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Optimal management of ADHD in older adults

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Torgersen, Terje, Gjervan, Bjørn, Lensing, Michael B., Rasmussen, Kirsten·2016·Neuropsychiatric Disease and Treatment
DOI 10.2147/ndt.s59271PMC PMC4712975
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Abstract

BACKGROUND: The manifestation of attention-deficit/hyperactivity disorder (ADHD) among older adults has become an interesting topic of interest due to an increasing number of adults aged 50 years and older (≥50 years) seeking assessment for ADHD. Unfortunately, there is a lack of research on ADHD in older adults, and until recently only a few case reports existed. METHOD: A systematic search was conducted in the databases Medline/PubMed and PsycINFO in order to identify studies regarding ADHD in adults ≥50 years. RESULTS: ADHD persists into older ages in many patients, but the prevalence of patients fulfilling the criteria for the diagnosis at age ≥50 years is still unknown. It is reason to believe that the prevalence is falling gradually with age, and that the ADHD symptom level is significantly lower in the age group 70-80 years than the group 50-60 years. There is a lack of controlled studies of ADHD medication in adults ≥50 years, but this review suggests that many patients aged ≥50 years experience beneficial effects of pharmacological treatment. The problem with side effects and somatic complications may rise to a level that makes pharmacotherapy for ADHD difficult after the age of 65 years. Physical assessment prior to initiation of ADHD medication in adults ≥50 years should include a thorough clinical examination, and medication should be titrated with low doses initially and with a slow increase. In motivated patients, different psychological therapies alone or in addition to pharmacotherapy should be considered. CONCLUSION: It is essential when treating older adult patients with ADHD to provide good support based on knowledge and understanding of how ADHD symptoms have affected health, quality of life, and function through the life span. Individualized therapy for each elderly patient should be recommended to balance risk-benefit ratio when pharmacotherapy is considered to be a possible treatment.

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  • In the Torgersen et al. 2016 systematic review, only four studies assessing the prevalence of ADHD in older adults were identified.

    “In that systematic review, published in 2016, Torgersen and colleagues (Torgersen et al., 2016) identified only four studies assessing the prevalence of ADHD in older adults.”

    From Prevalence of attention-deficit/hyperactivity disorder in older adults: a systematic review and meta-analysis (2020) · cites this paper as Torgersen et al., 2016

    The Procedure section confirms that Torgersen et al. conducted a systematic search for studies of ADHD in adults aged 50 or older. But the Introduction identifies three epidemiological studies of prevalence, not four; the claimed count conflicts with the paper's stated count (page unavailable in our copy). (LLM, conf=0.90)

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  • 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).”

    From Prevalence of attention-deficit/hyperactivity disorder in older adults: a systematic review and meta-analysis (2020) · cites this paper as Torgersen et al., 2016

    The Introduction (page not provided) says studies show a growing number of adults aged ≥50 are assessed and treated for ADHD. It does not establish that a growing number are being diagnosed for the first time at that age. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Only one systematic review focusing on ADHD prevalence in adults older than 50 has been conducted thus far.

    “To our knowledge, only one systematic review focusing on the ADHD prevalence in adults older than 50 has been conducted thus far (Torgersen et al., 2016).”

    From Prevalence of attention-deficit/hyperactivity disorder in older adults: a systematic review and meta-analysis (2020) · cites this paper as Torgersen et al., 2016

    The Procedure and Abstract Method describe a systematic search for studies of ADHD in adults aged 50 or older, and the Introduction reviews prevalence findings in that age group. The paper is a broader review of ADHD management, however, and these passages do not establish that it was the only systematic review focusing on prevalence. (LLM, conf=0.81)

    Experimental — accuracy not yet measured

  • Across the studies included in Torgersen et al. 2016, prevalence estimates ranged from 1.0% to 6.2%.

    “Across the included studies, the prevalence estimates ranged from 1.0 % to 6.2 %.”

    From Prevalence of attention-deficit/hyperactivity disorder in older adults: a systematic review and meta-analysis (2020) · cites this paper as Torgersen et al., 2016

    The Introduction reports 1.0%–2.8% for ADHD symptoms in the oldest age groups. It also gives 6.2%, but that figure is for a middle-aged comparison group, not the older adults whose prevalence the paper is reviewing. The claimed range therefore combines estimates from different age groups. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • 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).”

    From Prevalence of attention-deficit/hyperactivity disorder in older adults: a systematic review and meta-analysis (2020) · cites this paper as Torgersen et al., 2016

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Authors
Torgersen, T., Gjervan, B., Lensing, M. B., & Rasmussen, K.
Affiliations
  • Norwegian University of Science and Technology (NO)
  • Oslo University Hospital (NO)
Corresponding author
Torgersen, Terje
ORCID
Venue
Neuropsychiatric Disease and Treatment
Publisher
Informa UK Limited
Published
2016-01
Volume
12
Pages
79
ISSN
  • 1176-6328 (ISSN-L)
  • 1178-2021
DOI
10.2147/ndt.s59271
PMC
PMC4712975
OpenAlex
W2222106156
Cited by
42
References
26
Citations by year
2026: 3 · 2025: 6 · 2024: 1 · 2023: 5 · 2022: 2 · 2021: 7 · 2020: 6 · 2019: 7 · 2018: 1 · 2017: 2 · 2016: 2
FWCI
0.57
Type
journal article
Language
en
Open access
Licence
Locations
  • Neuropsychiatric Disease and Treatment (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
  • NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
attention deficit hyperactivity disorder, older adults, ADHD medication, adverse drug reactions, psychotherapy, personalized treatment, risk-benefit assessment, quality of life

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