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ADD in older adults

December 22 2015

ADHD in older adults: First published review of world-wide literature

David W. Goodman, MD Clinician Articles, Doctor's Blog, Patient Education, Professional Research Publications ADD in older adults, ADHD in older adults, Diagnosis of ADD in older adults, Diagnosis of ADHD in older adults, Research on ADD in older adults, Research on ADHD in older adults, Review of ADD in older adults, Review of ADHD in older adults, Treatment of ADD in older adults, Treatment of ADHD in older adults

On December 16, 2015, our article reviewing the world’s English scientific literature on ADHD in adults over age 50 years was published online in Drugs and Aging, an international journal. While there is a paucity of research, there are enough publications to merit pulling this literature together into one paper. Most of research comes out of the Amsterdam ADHD research group under the direction of Dr. Sandra Kooji. Some preliminary findings:

Prevalence estimated at 3%. To put this into perspective, ADHD prevalence rate for children in the U.S. is approximately 8%, and 4.5% for adults. We know that for most children ADHD symptoms persist into adulthood. While we have prospective, longitudinal studies of ADHD children for 30 years, we do not have this information as the children age past 50 years old.
Only 1 of 5 memory clinics actively screen for ADHD. This will leave many with ADHD misdiagnosed and likely mistreated
Older adults on stimulant medication report better attention and greater ability to manage daily tasks compared to ADHD older adult not on medication.

Our paper reviews a broader range of findings and will be helpful to researchers and clinicians seeking to broaden their knowledge and polish their clinical skills as these patients present for evaluation of cognitive complaints. We look forward to participating in the expansion of this knowledge.

David W. Goodman, M.D.

October 13 2015

The New York Times: Older Adults with ADHD

David W. Goodman, MD Doctor's Blog, Media Interviews Online Articles, Patient Education ADD and geriatrics, ADD in older adults, ADHD and geriatrics, ADHD in older adults, adult ADD, adult ADD diagnosis, adult ADD education, adult ADD treatment, adult ADHD, adult ADHD treatment, Adult Attention Deficit Disorder, attention deficit disorder, CHADD, David W. Goodman MD, help for adult ADD, help for adult ADHD, The New York Times ADD

On September 30, 2015, The New York Times ran an article in the Tuesday Science section on ADHD in older adults. I was interviewed for the article and discussed a former patient age 73 who was first diagnosis with ADHD by me and successfully treated. The article is an introduction into an important clinical area for ADHD heretofore ignored. As we discovered, 60% of children will continue to have ADHD symptoms to an impairing degree into adulthood. The presumption is that ADHD in adults will simply continue throughout one’s life. However, the research is only just accumulating to support this assumption. The largest collection of research in this age group is published by my colleagues in Amsterdam and additional research from other research groups around the world.

Early this year I wrote an article for CHADD’s Attention Magazine on issues related to diagnosis and treatment of ADHD in older adults. The diagnostic issues and treatment considerations in older adults are more complex. In brief, diagnosis needs to consider medical illnesses, medications, history of head trauma, and other medical illness that worsen thinking ability. Treatment consideration are complicated by the presence of medications and medical illnesses that might limit the use of ADHD medications. Older patients and families considering an evaluation for possible ADHD should see a psychiatrist or mental health professional who has expertise and experience treating adults with ADHD.

Remember, while attentional changes occur in those of us over age 50, the cornerstone for the diagnosis of ADHD is the presence of symptoms since childhood that are relatively chronic and unchanged over one’s life and that these symptoms cause impairment in daily functioning. A comprehensive evaluation of all possible psychiatric and medical is critical for the accuracy of the diagnosis.

David W. Goodman, M.D., FAPA