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-9092197/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9092197/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104684087,"identity":"dd0ce5f3-6cc6-417d-a182-9f72512aaf8a","added_by":"auto","created_at":"2026-03-16 03:47:21","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":137365,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eMean QoL scores across domains by Age Group (Midlife vs. Older Age) and Autism Status.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9092197/v1/f4325802a78bf9e3b6ddfc42.png"},{"id":104684088,"identity":"a792c9d6-f26b-4e76-8eb1-b97070552e52","added_by":"auto","created_at":"2026-03-16 03:47:22","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":523832,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eScatter plots between QoL Domains, Social Connectedness (top) and Age (bottom), split by autism and gender groups.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-9092197/v1/6c62a979191f3ce26469adbf.png"},{"id":104783039,"identity":"471fae0b-81ea-4085-a304-a6852af8d56b","added_by":"auto","created_at":"2026-03-17 07:58:08","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2203660,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9092197/v1/ec5c0bcf-e723-474f-92bc-4a3d4562d2c9.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eBeing Connected: Exploring associations between quality of life and social connectedness in middle-aged and older autistic adults\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"COMMUNITY BRIEF","content":"\u003cp\u003e\u003cb\u003eWhy is this an important issue?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eMany autistic adults report a lower quality of life than non-autistic people. However, most autism research focuses on children or young adults, and we know little about autistic people in midlife and old age. Getting older comes with many changes, so understanding autistic peoples\u0026rsquo; needs as they age is essential. Social connection, such as feeling supported and having people to rely on, may play an important role in wellbeing, but this has not been well studied in older autistic adults.\u003c/p\u003e\u003cp\u003e\u003cb\u003eWhat was the purpose of this study?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study examined how social connectedness relates to quality of life in autistic adults aged 40 and over. The researchers compared autistic and non-autistic adults and explored whether age and gender affected these patterns.\u003c/p\u003e\u003cp\u003e\u003cb\u003eWhat did the researchers do?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eA total of 432 adults aged 40 to 93 completed an online survey. This included 265 autistic adults and 167 non-autistic adults. Participants answered questions about their quality of life, social connectedness (how socially supported and connected they felt), and their mental health. Autistic adults helped shape the survey.\u003c/p\u003e\u003cp\u003e\u003cb\u003eWhat were the results and conclusions of the study?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAutistic participants reported lower social connectedness and lower quality of life than non-autistic participants. In both groups, people who felt more socially connected reported better quality of life. This link was stronger for autistic adults, especially for mental and social quality of life. Age also mattered; older autistic adults reported lower quality of life than autistic people in midlife, and this pattern was not seen in the non-autistic group. Gender differences were also found, with autistic women reporting lower mental and social quality of life than autistic men. When thinking about how age and gender may interact, older autistic men showed a stronger drop in social connectedness with age. Overall, the findings suggest that social connection is especially important for wellbeing in autistic adults and that risks for poorer outcomes may increase in later life.\u003c/p\u003e\u003cp\u003e\u003cb\u003eWhat is new or controversial about these findings?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eMost autism research focuses on younger people. This study adds new evidence about autistic peoples\u0026rsquo; experiences in midlife and old age. It shows that quality of life may decline in older autistic adults, that social connectedness may be more strongly linked to quality of life for autistic adults, and that support may need to differ by gender and age.\u003c/p\u003e\u003cp\u003e\u003cb\u003eWhat are potential weaknesses in the study?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAll data were self-reported, which may not reflect the full picture of autistic peoples\u0026rsquo; experiences. The online format may have excluded people without internet access or people with higher support needs. Also, the social connectedness measure counted the number of contacts but not relationship quality. And finally, because the study looked at one time point, it cannot show cause and effect.\u003c/p\u003e\u003cp\u003e\u003cb\u003eHow will these findings help autistic adults now or in the future?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe results highlight the need for services that support meaningful social connection across adulthood, especially in later life. Policymakers and providers can use this evidence to develop long-term, age-focused support. Early and ongoing support for social connection may help improve quality of life as autistic people grow older.\u003c/p\u003e"},{"header":"INTRODUCTION","content":"\u003cp\u003eAutism is a lifelong neurodevelopmental condition characterised by differences in social communication and repetitive behaviours and interests (American Psychiatric Association, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Approximately 1% of the global population are autistic, although rates of diagnosis amongst those in midlife and older age are substantially lower than this, suggesting widespread underdiagnosis in this age group (Santomauro et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; World Health Organization, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; O\u0026rsquo;Nions et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Stewart and Happ\u0026eacute;, 2025). Research focusing on autism in midlife and older age is scarce (Mason et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). With an increasing number of autistic people being identified later in life, as well as ageing into older adulthood, there is a growing need for research that examines their experiences as they age, and that identifies factors associated with positive outcomes (Pellicano \u0026amp; Heyworth, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOne area that has been identified as a research priority by the autistic community is improving Quality of Life (QoL). While conceptualisations of QoL can vary, it often centres around hedonic (i.e., pleasure and satisfaction) and eudaimonic (i.e., meaning and purpose) well-being (Ryan \u0026amp; Deci, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2001\u003c/span\u003e). The World Health Organisation operationalises QoL as a multidimensional concept encompassing various domains, including physical health, psychological, social relationships, and environmental well-being (World Health Organization (WHO) 1996). Several studies indicate that autistic adults often report lower QoL than their non-autistic counterparts across these four domains. Skaletski et al., (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) conducted a rapid review of 27 studies that included that autistic people (including those in adolescence into adulthood) consistently reported lower QoL than their non-autistic counterparts. This pattern of results has also been found in studies involving middle-aged and older autistic people; Mason et al., (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) found that autistic adults (n\u0026thinsp;=\u0026thinsp;370, aged\u0026thinsp;=\u0026thinsp;17\u0026ndash;80) had significantly lower QoL than non-autistic adults across all four domains proposed by WHO. Similar findings were reported by Yarar et al. (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) (n\u0026thinsp;=\u0026thinsp;79, aged\u0026thinsp;=\u0026thinsp;19\u0026ndash;71). However, the autistic adults aged 50\u0026thinsp;+\u0026thinsp;years in Yarar et al. (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) rated social aspects of their QoL higher than their younger autistic counterparts, highlighting the importance of considering age when examining QoL in autistic populations. Finally, subjective differences in QoL have also been described in qualitative studies; Francis et al. (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2025\u003c/span\u003e) found that autistic and non-autistic adults in midlife and older age shared many similarities in QoL experiences but differed in the impact of mental health and access to support.\u003c/p\u003e \u003cp\u003eWhile many factors have been suggested for this disparity in QoL (e.g., autistic people experiencing high rates of poor health), autistic people often report being lonely \u003cb\u003e(\u003c/b\u003eGrace et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), and their susceptibility to experiencing social isolation (i.e., having poor social connectedness) may be a driving force in the experience of lower QoL (Stewart et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Social isolation refers to an objective lack of social interactions, relations and connections (Valtorta \u0026amp; Hanratty, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Social isolation is viewed as a significant public health concern, particularly in older populations, and has been linked to poor physical and mental health outcomes such as depression, anxiety, and increased mortality (Fakoya et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Leigh-Hunt et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Autistic people may be even more vulnerable to these challenges due to barriers in forming social relationships, such as communication difficulties, social stigma, and limited opportunities for social interaction (Mason et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Grace et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Howlin and Moss, (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2012\u003c/span\u003e) reviewed 23 studies and found that autistic adults, including those with average or above-average IQs, faced significant challenges in establishing meaningful social connections. Moreover, Stewart et al., (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) using data from the AgeWellAutism study (autistic n\u0026thinsp;=\u0026thinsp;265, with age/sex matched comparison group), examined social connectedness in middle-aged and older autistic adults (age\u0026thinsp;=\u0026thinsp;40\u0026ndash;91, mean age\u0026thinsp;=\u0026thinsp;60.59 years). Stewart and colleagues found that middle-aged and older autistic adults reported lower levels of social connectedness compared to the non-autistic comparison group, and these experiences were cross-sectionally associated with age, suggesting that social isolation may increase with age.\u003c/p\u003e \u003cp\u003eThe relationship between being socially connected and QoL was examined by Charlton et al., (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2023\u003c/span\u003e); using data from a study of autistic adults (n\u0026thinsp;=\u0026thinsp;388, aged\u0026thinsp;=\u0026thinsp;40\u0026ndash;83), they found that subjective social support significantly predicted all QoL domains. More specifically, social interactions were associated with physical and psychological QoL, while instrumental support contributed to social, environment, and autism-specific QoL (Charlton et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). The importance of social connections has also been highlighted in qualitative studies, for example Hickey et al., (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) and Francis et al., (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Together, social connections appear important for positive outcomes (i.e., flourishing). However, despite these findings, no study has yet directly examined how age and social connectedness jointly relate to QoL in autistic adults, representing a significant gap in the literature.