There’s growing recognition that attention-deficit hyperactive disorder (ADHD) is not just a disruptive childhood condition, with conservative numbers estimating that 8.7 million adults in the US are living with it, both diagnosed and not. Yet older adults, aged 50 and over, are not only consistently absent from ADHD studies, but face roadblocks if they even try to seek help.
Researchers from Örebro University in Sweden looked at international registry data and community-based studies of more than 20 million people around the globe, including 41,000 with an ADHD diagnosis, and found that as of 2020, only 20 papers with 32 datasets factored in older adults.
“A considerable number of adults aged 50 and older have elevated levels of ADHD symptoms,” said study author Maja Dobrosavljevic, a researcher at Örebro University. “But many of them have not received a diagnosis or treatment.”
While a neurodevelopmental condition, most people don’t ‘grow out' of ADHD. And it's a complex disorder that is difficult to diagnose and treat.
ADHD brains have a deficit of the neurotransmitter norepinephne, which is closely linked to dopamine, regulating the brain’s reward and pleasure center. On top of this, an ADHD brain has impaired function in the frontal cortex, the limbic system, the basal ganglia and the reticular activating system, essentially short-wiring neural communication that manifests in a swathe of symptoms that can vary widely between people.
It's an incredibly complicated neurological disorder, and it’s made more difficult to spot in older adults because many symptoms have the hallmarks of age-related cognitive decline.
“One reason why many older people are not diagnosed is that the symptoms are often mistaken for the natural process of ageing or early phases of dementia,” said Dobrosavljevic.
While behaviors such as forgetfulness, poor memory and mood swings can be overlooked as symptoms associated with aging, older adults with ADHD are also more likely to develop dementia, high blood pressure, heart failure, stroke, type 2 diabetes and obesity.
“Persons with ADHD were at a significantly higher risk of developing dementia and mild cognitive impairment, affecting their ability to remember, take in and process information,” said Dobrosavljevic.
And because ADHD is heritable, researchers believe that it’s a huge oversight to exclude such a large section of the population from studies and not review current diagnostic systems that are skewed towards children and younger adults.
“Raising awareness of ADHD in this age group is important as it enables proper diagnosis and adequate treatment for more people," said Dobrosavljevic.
The study was published in the journal Expert Review of Neurotherapeutics.
Source: Örebro University
