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ADHD & Dementia

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Using data from a prospective cohort study, an association was observed between adult-onset attention-deficit/hyperactivity disorder (ADHD) and an increased risk for dementia later in life, with an analysis recently published in JAMA Network Open. This association was generated using data from a prospective birth cohort comprised of individuals from Israel born between 1933 and 1952, including nearly 110,000 participants (at a mean age of 57.7) that were followed from 2003 for just over 17 years. It’s important to make the distinction between adult ADHD and childhood ADHD, as relatively recent data suggests there is minimal overlap between the two diagnoses, i.e., the adult syndrome does not represent a continuation from a neurodevelopmental disorder that begins during childhood.

In this population, 13.2% of people classified with adult ADHD received an incident dementia diagnosis during the study period, compared to only 7% of people without ADHD, representing a statistically significant 3.62-fold greater risk (2.77-fold after multivariate adjustments). Multiple analyses were performed to examine possible confounding factors, including demographics, socioeconomic status, and a variety of health conditions (obesity, depression, mild cognitive impairment, etc.), yet the link between adult ADHD and dementia was not accounted for by any of these additional factors. However, there was no clear association among adults with ADHD who used psychostimulant medications (used by 22% in this study), suggesting a possible but unproven protective effect. The authors speculate that adult ADHD may reflect a diminished ability of the brain to compensate for degenerative processes, though there is some possibility (with mild evidence reported in this study) for reverse causation.

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