\u003c/p\u003e \u003cp\u003eThe current study aims to build on previous research, particularly the findings from Stewart et al., (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), Yarar et al., (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) and Charlton et al. (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). We seek to further examine the relationship between social connectedness and quality of life in middle-aged and older autistic adults, with comparisons being made to a non-autistic group. Stewart and colleagues highlighted that older autistic adults experience significantly lower levels of social connectedness compared to non-autistic people, and these issues appear to worsen with age. However, Yarar and colleagues highlighted that some aspects of QoL may improve in older age their autistic sample. Additionally, Charlton and colleagues found social support to be a strong predictor of QoL in their autistic sample. As such, this study aims to expand on those findings by examining group differences and the relationships between social connectedness, QoL and age, as well as examine potential gender interactions in these experiences. By focusing specifically on autistic adults in midlife and older age (Stewart, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2025\u003c/span\u003e), this study aims to fill a critical gap in understanding how social connectedness and QoL associate with age and how these factors interact with gender and being autistic. A better understanding of these associations could benefit how we support autistic people to flourish in midlife and older age. We hypothesise that: 1) the autistic group will report lower QoL scores across all four domains compared to the non-autistic group, and 2) social connectedness will be positively associated with QoL scores. Exploratory analyses will be conducted to examine the influence of age (midlife vs. old age) and gender (men vs. women) differences on these two hypotheses.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy Design\u003c/h2\u003e\n \u003cp\u003eThis study uses cross-sectional data from the first wave of the \u0026lsquo;AgeWellAutism\u0026rsquo; study, an online survey exploring ageing on the autism spectrum collected in early 2019. The AgeWellAutism study has been described elsewhere (Stewart et al., \u003cspan class=\"CitationRef\"\u003e2024\u003c/span\u003e). In brief, the study was steered by 12 middle-aged and older autistic adults, who were compensated for their involvement.\u003c/p\u003e\n \u003cp\u003eRecruitment was conducted via established research networks (e.g., Autistica, the ReSpect Lab database), older adult residential communities, and through social media. Inclusion criteria for the study were: being 40 years of age or older, having access to an internet-enabled device, and being able to read English. The study had no specific exclusion criteria. The survey was conducted on Qualtrics. Participants reviewed an information sheet with detailed study aims and objectives, provided informed consent, and were informed of their right to withdraw at any time. Participants were then presented with a demographics form and a series of standardised questionnaires. Participants were entered into a raffle to win one of twenty \u0026pound;20 Amazon gift vouchers. Full ethical approval was received for this study through the PNM Research Ethics Subcommittee at King\u0026apos;s College London (HR-18/19\u0026ndash;10941).\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eParticipants\u003c/h3\u003e\n\u003cp\u003eIn total, 502 completed surveys were recorded, of which 70 were removed due to suspected spam (i.e., very short completion times and/or irregular responses to open-text questions, such as repeating the question text or nonsensical text). This resulted in a final total of 432 participants aged 40\u0026ndash;93 years completing the online survey. Participants who disclosed that they either had an autism diagnosis (n\u0026thinsp;=\u0026thinsp;254) or self-identified as autistic (n\u0026thinsp;=\u0026thinsp;11) formed an autistic group (total autistic n\u0026thinsp;=\u0026thinsp;265). The autistic group were asked when they received their autism diagnosis/began to identify as autistic; responses ranged from the current year to 43 years ago as a child (mean years since diagnosis\u0026thinsp;=\u0026thinsp;10.3 years, 17 (6.4%) of sample diagnosed under 18 years of age). The remaining participants formed a non-autistic comparison group (total non-autistic n\u0026thinsp;=\u0026thinsp;167).\u003c/p\u003e\n\u003cp\u003eGroups did not differ on age (autistic mean age\u0026thinsp;=\u0026thinsp;60.6 years; non-autistic mean age\u0026thinsp;=\u0026thinsp;60.5 years) and gender ratio (autistic group men\u0026thinsp;=\u0026thinsp;46.8%; non-autistic group men\u0026thinsp;=\u0026thinsp;50.3%). The groups were also comparable in education level. Some group differences were found in demographic characteristics, specifically, autistic participants reported lower rates of employment and were more likely to live with non-marital family members. Specific data on race/ethnicity and socio-economic status were not recorded. See Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e for demographic characteristics of the autistic and non-autistic group.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e \u003cstrong\u003e\u0026ndash; DEMOGRAPHICS HERE\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -\u003c/strong\u003e\u003c/p\u003e\n\u003ch3\u003eMaterials\u003c/h3\u003e\n\u003cp\u003e\u003cem\u003eDemographic characteristics \u0026ndash;\u003c/em\u003e Participants provided detailed demographic information including age, gender, education level, employment status, and living situation.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eQuality of Life\u003c/em\u003e \u0026ndash; Participants self-reported their QoL using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF; World Health Organization, \u003cspan class=\"CitationRef\"\u003e1996\u003c/span\u003e)). The WHOQOL-BREF assesses four domains: 1) Physical Health, 2) Psychological, 3) Social Relationships, and 4) Environment. Each of the 26 items are rated on a five-point scale. Using the standard scoring method, domain scores range from 4 to 20. Higher scores indicate better QoL. The WHOQOL-BREF has been widely used in both autistic and non-autistic populations and is validated for cross-group comparisons (Mason et al., \u003cspan class=\"CitationRef\"\u003e2018\u003c/span\u003e). In the current study, internal consistency was excellent for both the autistic (Cronbach\u0026apos;s \u0026alpha;\u0026thinsp;=\u0026thinsp;.93) and non-autistic groups (Cronbach\u0026apos;s \u0026alpha;\u0026thinsp;=\u0026thinsp;.95).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSocial Connectedness and Isolation\u003c/em\u003e \u0026ndash; Participants self-reported their experiences of social connectedness using the six-item Lubben Social Network Scale (LSNS-6; Lubben et al., \u003cspan class=\"CitationRef\"\u003e2006\u003c/span\u003e). The LSNS-6 has two subscales that explore social integration and support access availability from family members and friends. Each of the six items is rated on a six-point scale (scores ranging from \u0026lsquo;none\u0026rsquo; to \u0026lsquo;nine or more\u0026rsquo;). Scores are totalled for each subscale (family member total, friend total), as well as an overall combined total score. High scores indicate the individual has good social integration and support access, while low scores suggest the individual may be socially isolated with poor support access. The LSNS-6 has been widely used in older non-autistic adult populations and has high internal consistency and stable factor structure (Lubben et al., \u003cspan class=\"CitationRef\"\u003e2006\u003c/span\u003e). In the current sample, the internal consistency of the LSNS was very good in the autistic group (Cronbach\u0026apos;s \u0026alpha;\u0026thinsp;=\u0026thinsp;.83) and excellent in the non-autistic group (Cronbach\u0026apos;s \u0026alpha;\u0026thinsp;=\u0026thinsp;.93).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eDepression \u0026ndash;\u003c/em\u003e Symptoms of depression were measured using the Patient Health Questionnaire (PHQ-9; Kroenke et al., \u003cspan class=\"CitationRef\"\u003e2001\u003c/span\u003e). The PHQ-9 is a nine-item questionnaire with a 4-point scale which ask the participant to report whether they have been bothered by a range of problems over the past two weeks such as anhedonia, low mood, sleep problems, fatigue, poor appetite or weight change, concentration difficulty, psychomotor disturbance, and suicidal ideation. Using the conventional cut-off score of \u0026ge;\u0026thinsp;10, the PHQ-9 has a sensitivity of 88% and a specificity of 88% for major depressive disorder. The PHQ-9 has been validated with autistic adults (Arnold et al., \u003cspan class=\"CitationRef\"\u003e2020\u003c/span\u003e; Robeson et al., \u003cspan class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAnxiety\u003c/em\u003e \u0026ndash; Symptoms of anxiety were measured using the General Anxiety Disorder questionnaire (GAD-7; Spitzer et al., \u003cspan class=\"CitationRef\"\u003e2006\u003c/span\u003e) The GAD-7 is a seven-item questionnaire with a 4-point scale which asks the participant to report whether they have been bothered by a range of problems over the past two weeks such as nervousness, uncontrollability of worrying, issues relaxing, restlessness, and irritability. Using the conventional cut-off score of \u0026ge;\u0026thinsp;10, the GAD-7 has a sensitivity of 89% and a specificity of 82% for generalised anxiety disorder. The GAD-7 has been validated with autistic adults (Robeson et al., \u003cspan class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\n \u003ch2\u003eData Analysis\u003c/h2\u003e\n \u003cp\u003eAll statistical analyses were conducted using SPSS (v29.0.2.0; IBM Corp., 2023). Group differences (autistic vs. non-autistic) in demographic characteristics were assessed using t-tests (for continuous variables) and chi-square (\u0026chi;\u0026sup2;) tests (for categorical variables). A 2x2 ANOVA examined group (autistic vs. non-autistic) and gender (men vs. women) differences in Quality of Life (QoL) scores (Hypothesis 1). A 2x2 ANCOVA was also used to account for the potential confounding effects of depression and anxiety on QoL. Bivariate correlations (with Fisher\u0026rsquo;s r-to-z transformations) examined associations between social connectedness and QoL scores within each group (autistic and non-autistic; Hypothesis 2). To explore the influence of age and gender on social connectedness and QoL, additional Pearson\u0026rsquo;s correlations and Fisher\u0026rsquo;s r-to-z transformations were performed, with comparisons across gender and group to assess potential interaction effects. To further explore age group effects on QoL domains, a post-hoc 2x2 ANOVA was conducted between autism groups and age (midlife, age 40\u0026ndash;64 vs. old age, age 65+) groups. Multiple comparisons were corrected using the False Discovery Rate (FDR) method (Benjamini \u0026amp; Hochberg, \u003cspan class=\"CitationRef\"\u003e1995\u003c/span\u003e), with a final \u0026alpha;-value of .037.