Examining the validity of the ADHD concept in adults and older adults
Abstract
Objective: It is crucial to clarify the structure of attention-deficit/hyperactivity disorder (ADHD) symptomatology in all age groups to determine how to best conceptualize this disorder across the lifespan. We tested the ADHD factor structure across adulthood and investigated independent associations with executive functions. Method: Data from 645 adults aged 18–59 and 233 adults aged 60–85 were drawn from the Nathan Kline Institute Rockland Sample. Participants completed the Conners Adult ADHD Rating Scale and tests of executive functioning. Invariance of the ADHD factor structure was investigated using confirmatory factor analyses. Associations with cognition were explored using multiple linear regression. Results: Results confirmed a bifactor model with 3 specific factors (inattention, hyperactivity, and impulsivity). Factor loadings and item intercepts were invariant across ages. Levels of hyperactivity and impulsivity were lower in older adults. Inattentive symptoms in young adults were positively related to cognitive flexibility. In older adults, ADHD symptoms predicted poorer working memory. Conclusion: ADHD symptoms manifest similarly across adulthood. The lack of robust associations between ADHD symptomatology and executive functions raises concerns about the usefulness of neuropsychological measures in diagnosing adult ADHD. These results support the validity of the ADHD concept in older adults but suggest a need for age-appropriate normative criteria.
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In both men and women, hyperactivity and impulsivity decline in adulthood, whereas inattention remains nearly unchanged.
“In both men and women, hyperactivity and impulsivity decline in adulthood, whereas inattention remains nearly unchanged (Callahan & Plamondon 2019).”
From ADHD and associated psychopathology in older adults in a German community sample (2023) · cites this paper as Callahan & Plamondon 2019
The decline of impulsivity and hyperactivity in ADHD patients across the lifespan is well documented by follow-up studies.
“The decline of impulsivity and hyperactivity in ADHD patients across the lifespan is well documented by follow-up studies that observed the persistence of ADHD from childhood into adulthood (Biederman et al. 2000; Callahan and Plamondon 2019) and confirms our hypothesis of an ongoing decrease of ADHD symptoms over the lifespan.”
From ADHD and associated psychopathology in older adults in a German community sample (2023) · cites this paper as Callahan and Plamondon 2019
Cites
Gene-Wide Analysis Detects Two New Susceptibility Genes for Alzheimer's Disease
Escott-Price, V., Bellenguez, C., Wang, L.-S., Choi, S.-H., Harold, D., Jones, L., Holmans, P., Gerrish, A., Vedernikov, A., Richards, A., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0094661 · Cited by 1,398 · see citing works
Barkley, R. A. (2013) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2012.734259 · Cited by 398 · see citing works
Rapport, M. D., Bolden, J., Kofler, M. J., Sarver, D. E., Raiker, J. S., & Alderson, R. M. (2009) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-008-9287-8 · Cited by 265 · cited 1× · see citing works
“This association has been similarly shown in children, and has been taken as evidence that increased motor activity deleteriously imposes on working memory demands.(44) One limitation of the study is that we did not include all the scales included in the CAARS-S:S.”
BackgroundPrevalence of attention-deficit hyperactivity disorder in older adults in the Netherlands
Michielsen, M., Semeijn, E., Comijs, H. C., van de Ven, P., Beekman, A. T. F., Deeg, D. J. H., & Kooij, J. J. S. (2012) · British Journal of Psychiatry · doi:10.1192/bjp.bp.111.101196 · Cited by 181 · see citing works
Kurtz, M. (2004) · Archives of Clinical Neuropsychology · doi:10.1016/s0887-6177(03)00003-9 · Cited by 101 · see citing works
Bramham, J., Murphy, D. G. M., Xenitidis, K., Asherson, P., Hopkin, G., & Young, S. (2012) · Psychological Medicine · doi:10.1017/s0033291712000219 · Cited by 84 · see citing works
Lee, S., Burns, G. L., Beauchaine, T. P., & Becker, S. P. (2016) · Psychological Assessment · doi:10.1037/pas0000232 · Cited by 54 · see citing works
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Alarachi, A., Merrifield, C., Rowa, K., & McCabe, R. E. (2024) · Assessment · doi:10.1177/10731911231225190 · Cited by 17 · see citing works
ADHD and associated psychopathology in older adults in a German community sample
Müller, M., Turner, D., Barra, S., Rösler, M., & Retz, W. (2023) · Journal of Neural Transmission · doi:10.1007/s00702-022-02584-4 · Cited by 10 · see citing works
- Authors
- Callahan, B. L., & Plamondon, A.
- Affiliations
- University of Calgary (CA)
- Université Laval (CA)
- Corresponding author
- Callahan, Brandy L.
- ORCID
- Callahan, Brandy L.
- Venue
- CNS Spectrums
- Publisher
- Cambridge University Press (CUP)
- Published
- 2018-10-08
- Volume
- 24
- Issue
- 5
- Pages
- 518-525
- ISSN
- 1092-8529 (ISSN-L)
- 2165-6509
- OpenAlex
- W2898018235
- Cited by
- 28
- References
- 7
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 3 · 2023: 6 · 2022: 5 · 2021: 1 · 2020: 3 · 2019: 1
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- CNS Spectrums (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- adult ADHD, older adults, bifactor model, inattention, hyperactivity, impulsivity, executive function, cognitive flexibility, working memory, age differences, ADHD diagnosis, normative criteria
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Aging, Attention Deficit Disorder with Hyperactivity, Cognition, Female, Humans, Impulsive Behavior, Male, Memory, Short-Term, Middle Aged, Psychiatric Status Rating Scales, Executive Function
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