Clinical Presentation, Diagnosis and Treatment of Attention-Deficit Hyperactivity Disorder (ADHD) in Older Adults: A Review of the Evidence and its Implications for Clinical Care

Most previous research has not found any decline of prevalence estimates with increasing age within adulthood, and ADHD prevalence in older adults (e.g., above 50 years) was estimated to be around 3%.

“Most previous research has not found any decline of prevalence estimates with increasing age within adulthood, and just as throughout adulthood in general, the ADHD prevalence in older adults (e.g., above 50 years of age) was estimated to be around 3% (Dobrosavljevic et al. 2020; Goodman et al. 2016; Guldberg-Kjar and Johansson 2009; Kooij et al. 2016; Michielsen et al. 2012; Sharma et al. 2021; T”

The age cut-off of 50 years and older was chosen because previous studies have shown a growing number of people aged 50 or older being diagnosed with ADHD for the first time.

“The age cut-off ≥50 was chosen as previous studies have shown that there is a growing number of people aged 50 or older who are being diagnosed with ADHD for the first time (Goodman et al., 2016;Torgersen et al., 2016).”

ADHD is a neurodevelopmental disorder associated with multiple psychiatric and physical disorders that can persist into adulthood.

“Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder associated with multiple psychiatric and physical disorders that can persist into adulthood (Goodman et al., 2016;Nigg, 2013;Torgersen et al., 2016).”

Clinicians may lack awareness of the benefits of ADHD medication and of proper drug dosage in older adults.

“however, clinicians may lack awareness on the benefits and proper drug dosage in this age group (Goodman et al., 2016(Lensing et al., 2015).”

Some older adults who do not meet official clinical criteria for an ADHD diagnosis may experience distressing symptoms and may be in need for care.

“Additionally, some older adults who do not meet official clinical criteria for an ADHD diagnosis may experience distressing symptoms and may be in need for care (Goodman et al., 2016).”

Problems with attention, anterograde memory and executive functions are common in ADHD and age-related cognitive impairment, such as Mild cognitive impairment (MCI) or prodromal dementia.

“As problems with attention, anterograde memory and executive functions are common in ADHD and age related cognitive impairment, such as Mild cognitive impairment (MCI) or prodromal dementia (Goodman et al., 2016;Pollak, 2012)”

Older patients and/or their medical care providers may have concerns about potential ADHD medication side effects because of older age, comorbid psychiatric and somatic disorders (in particular cardiovascular conditions), and interactions with other medications.

“Additionally, older patients and/or their medical care providers may have concerns regarding potential ADHD medication side effects due to older age, comorbid psychiatric and somatic disorders (in particular cardiovascular conditions), and interactions with other medications (Goodman et al., 2016;Lensing et al., 2015;Brod et al., 2012;Herrmann et al., 2008).”