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n \u003ch2\u003eEffects of Autism group and Gender on Social Connectedness and Quality of Life domains\u003c/h2\u003e\n \u003cp\u003eA series of 2x2 ANOVAs were used to explore the main effects of autism group (autistic vs. non-autistic) and gender group (men vs. women) in social connectedness scores and the four QoL domain QoL scores, the results of which are presented in Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\n \u003cp\u003eFor social connectedness, a significant main effect of autism group was found; the autistic group reported significantly lower social connectedness scores compared to those in the non-autistic group, F(1,424)\u0026thinsp;=\u0026thinsp;217.26, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001, with a large effect size (Cohen\u0026rsquo;s d=-1.43). No main effect of gender was found, F(1,424)\u0026thinsp;=\u0026thinsp;2.54, \u003cem\u003ep\u003c/em\u003e=.111. Additionally, no interaction between autism and gender group was found F(1,424)\u0026thinsp;=\u0026thinsp;0.09, \u003cem\u003ep\u003c/em\u003e=.923.\u003c/p\u003e\n \u003cp\u003eFor Physical QoL, a significant main effect of autism group was found; the autistic group reported significantly lower Physical QoL scores compared to those in the non-autistic group, F(1,424)\u0026thinsp;=\u0026thinsp;229.52, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001, with a large effect size (Cohen\u0026apos;s d=-1.50). No main effect of gender group was found, F(1,424)\u0026thinsp;=\u0026thinsp;1.70, \u003cem\u003ep\u003c/em\u003e=.193. Additionally, there was no interaction of Autism group and gender was found, F(1,424)\u0026thinsp;=\u0026thinsp;0.31, \u003cem\u003ep\u003c/em\u003e=.579.\u003c/p\u003e\n \u003cp\u003eFor Psychological QoL, a significant main effect of autism group was found; the autistic group reported significantly lower Psychological QoL scores compared to those in the non-autistic group, F(1,424)\u0026thinsp;=\u0026thinsp;210.72, p\u0026lt;.001, with a large effect size (Cohen\u0026apos;s d=-1.44). A significant main effect of gender group was also found, with men reporting higher Psychological QoL scores than women, F(1,424)\u0026thinsp;=\u0026thinsp;4.99, \u003cem\u003ep\u003c/em\u003e=.026, with a small effect size (Cohen\u0026rsquo;s d\u0026thinsp;=\u0026thinsp;0.22). However, no interaction of Autism group and gender was found, F(1,424)\u0026thinsp;=\u0026thinsp;0.02, \u003cem\u003ep\u003c/em\u003e=.887.\u003c/p\u003e\n \u003cp\u003eFor Social QoL, a significant main effect of autism group was found; the autistic group reported significantly lower Social QoL scores compared to those in the non-autistic group, F(1,424)\u0026thinsp;=\u0026thinsp;173.79, p\u0026lt;.001, with a large effect size (Cohen\u0026rsquo;s d=-1.41). No main effect of gender group was found, F(1,424)\u0026thinsp;=\u0026thinsp;2.85, \u003cem\u003ep\u003c/em\u003e=.092. Additionally, no interaction of Autism group and gender was found, F(1,424)\u0026thinsp;=\u0026thinsp;0.001, \u003cem\u003ep\u003c/em\u003e=.976.\u003c/p\u003e\n \u003cp\u003eFor Environment QoL, a significant main effect of autism status was found; the autistic group reported significantly lower Environment QoL scores compared to those in the non-autistic group, F(1,424)\u0026thinsp;=\u0026thinsp;175.62, p\u0026lt;.001, with a large effect size (Cohen\u0026rsquo;s d=-1.33). No main effect of gender group was found, F(1,424)\u0026thinsp;=\u0026thinsp;1.44, \u003cem\u003ep\u003c/em\u003e=.231. Additionally, no interaction of Autism group and gender was found, F(1,424)\u0026thinsp;=\u0026thinsp;0.064, \u003cem\u003ep\u003c/em\u003e=.801. Across all QoL domains, the same pattern of results was found after controlling for current symptoms of depression and anxiety.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eTable \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cstrong\u003e\u0026ndash;2x2 TABLE HERE\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eFIGURE \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cstrong\u003e\u0026ndash;2x2 PLOTS HERE\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -\u003c/strong\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eAssociations between Social Connectedness and Quality of Life Domains\u003c/h3\u003e\n\u003cp\u003eA series of Pearson correlations were conducted to explore the association between Social Connectedness (LSNS combined score) and QoL domains in the autistic and non-autistic groups. See Table\u0026nbsp;5 for correlations by group.\u003c/p\u003e\n\u003cp\u003eIn the autistic group, significant positive associations were found between Social Connectedness and all four QoL domains: Physical Health QoL (r=.445, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), Psychological QoL (r=.550, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), Social Relationships QoL (r=.526, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), and Environment QoL (r=.373, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001). In the non-autistic group, significant positive associations were also found between social connectedness and all four QoL domains: Physical QoL (r=.321, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), Psychological QoL (r=.378, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), Social QoL (r=.210, \u003cem\u003ep\u003c/em\u003e=.007), and Environment QoL (r=.317, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001).\u003c/p\u003e\n\u003cp\u003eTo test whether the strength of these associations differed by group, Fisher\u0026rsquo;s r-to-z transformation was used. The strength of association was found to be stronger in the autistic group than the non-autistic group for Social Connectedness and Psychological QoL (z=-2.22, \u003cem\u003ep\u003c/em\u003e=.013), as well as Social QoL (z=-3.73, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001). However, no significant difference in strength of association was found for Physical QoL (z=-1.46, \u003cem\u003ep\u003c/em\u003e=.072) or Environment QoL (z=-0.64, \u003cem\u003ep\u003c/em\u003e=.261).\u003c/p\u003e\n\u003cp\u003eG\u003cem\u003eender differences within/between Autism group\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAn additional series of Pearson\u0026rsquo;s correlations were used to explore the association between Social Connectedness and QoL domains in the autistic and non-autistic groups split by gender. See Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e for correlations by group and gender.\u003c/p\u003e\n\u003cp\u003eSignificant positive correlations between Social Connectedness and Physical QoL were found in all groups: non-autistic men (r=.268, \u003cem\u003ep\u003c/em\u003e=.014), non-autistic women (r=.358, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), autistic men (r=.435, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), and autistic women (r=.447, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001). Fisher\u0026rsquo;s r-to-z transformation revealed no significant group differences in any of the pairwise comparisons.\u003c/p\u003e\n\u003cp\u003eSimilarly, significant positive correlations of social connectedness with Psychological QoL were found across all groups: non-autistic men (r=.343, \u003cem\u003ep\u003c/em\u003e=.001), non-autistic women (r=.395, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), autistic men (r=.622, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), and autistic women (r=.483, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001). Fisher\u0026rsquo;s r-to-z transformation showed no significant difference between autistic men and women (z\u0026thinsp;=\u0026thinsp;1.61, \u003cem\u003ep\u003c/em\u003e=.054) or non-autistic men and women (z=-0.38, \u003cem\u003ep\u003c/em\u003e=.352). However, autistic men had a significantly stronger association than non-autistic men (z\u0026thinsp;=\u0026thinsp;2.58, \u003cem\u003ep\u003c/em\u003e=.005), while no difference was found between autistic and non-autistic women (z=.77, \u003cem\u003ep\u003c/em\u003e=.221).\u003c/p\u003e\n\u003cp\u003eFor Social QoL, significant positive correlations were found with social connectedness in non-autistic women (r=.274, \u003cem\u003ep\u003c/em\u003e=.012), autistic men (r=.558, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), and autistic women (r=.494, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), but not in non-autistic men (r=.111, \u003cem\u003ep\u003c/em\u003e=.315). Fisher\u0026rsquo;s r-to-z transformation showed no significant difference between autistic men and women (z\u0026thinsp;=\u0026thinsp;0.71, \u003cem\u003ep\u003c/em\u003e=.239) or non-autistic men and women (z=-1.08, \u003cem\u003ep\u003c/em\u003e=.140). Autistic men showed a significantly stronger association than non-autistic men (z\u0026thinsp;=\u0026thinsp;3.61, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), and autistic women had a stronger association than non-autistic women (z\u0026thinsp;=\u0026thinsp;1.84, \u003cem\u003ep\u003c/em\u003e=.033).\u003c/p\u003e\n\u003cp\u003eLastly, significant positive correlations between Social Connectedness and Environment QoL were observed across all groups: non-autistic men (r=.318, \u003cem\u003ep\u003c/em\u003e=.003), non-autistic women (r=.311, \u003cem\u003ep\u003c/em\u003e=.004), autistic men (r=.355, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), and autistic women (r=.384, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001). Fisher\u0026rsquo;s r-to-z transformation revealed no significant group differences in any of the pairwise comparisons.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFIGURE \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e \u003cstrong\u003e\u0026ndash; SCATTER PLOTS HERE\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -\u003c/strong\u003e\u003c/p\u003e\n\u003ch3\u003eAge associations in Quality of Life\u003c/h3\u003e\n\u003cp\u003eA series of Pearson\u0026rsquo;s correlations were used to explore the association between age and QoL domains in the autistic and non-autistic groups. See Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e for correlations by group.\u003c/p\u003e\n\u003cp\u003eIn the autistic group, significant negative associations were found between age and Physical QoL (r=-.498, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), Psychological QoL (r=-.235, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), Social QoL (r=-.225, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), and Environment QoL (r=-.343, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001). In the non-autistic group, significant positive associations were found between age and Physical QoL (r=.160, \u003cem\u003ep\u003c/em\u003e=.039) and Social QoL (r=.241, \u003cem\u003ep\u003c/em\u003e=.002). No associations were found between age and Psychological QoL (r=.103, \u003cem\u003ep\u003c/em\u003e=.186) or Environment QoL (r=.083, \u003cem\u003ep\u003c/em\u003e=.284).\u003c/p\u003e\n\u003cp\u003eTo test whether the strength of these associations differed by group, Fisher\u0026rsquo;s r-to-z transformation was used. The strength or direction of association was found to be significantly different in the autistic group than the non-autistic group for age and Physical QoL (z=-7.09, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), Psychological QoL (z=-3.43, \u003cem\u003ep\u003c/em\u003e=.006), Social QoL (z=-4.75, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001), and Environment QoL (z=-4.41, \u003cem\u003ep\u003c/em\u003e\u0026lt;.001).\u003c/p\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003ch2\u003eGender differences within/between Autism group\u003c/h2\u003e\n \u003cp\u003eAn additional series of Pearson\u0026rsquo;s correlations were used to explore the association between age and QoL domains in the autistic and non-autistic groups split by gender. See Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e for correlations by group and gender.