ADHD in Older Adults

ADHD is Lifelong

ADHD is a lifelong condition.  Estimates are that at least two-thirds of individuals diagnosed with ADHD at a young age continue to have symptoms into adulthood. And ADHD doesn’t diminish as adults age. While adults can learn coping strategies, it can continue to affect your quality of life at any age.

In fact, the symptoms of ADHD may grow after midlife, particularly when combined with:

  • Normal age-related changes in brain health
  • Declining physical health
  • Loss of daily structure that often accompanies retirement

ADHD is hereditary and you’re nine times more likely to get it if a close relative has it. For that reason, many older adults first become aware of their own ADHD symptoms only when a family member, like a child or grandchild, gets a diagnosis.

How ADHD Shows Up in Older Adults

Symptoms of ADHD in older age may include:

  • Less reliable memory
  • Distraction
  • Difficulty learning new things
  • Talking too much, often without realizing it
  • Interrupting others
  • Trouble following conversations
  • Difficulty maintaining relationships and keeping in touch
  • Difficulty maintaining order within their homes
  • Struggles to make ends meet financially after a lifetime of poor money management

For menopausal women, the loss of estrogen – which lowers dopamine levels – can result in mood swings, feelings of depression and anxiety.

The Challenge of Diagnosis

Many clinical professionals are unfamiliar with ADHD in adults and may never have seen a case of adult ADHD. In addition, there is a lack of tools designed specifically to diagnose adult ADHD and particular ADHD in older adults. Most ADHD symptom criteria and diagnostic questionnaires are designed for the diagnosis of children, not adults.

Patients aged 60 (and beyond) without a formal diagnosis may exhibit symptoms of ADHD that differ significantly from those that are listed in the DSM. They also may not be able to consistently recall when their symptoms started or how they’ve changed over time.

Finally, there may be confusion between whether the symptoms are the result of dementia or mild cognitive impairment or ADHD. Adult ADHD often occurs with co-morbid conditions which can further frustrate attempts at diagnosis. All of these can contribute to a delay in getting a diagnosis of ADHD for older adults.

ADHD Treatment Options for Older Adults

The treatment options for older adults are similar to those for younger adults:

  • Stimulant medications to improve focus and attention
  • Education to expand your awareness of ADHD, its symptoms and its impacts
  • Skills training, for example, in organization and time management
  • Psychological counseling

If you think you might have ADHD symptoms, it’s never too late to get a diagnosis and treatment. It can be challenging, but try to find a specialist who is familiar with ADHD, especially in older adults.

As more older adults become diagnosed with ADHD and researchers learn more about the long term manifestations of ADHD, the diagnostic tools and treatments options will no doubt be refined and improved.

References

  1. https://www.additudemag.com/adhd-in-seniors-diagnosis-and-treatment-after-60/
  2. https://www.webmd.com/add-adhd/adhd-older-adults
  3. https://drhallowell.com/2020/02/28/adhd-in-the-elderly/
  4. https://www.todaysgeriatricmedicine.com/news/ex_120512.shtml
  5. https://chadd.org/adhd-weekly/its-not-a-senior-moment-its-adhd/

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