Attention Deficit Disorder May Increase Dementia Risk

November 1, 2023

Adults with attention deficit hyperactivity disorder, or ADHD, are nearly three times more likely than their peers without attention problems to develop dementia in old age, according to a new report. But adults with ADHD who are taking psychostimulant medications to treat their attention deficits are not at increased risk of dementia, the study found. 

The findings raise intriguing questions about the connections between ADHD and the risk of dementia, including Alzheimer’s disease, and whether drugs or lifestyle modifications to treat attention problems can affect the risk of developing dementia.  

For the study, published in JAMA Network Open, researchers looked at 109,218 older men and women living in Israel. They were in their 50s or 60s at the start of the study period, in 2003. None had Alzheimer’s disease or other forms of dementia when the study began. 

The researchers followed them for the next 17 years, into 2020. During that time, 7,726 of them, or about 7 percent, had received a diagnosis of dementia. Less than 1 percent, or 730, received a diagnosis of adult ADHD, 96 of whom were also diagnosed with dementia. 

The research team calculated that having a diagnosis of ADHD was associated with a 2.77-fold increased risk of developing dementia, compared to those without ADHD. But those with adult ADHD who were taking stimulant medications like Ritalin, Concerta, or Adderall to treat their condition were not at increased risk of developing dementia. 

The researchers say that more study is needed to better understand the links between ADHD and dementia risk, and how medications or other treatments for the condition may affect the risk. ADHD is a complicated and still poorly understood disease, affecting up to 3 percent of adults, and even more children. This study did not look at children with the disease or adults who had the condition since childhood. 

“Physicians, clinicians and caregivers who work with older adults should monitor ADHD symptoms and associated medications,” said Abraham Reichenberg, a professor at the Department of Psychiatry at the Icahn School of Medicine at Mount Sinai and senior author of the study. 

Symptoms of ADHD in adults include an inability to focus or pay attention as well as being disorganized or impulsive. These symptoms may make it more difficult to plan or organize, or to achieve longer-term goals. Fidgeting or hyperactivity is less common in adults with ADHD than in children with the disorder. 

Untreated ADHD may result in unpaid bills, being late to work, missing doctor’s appointments, increased accidents, and a general sense of chaos. Unhealthy lifestyle choices associated with ADHD, such as a poor diet and lack of exercise, increased alcohol use or smoking, may further increase the risk of developing dementia. 

“Symptoms of attention deficit and hyperactivity in old age shouldn’t be ignored and should be discussed with physicians,” said study author Stephen Levine, a professor at the School of Public Health at the University of Haifa.  

ADHD can be treated with stimulant medications like Adderall as well as non-stimulant drugs like Strattera. Psychotherapy and coaching, mindfulness-based training, a change of diet and exercise may also help some people manage the condition. If you think you might have ADHD, check with your doctor. Treatments can help to relieve symptoms, and may be good for your brain over the long haul.  

By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Eric Schmidt, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.  

Source: Stephen Z. Levine, PhD; Anat Rotstein, PhD; Arad Kodesh, MD; et al: “Adult Attention-Deficit/Hyperactivity Disorder and the Risk of Dementia.” JAMA Network Open, October 17, 2023


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