\u003c/p\u003e\n \u003cp\u003eIn the autistic group, significant negative associations are found between age and Physical QoL, Psychological QoL, Social QoL, and Environment QoL for the autistic men and women. In the non-autistic group, significant positive associations are found between age and physical QoL, psychological QoL, and environment QoL for the non-autistic men and women. A significant positive association was found between age and social QoL for non-autistic women, but no association was found for non-autistic men.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eTable\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e \u003cstrong\u003e\u0026ndash; CORRELATIONS TABLE HERE\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ePost-hoc effects of Autism group and Age group on Social Connectedness and Quality of Life domains\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eTo examine whether there are differences between those in midlife (i.e., aged 40\u0026ndash;64 years) and old age (i.e., aged 65\u0026thinsp;+\u0026thinsp;years), post-hoc analyses were conducted stratifying the sample into these age groups.\u003c/p\u003e\n \u003cp\u003eFor social connectedness, both autism status and age group had significant effects (\u003cem\u003ep\u003c/em\u003e\u0026lt;.001), with older autistic adults reporting notably lower scores than midlife autistic adults. However, no interaction between autism and age group was found.\u003c/p\u003e\n \u003cp\u003eFor Physical QoL, both autism status and age group had significant effects (\u003cem\u003ep\u003c/em\u003e\u0026lt;.001), with older autistic adults reporting notably lower scores than midlife autistic adults. A significant interaction was observed (\u003cem\u003ep\u003c/em\u003e\u0026lt;.001), indicating that the old age non-autistic group had comparable Physical QoL scores to the midlife non-autistic group.\u003c/p\u003e\n \u003cp\u003eFor Psychological QoL, there was a significant main effect of autism diagnosis (\u003cem\u003ep\u003c/em\u003e\u0026lt;.001), but no main effect of age group. However, a significant interaction was observed (\u003cem\u003ep\u003c/em\u003e=.001), meaning the effect of age depends on autism status. Again, older autistic adults showed lower scores than their midlife counterparts, while this pattern was not observed in the non-autistic group.\u003c/p\u003e\n \u003cp\u003eFor Social QoL, a similar pattern was observed. Autistic participants had significantly lower scores than non-autistic participants (\u003cem\u003ep\u003c/em\u003e\u0026lt;.001), with no main effect of age. However, the group x age interaction was significant (\u003cem\u003ep\u003c/em\u003e\u0026lt;.001), with the age effect not being observed in the non-autistic group.\u003c/p\u003e\n \u003cp\u003eFinally, for Environment QoL, both group and age had significant effects (\u003cem\u003ep\u003c/em\u003e\u0026lt;.001), and a significant interaction was observed (\u003cem\u003ep\u003c/em\u003e\u0026lt;.001); Older autistic adults showed lower scores than their midlife counterparts, while this pattern was not observed in the non-autistic group. As with other QoL domains, older autistic adults reported the lowest Environment QoL scores.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eTable\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cstrong\u003e\u0026ndash;2x2 TABLE ABOUT HERE\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -\u003c/strong\u003e\u003c/p\u003e\n\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eOur study quantitatively examined quality of life (QoL) and social connectedness in a sample of 265 middle-aged and older autistic adults (aged 40\u0026ndash;93), compared to an age- and gender-matched non-autistic comparison group (n\u0026thinsp;=\u0026thinsp;167). As hypothesised, our sample of autistic adults in midlife and old age reported significantly and substantially lower social connectedness and QoL across all QoL domains. Additionally, better social connectedness was found to be positively associated with better QoL scores across all domains. Furthermore, both gender and age appeared to influence the relationship between QoL and social connectedness, although patterns of differences and associations varied across QoL domains. For group differences, autistic women were more likely to report lower Psychological and Social QoL than autistic men. For associations, a stronger association was observed between older age and lower social connectedness for autistic men than autistic women (as well as their non-autistic counterparts). These findings suggest that autistic adults, especially men, may be at greater risk of lower QoL and reduced social support in older age.\u003c/p\u003e \u003cp\u003eFirst, when considering differences in QoL, our study found that our sample of middle-aged and older autistic adults reported significantly lower QoL scores across all WHOQOL-BREF domains compared to the non-autistic comparison group. While few gender differences were found, autistic women reported significantly lower Psychological QoL than autistic men. A similar pattern of results was found when accounting for symptoms of depression and anxiety. When viewing these findings alongside existing literature examining QoL in autistic adult populations, our findings are broadly consistent with prior studies (e.g., Lin et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Mason et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Skaletski et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), with our current findings extending this pattern into midlife and old age.\u003c/p\u003e \u003cp\u003eWhen considering factors associated with QoL, we found that social connectedness was positively associated with all four QoL domains. In the autistic and non-autistic groups, higher social connectedness was associated with better QoL across all domains, with notably strong associations with Psychological QoL and Social QoL in the autistic group. This pattern of results remained when examining gender differences, and when accounting for symptoms of poor depression and anxiety. These findings are comparable with previous work conducted by Charlton et al. (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) who found that perceived social support (a construct very similar to the measure used in the current study) was a key predictor in QoL among autistic adults in midlife and older age.\u003c/p\u003e \u003cp\u003eWhen considering the associations with and impact of age on QoL, the current study found that older age was associated with lower QoL in the autistic group across all domains. In contrast, age was not consistently associated with QoL in the non-autistic group. Gender further moderated these patterns, with autistic men showing stronger age-related declines in QoL, particularly in social and psychological domains. We further explored these age differences as post-hoc tests, with our analyses indicating interactions between being autistic and in old age group. While autistic (but not non-autistic) adults in old age reported lower QoL than autistic adults in midlife across all domains, this effect was particularly strong in the physical health and environment domains. While the current study is cross-section, this interaction effect suggests that ageing may uniquely impact QoL outcomes in autistic adults. When considering how this pattern fits with the existing literature, to our knowledge, no study has compared QoL in middle-aged and older autistic adults with non-autistic comparisons before. However, some studies have explored age-differences from young adulthood to older age. For example, Mason et al., (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) reported that younger autistic adults experienced higher Environment QoL compared to autistic adults in midlife and older age (i.e., 40\u0026thinsp;+\u0026thinsp;years old). Similarly, Yarar et al., (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) found age differences in Social QoL (adults age 18\u0026ndash;49 years\u0026thinsp;\u0026gt;\u0026thinsp;adults age 50\u0026thinsp;+\u0026thinsp;years). While this presented a complex pattern of results, these findings \u0026ndash; along with our current findings \u0026ndash; suggest that age may negatively impact QoL in autistic populations, particularly for autistic men. However, given the inconsistency of findings and the cross-sectional nature of these findings, further longitudinal work is required to understand age-related change in QoL in autistic populations.\u003c/p\u003e \u003cp\u003eThese findings have important implications. Specifically, our findings suggest that autistic men may face increasing vulnerability to poorer QoL with age, which may reflect both increasing challenges in maintaining social connectedness and broader age-related declines in wellbeing. However, autistic women may experience persistently lower QoL across midlife and older age. Given the positive (and perhaps protective) association between social connectedness and QoL (particularly psychological and social relationships QoL), our findings suggest that promoting social integration may be important contributor to QoL for autistic adults in midlife and older age. Additionally, this association highlights that selecting social connectedness as a target for intervention, e.g. through social prescribing (Charlton et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) or in other ways that are wanted by autistic people, could help promote flourishing among autistic people, including those in midlife and old age.\u003c/p\u003e \u003cp\u003eThis study has several strengths and limitations that should be considered when contextualising the findings. A key strength of the current study is that it involved PPI contributions from autistic adults to help shape the survey content and language. The study also employed multiple methods to recruit a large gender- balanced sample of middle-aged and older adults. Additionally, the inclusion of an age- and gender- matched non-autistic comparison group allowed for well-powered between-group comparisons. Our study also administered widely used and well-established instruments (e.g., WHOQOL-BREF, LSNS), which have previously been used in autistic populations. Importantly, the current study contributes to a critically under-researched area: the experiences of middle-aged and older autistic adults; much of the existing autism research focuses on childhood or young adulthood, and this study provides valuable insights into social experiences and QoL in later life.\u003c/p\u003e \u003cp\u003eHowever, some limitations must be acknowledged. First, the study relied entirely on self-report measures, which may be subject to response bias and differing interpretations. Second, while rigorous steps were taken to screen for spam responses, the online survey format inevitably carries some risk of compromised data integrity, which is becoming increasingly common in online research (Lo et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Pellicano et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). The online format may have also excluded people with limited internet access or those with greater support needs, thereby reducing the representativeness of the sample. Third, the LSNS-6 captures the quantity but not the quality of or satisfaction with social relations, which may be particularly important for autistic people when considering their social experiences. Additionally, our sample only included a small number of trans and non-binary participants in the sample, precluding meaningful analysis of these subgroups, who may face distinct barriers to social connectedness and QoL. Like most ageing research, this study may also be subject to a survivor effect; older adults who participate in research may be healthier and better resourced than their peers, which could bias the findings (Golomb et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Finally, as this study employed a cross-sectional design, we cannot infer causality in age-related changes in QoL and social connectedness.\u003c/p\u003e \u003cp\u003eThese limitations present valuable opportunities for future research. Longitudinal designs are needed to examine how social connectedness and QoL evolve across the ageing process in autistic populations. Future studies should also aim to include more diverse samples, particularly people with higher support needs, trans and non-binary individuals, those from varied socioeconomic backgrounds, and those from racial and ethnic backgrounds that more closely match the general population. Furthermore, future studies should consider examining the types of social connections and interactions that autistic people want, and whether these differ in middle-aged and older adult populations. Through this, we could develop a deeper understanding of what aspects of being social connectedness promotes flourishing and positive ageing outcomes in autistic adults.\u003c/p\u003e \u003cp\u003eIn conclusion, this study quantitatively examined social connectedness and quality of life in a large sample of middle-aged and older autistic adults. In line with previous literature, autistic adults in midlife and older age reported lower QoL and social connectedness than their non-autistic peers, with these differences having a strong association with older age. Additionally, the identified associations between social connectedness and QoL, particularly in psychological and social domains, highlight the critical importance of fostering supportive social networks for autistic adults in midlife and old age. These findings emphasise the need for developing tailored, evidence-based interventions aimed at strengthening social connection and enhancing quality of life for autistic adults across the lifespan. Future research should prioritise longitudinal and inclusive designs to inform interventions that can support autistic adults in building and maintaining personally meaningful social connections well into later life. Early and sustained efforts to support social connectedness may help ensure that autistic adults can thrive well into later life.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAUTHOR CONTRIBUTIONS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthors WM, RAC, FH and GRS conceived the AgeWellAutism study. GRS designed the online survey and selected materials. HM and GRS conceived the current study. EL and GRS prepared the data, and HM and GRS conducted analyses. HM wrote the manuscript, with GRS reviewing and editing drafts. All authors have read and approved the final manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONFLICTS OF INTEREST\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone to declare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eACKNOWLEDGEMENTS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors are grateful to the 12 autistic people who offered suggestions on content and provided feedback on the language-use and accessibility of the study materials. At the time of data collection, GRS was funded by an UKRI/ESRC LISS-DTP PhD studentship (ES/P000703/1). GRS is currently funded by a British Academy Postdoctoral Research Fellowship (PFSS23\\230043). FH is part-funded by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre and King\u0026rsquo;s College London (KCL). The funders have had no role in the data collection, analysis, interpretation, or any other aspect pertinent to the study. The authors have not been paid to write this paper by any agency. This paper represents independent research conducted by the authors, and the views expressed are those of the author(s) and not necessarily those of the ESRC, BA, NIHR or KCL.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAmerican Psychiatric Association (2013) \u003cem\u003eDiagnostic and statistical manual of mental disorders\u003c/em\u003e (5th ed.)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArnold SRC, Uljarević M, Hwang YI, Richdale AL, Trollor JN, Lawson LP (2020) Brief Report: Psychometric Properties of the Patient Health Questionaire-9 (PHQ-9) in Autistic Adults. J Autism Dev Disord 50(6):2217\u0026ndash;2225. ttps://doi.org/10.1007/s10803-019-03947-9\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBenjamini Y, Hochberg Y (1995) Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing. 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J R Soc Med 105(12):518\u0026ndash;522. ttps://doi.org/10.1258/jrsm.2012.120128\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization (1996) \u003cem\u003eWHOQOL-BREF: Introduction, administration, scoring and generic version of the assessment: Field trial version, December 1996\u003c/em\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/publications/i/item/WHOQOL-BREF\u003c/span\u003e\u003cspan address=\"https://www.who.int/publications/i/item/WHOQOL-BREF\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization (2023) \u003cem\u003eAutism\u003c/em\u003e. World Health Organization. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders\u003c/span\u003e\u003cspan address=\"https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYarar EZ, Roestorf A, Spain D, Howlin P, Bowler D, Charlton R, Happ\u0026eacute; F (2022) Aging and autism: Do measures of autism symptoms, co-occurring mental health conditions, or quality of life differ between younger and older autistic adults? Autism Res 15(8):1482\u0026ndash;1494. ttps://doi.org/10.1002/aur.278\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"984\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" valign=\"top\" style=\"width: 984px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1.\u003c/strong\u003e \u003cem\u003eDemographic characteristics of the autistic and non-autistic groups.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 267px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAutistic group (n=265)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 190px;\"\u003e\n \u003cp\u003e\u003cstrong\u003enon-Autistic group (n=167)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup Difference\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect Size\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 267px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eM(SD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e60.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(12.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e60.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e(13.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 135px;\"\u003e\n \u003cp\u003et(430)= -.05, \u003cem\u003ep\u003c/em\u003e=.960\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cem\u003ed\u003c/em\u003e=0.01\u003c/p\u003e\n \u003cp\u003e[-0.19-0.19]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003e[95%CI]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 158px;\"\u003e\n \u003cp\u003e[59.03-62.15]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 190px;\"\u003e\n \u003cp\u003e[58.46-62.60]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eRange\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 158px;\"\u003e\n \u003cp\u003e40-91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 190px;\"\u003e\n \u003cp\u003e40-93\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 267px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003emale:female:nb/t\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 158px;\"\u003e\n \u003cp\u003e124 : 137 : 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 190px;\"\u003e\n \u003cp\u003e84 : 83 : 0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026chi;2=2.86, \u003cem\u003ep\u003c/em\u003e=.239\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cem\u003ed\u003c/em\u003e=0.10\u003c/p\u003e\n \u003cp\u003e[-0.09-0.29]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003e%\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 158px;\"\u003e\n \u003cp\u003e46.8% : 51.7% : 1.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 190px;\"\u003e\n \u003cp\u003e50.3% : 49.7% : 0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"8\" style=\"width: 267px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiving situation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eSpouse or Partner\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(37.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e(47.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026chi;2=4.52, \u003cem\u003ep\u003c/em\u003e=.034*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003ev=.102\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eChildren\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(26.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e(23.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026chi;2=.64, \u003cem\u003ep\u003c/em\u003e=.424\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003ev=.038\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eSibling\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(12.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026chi;2=23.26, \u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003ev=.232\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eParent\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(8.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e(4.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026chi;2=2.76, \u003cem\u003ep\u003c/em\u003e=.096\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003ev=.0.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eOther Family Member\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(3.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026chi;2=6.45, \u003cem\u003ep\u003c/em\u003e=.011*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003ev=.122\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eRoommate/Friend\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(7.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e(7.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026chi;2=.08, \u003cem\u003ep\u003c/em\u003e=.778\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003ev=.014\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eSupported Housing\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(16.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e(12.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026chi;2=1.74, \u003cem\u003ep\u003c/em\u003e=.187\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003ev=.063\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eAlone independently\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(19.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e(34.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026chi;2=12.32, \u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003ev=.169\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" style=\"width: 267px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation history\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eNo formal qualifications\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(10.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e(2.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026chi;2=1.05, \u003cem\u003ep\u003c/em\u003e=.310\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" style=\"width: 79px;\"\u003e\n \u003cp\u003ev=.209\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eSchool to 16\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(23.40%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e(16.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eSchool to 18\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(29.10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e(39.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eUndergraduate\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(22.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e(30.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003ePostgraduate\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(14.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e(11.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 267px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCurrent employment status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eEmployed\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(28.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e(52.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026chi;2=45.65, \u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 79px;\"\u003e\n \u003cp\u003ev=.325\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eRetired\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(47.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e(44.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eUnemployed\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(24.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e(3.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 267px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAutism Diagnosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eDiagnosed\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e254\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(95.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 109px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 135px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eSelf-identified\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(4.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 267px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYears since Autism Diagnosis/Identity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eM(SD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e10.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e(8.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 190px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 135px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cem\u003eMin/Max\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 158px;\"\u003e\n \u003cp\u003e0-43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" valign=\"top\" style=\"width: 984px;\"\u003e\n \u003cp\u003eNote: Effect size calculated by Cohen\u0026rsquo;s d and Cramer\u0026rsquo;s v. * \u003cem\u003ep\u0026lt;.\u003c/em\u003e05, ** \u003cem\u003ep\u0026lt;.\u003c/em\u003e01, *** \u003cem\u003ep\u0026lt;.\u003c/em\u003e001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003e\u003c/u\u003e\u003c/strong\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"986\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"13\" valign=\"top\" style=\"width: 986px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2.\u0026nbsp;\u003c/strong\u003e\u003cem\u003eDescriptive statistics and group differences for social connectedness and QoL domains, split by autism group and gender.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAutistic Men\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=124)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAutistic Women\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=137)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003enon-Autistic Men\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=84)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 111px;\"\u003e\n \u003cp\u003e\u003cstrong\u003enon-Autistic Women\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=83)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 118px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAutism Main Effect\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender Main Effect\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAutism x Gender Interaction\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocial connectedness\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(scores=0-25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cem\u003eM(SD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\"\u003e\n \u003cp\u003e9.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e(5.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e9.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e(4.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e17.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003e(5.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e16.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e(6.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 118px;\"\u003e\n \u003cp\u003eF(1,424)=217.26,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 113px;\"\u003e\n \u003cp\u003eF(1,424)=2.54,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep=\u003c/em\u003e.111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 149px;\"\u003e\n \u003cp\u003eF(1,424)=0.09,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e=.923\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cem\u003e[95%CI]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 86px;\"\u003e\n \u003cp\u003e[8.98-10.83]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 95px;\"\u003e\n \u003cp\u003e[8.28-9.93]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 99px;\"\u003e\n \u003cp\u003e[16.64-19.04]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 111px;\"\u003e\n \u003cp\u003e[15.57-18.30]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cem\u003eMin-Max\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0-20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0-24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 99px;\"\u003e\n \u003cp\u003e3-25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 111px;\"\u003e\n \u003cp\u003e0-25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eD1: Physical Health\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(scores=4-20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cem\u003eM(SD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\"\u003e\n \u003cp\u003e11.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e(3.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e10.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e(3.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e15.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003e(2.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e15.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e(3.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 118px;\"\u003e\n \u003cp\u003eF(1,424)=229.52,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 113px;\"\u003e\n \u003cp\u003eF(1,424)=1.70,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e=.193\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 149px;\"\u003e\n \u003cp\u003eF(1,424)=0.31,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e=.579\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cem\u003e[95%CI]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 86px;\"\u003e\n \u003cp\u003e[10.49-11.61]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 95px;\"\u003e\n \u003cp\u003e[9.93-11.00]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 99px;\"\u003e\n \u003cp\u003e[15.03-16.33]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 111px;\"\u003e\n \u003cp\u003e[14.67-16.21]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cem\u003eMin-Max\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 86px;\"\u003e\n \u003cp\u003e4.00-18.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 95px;\"\u003e\n \u003cp\u003e5.14-18.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 99px;\"\u003e\n \u003cp\u003e8.57-19.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 111px;\"\u003e\n \u003cp\u003e8.57-19.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eD2: Psychological Health\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(scores=4-20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cem\u003eM(SD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\"\u003e\n \u003cp\u003e11.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e(2.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e10.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e(3.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e15.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003e(2.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e14.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e(3.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 118px;\"\u003e\n \u003cp\u003eF(1,424)=210.72,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 113px;\"\u003e\n \u003cp\u003eF(1,424)=4.98,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e=.026*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 149px;\"\u003e\n \u003cp\u003eF(1,424)=0.02,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e=.887\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cem\u003e[95%CI]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 86px;\"\u003e\n \u003cp\u003e[10.56-11.54]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 95px;\"\u003e\n \u003cp\u003e[9.12-10.98]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 99px;\"\u003e\n \u003cp\u003e[14.59-15.62]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 111px;\"\u003e\n \u003cp\u003e[13.85-15.18]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cem\u003eMin-Max\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 86px;\"\u003e\n \u003cp\u003e5.33-16.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 95px;\"\u003e\n \u003cp\u003e5.33-16.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 99px;\"\u003e\n \u003cp\u003e8.00-18.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 111px;\"\u003e\n \u003cp\u003e8.00-18.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eD3: Social Relationships\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(scores=4-20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cem\u003eM(SD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\"\u003e\n \u003cp\u003e11.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e(3.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e10.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e(3.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e15.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003e(2.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e15.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e(3.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 118px;\"\u003e\n \u003cp\u003eF(1,424)=173.79,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 113px;\"\u003e\n \u003cp\u003eF(1,424)=2.85,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e=.092\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 149px;\"\u003e\n \u003cp\u003eF(1,424)=0.001,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e=.976\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cem\u003e[95%CI]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 86px;\"\u003e\n \u003cp\u003e[10.70-11.89]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 95px;\"\u003e\n \u003cp\u003e[10.12-11.34]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 99px;\"\u003e\n \u003cp\u003e[15.12-16.40]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 111px;\"\u003e\n \u003cp\u003e[14.40-15.96]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cem\u003eMin-Max\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 86px;\"\u003e\n \u003cp\u003e4.00-20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 95px;\"\u003e\n \u003cp\u003e4.00-20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 99px;\"\u003e\n \u003cp\u003e8.00-18.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 111px;\"\u003e\n \u003cp\u003e4.00-18.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eD4: Environment\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(scores=4-20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cem\u003eM(SD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\"\u003e\n \u003cp\u003e12.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e(2.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e11.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e(2.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e15.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003e(2.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e15.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e(2.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 118px;\"\u003e\n \u003cp\u003eF(1,424)=175.62,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 113px;\"\u003e\n \u003cp\u003eF(1,424)=1.44,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e=.064\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 149px;\"\u003e\n \u003cp\u003eF(1,424)=0.06,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e=.801\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cem\u003e[95%CI]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 86px;\"\u003e\n \u003cp\u003e[11.59-12.58]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 95px;\"\u003e\n \u003cp\u003e[11.23-12.18]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 99px;\"\u003e\n \u003cp\u003e[14.98-15.97]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 111px;\"\u003e\n \u003cp\u003e[14.70-15.76]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cem\u003eMin-Max\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 86px;\"\u003e\n \u003cp\u003e5.14-20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 95px;\"\u003e\n \u003cp\u003e5.14-18.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 99px;\"\u003e\n \u003cp\u003e9.71-18.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 111px;\"\u003e\n \u003cp\u003e9.71-18.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"13\" valign=\"top\" style=\"width: 986px;\"\u003e\n \u003cp\u003eNote: * \u003cem\u003ep\u0026lt;.\u003c/em\u003e05, ** \u003cem\u003ep\u0026lt;.\u003c/em\u003e01, *** \u003cem\u003ep\u0026lt;.\u003c/em\u003e001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003c/strong\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"1002\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"11\" valign=\"top\" style=\"width: 1002px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 3.\u0026nbsp;\u003c/strong\u003e\u003cem\u003eCorrelations and Fisher\u0026rsquo;s r-to-z Comparisons of Social Connectedness, Age, and QoL domains by Autism and Gender.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAutistic group (n=265)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cstrong\u003enon-Autistic group (n=167)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFisher\u0026apos;s r-to-z\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAutistic Men (n=124)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAutistic Women (n=137)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003enon-Autistic Men\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=84)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003enon-Autistic Women (n=83)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 159px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWithin-group\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eFisher\u0026apos;s r-to-z\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 169px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBetween-group Fisher\u0026apos;s r-to-z\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 31px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eSocial Connectedness\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eD1: Physical Health\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.445***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.321***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003ez=1.46,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep=\u003c/em\u003e.072\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.435***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.447***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.268*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.358***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 159px;\"\u003e\n \u003cp\u003eAut: z=-0.12, \u003cem\u003ep\u003c/em\u003e=.452\u003c/p\u003e\n \u003cp\u003enon-Aut: z=-0.63, \u003cem\u003ep\u003c/em\u003e=.264\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 169px;\"\u003e\n \u003cp\u003eMen: z=1.33, \u003cem\u003ep=\u003c/em\u003e.092\u003c/p\u003e\n \u003cp\u003eWomen: z=0.75, \u003cem\u003ep\u003c/em\u003e=.227\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eD2: Psychological Health\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.550***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.378***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003ez= 2.22,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e=.013*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.622***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.483***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.343***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.395***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 159px;\"\u003e\n \u003cp\u003eAut: z=1.61, \u003cem\u003ep\u003c/em\u003e=.054\u003c/p\u003e\n \u003cp\u003enon-Aut: z=-0.38, \u003cem\u003ep\u003c/em\u003e=.352\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 169px;\"\u003e\n \u003cp\u003eMen: z=2.58, \u003cem\u003ep\u003c/em\u003e=.005**\u003c/p\u003e\n \u003cp\u003eWomen: z=0.77, \u003cem\u003ep\u003c/em\u003e=.221\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eD3: Social Relationships\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.526***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.210**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003ez=3.73,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.558***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.494***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.274*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 159px;\"\u003e\n \u003cp\u003eAut: z=0.71, \u003cem\u003ep\u003c/em\u003e=.239\u003c/p\u003e\n \u003cp\u003enon-Aut: z=-1.01, \u003cem\u003ep\u003c/em\u003e=.156\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 169px;\"\u003e\n \u003cp\u003eMen: z=3.53, \u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003cp\u003eWomen: z=1.84, \u003cem\u003ep\u003c/em\u003e=.034*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eD4: Environment\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.373***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.317***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003ez=0.64,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep=\u003c/em\u003e.261\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.355***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.384***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.318**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.311**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 159px;\"\u003e\n \u003cp\u003eAut: z=-0.27, \u003cem\u003ep\u003c/em\u003e=.394\u003c/p\u003e\n \u003cp\u003enon-Aut: z=0.05, \u003cem\u003ep\u003c/em\u003e=.480\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 169px;\"\u003e\n \u003cp\u003eMen: z=0.29, \u003cem\u003ep\u003c/em\u003e=.386\u003c/p\u003e\n \u003cp\u003eWomen: z=0.59, \u003cem\u003ep\u003c/em\u003e=.278\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 31px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAge\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eD1: Physical Health\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=-.498***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.160*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003ez=-7.09, \u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=-.550***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=-.441***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.068\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.250*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 159px;\"\u003e\n \u003cp\u003eAut: z=-1.16, \u003cem\u003ep\u003c/em\u003e=.123\u003c/p\u003e\n \u003cp\u003enon-Aut: z=-1.19, \u003cem\u003ep\u003c/em\u003e=.234\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 169px;\"\u003e\n \u003cp\u003eMen: z=-4.78, \u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003cp\u003eWomen: z=-5.16, \u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eD2: Psychological Health\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=-.235***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003ez= 3.43, \u003cem\u003ep\u003c/em\u003e=.006**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=-.348***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=-.124\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=-.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.223**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 159px;\"\u003e\n \u003cp\u003eAut: z=-1.90, p=.029*\u003c/p\u003e\n \u003cp\u003enon-Aut: z=-1.69, \u003cem\u003ep\u003c/em\u003e=.046*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 169px;\"\u003e\n \u003cp\u003eMen: z=-2.26, \u003cem\u003ep\u003c/em\u003e=.012*\u003c/p\u003e\n \u003cp\u003eWomen: z=-2.49, \u003cem\u003ep\u003c/em\u003e=.006**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eD3: Social Relationships\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=-.225***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cem\u003er=\u003c/em\u003e.241**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003ez=-4.75, \u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=-.293***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=-.157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.154\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.322**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 159px;\"\u003e\n \u003cp\u003eAut: z=-1.14, \u003cem\u003ep\u003c/em\u003e=.127\u003c/p\u003e\n \u003cp\u003enon-Aut: z=-1.13, \u003cem\u003ep\u003c/em\u003e=.129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 169px;\"\u003e\n \u003cp\u003eMen: z=-3.18, \u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003cp\u003eWomen: z=-3.48, \u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eD4: Environment\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=-.343***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003ez=-4.41, \u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=-.344***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=-.334***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=-.077\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cem\u003er\u003c/em\u003e=.252**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 159px;\"\u003e\n \u003cp\u003eAut: z=-0.09, \u003cem\u003ep\u003c/em\u003e=.464\u003c/p\u003e\n \u003cp\u003enon-Aut: z=-2.12, \u003cem\u003ep\u003c/em\u003e=.017*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 169px;\"\u003e\n \u003cp\u003eMen: z=-1.96, \u003cem\u003ep\u003c/em\u003e=.025*\u003c/p\u003e\n \u003cp\u003eWomen: z=-4.28, \u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"11\" style=\"width: 1002px;\"\u003e\n \u003cp\u003eNote: * \u003cem\u003ep\u0026lt;.\u003c/em\u003e05, ** \u003cem\u003ep\u0026lt;.\u003c/em\u003e01, *** \u003cem\u003ep\u0026lt;.\u003c/em\u003e001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003c/strong\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"983\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"13\" valign=\"top\" style=\"width: 983px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 4.\u0026nbsp;\u003c/strong\u003e\u003cem\u003eDescriptive statistics and group differences for social connectedness and QoL domains, split by autism group and age group.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 197px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cu\u003eAutistic group\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 197px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cu\u003enon-Autistic group\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAutism\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMain Effect\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMain Effect\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAutism x Age Interaction\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMidlife\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=159)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOld Age (n=106)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMidlife\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=106)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOld Age\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=61)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocial connectedness\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(scores=0-25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cem\u003eM(SD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e9.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(5.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e7.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(4.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e19.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(4.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e13.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(6.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 138px;\"\u003e\n \u003cp\u003eF(1,428)=214.57,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 123px;\"\u003e\n \u003cp\u003eF(1,428)=77.65,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 142px;\"\u003e\n \u003cp\u003eF(1,428)=5.91,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep=.\u003c/em\u003e055\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cem\u003e[95%CI]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[9.98-11.62]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[6.76-8.37]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[18.56-20.39]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[12.23-15.30]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cem\u003eMin-Max\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e0-24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e0-18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e3-25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e0-25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eD1: Physical Health\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(scores=4-20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cem\u003eM(SD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e11.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(2.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e8.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(2.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e15.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(3.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e16.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(2.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 138px;\"\u003e\n \u003cp\u003eF(1,428)=294.57,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 123px;\"\u003e\n \u003cp\u003eF(1,428)=14.03,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 142px;\"\u003e\n \u003cp\u003eF(1,428)=39.65,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cem\u003e[95%CI]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[11.52-12.41]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[8.35-9.44]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[14.57-15.98]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[15.45-16.66]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cem\u003eMin-Max\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e4.00-18.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e4.00-18.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e8.57-19.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e11.43-19.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eD2: Psychological Health\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(scores=4-20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cem\u003eM(SD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e11.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(2.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e9.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(2.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e14.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(3.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e15.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(1.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 138px;\"\u003e\n \u003cp\u003eF(1,428)=226.85,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 123px;\"\u003e\n \u003cp\u003eF(1,428)=1.61,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e=.206\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 142px;\"\u003e\n \u003cp\u003eF(1,428)=10.85,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cem\u003e[95%CI]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[10.76-11.67]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[9.35-10.45]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[13.99-15.20]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[14.72-15.64]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cem\u003eMin-Max\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e5.33-16.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e5.33-16.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e8.00-18.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e12.67-18.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eD3: Social Relationships\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(scores=4-20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cem\u003eM(SD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e11.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(3.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e10.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(3.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e14.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(3.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e16.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(2.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 138px;\"\u003e\n \u003cp\u003eF(1,428)=197.24,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 123px;\"\u003e\n \u003cp\u003eF(1,428)=0.04,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e=.845\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 142px;\"\u003e\n \u003cp\u003eF(1,428)=15.04,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cem\u003e[95%CI]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[109-12.05]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[9.62-10.79]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[14.25-15.68]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[15.83-16.89]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cem\u003eMin-Max\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e4.00-20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e4.00-20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e4.00-18.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e12.00-18.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eD4: Environment\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(scores=4-20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cem\u003eM(SD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e12.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(2.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e10.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(2.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e15.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(2.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e15.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49px;\"\u003e\n \u003cp\u003e(1.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 138px;\"\u003e\n \u003cp\u003eF(1,428)=207.06,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 123px;\"\u003e\n \u003cp\u003eF(1,428)=13.96,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 142px;\"\u003e\n \u003cp\u003eF(1,428)=19.59,\u003c/p\u003e\n \u003cp\u003e\u003cem\u003ep\u0026lt;.\u003c/em\u003e001***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cem\u003e[95%CI]\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[12.33-13.17]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[10.08-11.16]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[14.79-15.79]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e[14.99-15.94]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cem\u003eMin-Max\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e6.86-20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e5.14-18.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e9.71-18.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 98px;\"\u003e\n \u003cp\u003e12.00-18.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"13\" valign=\"top\" style=\"width: 983px;\"\u003e\n \u003cp\u003eNote: * \u003cem\u003ep\u0026lt;.\u003c/em\u003e05, ** \u003cem\u003ep\u0026lt;.\u003c/em\u003e01, *** \u003cem\u003ep\u0026lt;.\u003c/em\u003e001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"King's College London","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Quality of Life, Social Connectedness, Autism, Midlife, Old Age","lastPublishedDoi":"10.21203/rs.3.rs-9092197/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9092197/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eAutistic adults report lower quality of life (QoL), but little is known about how social connectedness and ageing interact to shape QoL in middle-aged and older autistic populations. This study examined differences in QoL and social connectedness between autistic and non-autistic adults, and how age and gender influence these patterns.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003e265 autistic adults and 167 non-autistic adults aged 40\u0026ndash;93 completed self-report measures of social connectedness, QoL, and symptoms of poor mental health. Group and gender differences in QoL were analysed using 2x2 ANOVAs. Pearson correlations and Fisher\u0026rsquo;s r-to-z tests assessed associations between social connectedness and QoL. Post hoc analyses examined age group differences.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eWhen compared to the non-autistic group, the autistic group reported significantly lower social connectedness scores, as well as lower QoL across all domains. Social connectedness was positively associated with QoL in both groups but was significantly stronger for Psychological QoL and Social QoL in the autistic group. Gender and age moderated these associations, with autistic men having stronger associations compared to autistic women. Post-hoc analyses revealed interactions with autism group and age group on all four QoL domains, with autistic people in older age having significantly lower scores than autistic people in midlife, a pattern not observed in the non-autistic group.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eSocial connectedness may play a key role in shaping QoL for autistic adults as they age. Tailored, lifespan-focused support is needed to promote sustained social connection and foster wellbeing.\u003c/p\u003e","manuscriptTitle":"Being Connected: Exploring associations between quality of life and social connectedness in middle-aged and older autistic adults","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-16 03:47:17","doi":"10.21203/rs.3.rs-9092197/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"718d4649-3fc9-4d83-bddd-adafda7abf4f","owner":[],"postedDate":"March 16th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-16T03:47:17+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-16 03:47:17","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9092197","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9092197","identity":"rs-9092197","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}