Adults With ADHD Face Higher Risk Of Developing Dementia Later In Life

TL;DR

For listenersOffer from Amazon

Turn quiet afternoons into listening time

• Thousands of audiobooks, podcasts and originals
• Listen on your phone, tablet or Echo — also offline
• Cancel anytime

Try Audible free →Free trial for new members

As an affiliate, we earn on qualifying purchases.Hide

A study in JAMA Psychiatry found that adults with ADHD were more likely to develop dementia or other cognitive impairment than adults without ADHD in a U.S. cohort of more than 187,000 people aged 50 and older. Genetic risk for ADHD was also associated with dementia, but the researchers said the findings do not establish that ADHD causes cognitive decline.

A study led by researchers at the University of Pittsburgh School of Medicine found that adults with attention-deficit/hyperactivity disorder were more likely to develop dementia or mild cognitive impairment later in life than adults without ADHD. The analysis covered more than 187,000 adults aged 50 and older; its results show an association, not proof that ADHD causes dementia.

Using health records and genetic information from participants in the National Institutes of Health’s All of Us Research Program, researchers found that 6.7% of participants with ADHD developed dementia or cognitive impairment, compared with 3.4% of those without a recorded ADHD diagnosis. After adjusting for factors including age, sex and other health conditions, the team reported that participants with ADHD had more than four times the risk of developing cognitive impairment over time.

The researchers also examined genetic risk scores, which estimate how strongly a person’s common genetic variants are associated with ADHD. Participants in the highest-risk group had a 35% greater chance of dementia than those in the lowest-risk group. This genetic analysis included people regardless of whether they had received a formal ADHD diagnosis; it does not establish that genetic risk itself causes dementia.

Among participants who developed cognitive impairment, those with a co-occurring ADHD diagnosis reported worse mental health, lower quality of life and less social satisfaction than those with cognitive impairment alone. They also used about 20% more health care in the year after diagnosis, according to the study. The findings were published October 7 in JAMA Psychiatry.

ADHD May Shape Cognitive Aging

The results matter because they connect a condition often diagnosed earlier in life with later cognitive health, and suggest that the association may be relevant beyond people with a documented ADHD diagnosis. The study’s combination of medical records and genetic data provides two lines of evidence pointing in a similar direction, although neither can establish cause and effect.

The findings also point to a heavier burden among people living with both ADHD and cognitive impairment: the study reports poorer self-reported well-being and higher health care use after diagnosis. Researchers said the work supports closer study of ADHD in cognitive aging, but it does not show that treating ADHD prevents dementia or that an individual with ADHD will develop it.

Records and Genes in One Study

The research builds on earlier work from senior author Tharick A. Pascoal’s team. A 2022 study linked genetic risk for ADHD with Alzheimer’s-related brain changes in older adults who had no apparent cognitive impairment. The new report examines diagnosed ADHD and genetic risk within the same large population, extending that line of research to clinical outcomes recorded over time.

The authors also considered whether early signs of dementia might sometimes be mistaken for ADHD before a cognitive diagnosis is made. They reported that the association remained statistically significant when they required at least eight years between an ADHD diagnosis and cognitive impairment. That timing makes diagnostic confusion less likely to explain the entire association, but does not rule out other explanations.

The study, “Attention-Deficit/Hyperactivity Disorder and Late-Life Cognitive Impairment,” appeared in JAMA Psychiatry. Its authors include researchers affiliated with the University of Pittsburgh and UPMC. The analysis draws on the All of Us program’s health records and genetic data rather than a trial designed to test whether ADHD causes dementia.

“Two different kinds of evidence are pointing in the same direction.”

— Tharick A. Pascoal, M.D., Ph.D., senior author and associate professor of psychiatry and neurology at the University of Pittsburgh

Cause and Treatment Remain Unknown

The study does not determine whether ADHD contributes to dementia, whether shared biological or health factors account for both, or whether other influences explain some of the association. Although the eight-year analysis makes it less likely that early dementia symptoms mistaken for ADHD account for the full result, it cannot eliminate that possibility.

The researchers said it remains unknown whether ADHD medicines, including stimulants, change dementia risk over time. They also raised cardiovascular health as a possible factor because it is linked to both ADHD and dementia, but the study did not test whether managing cardiovascular risks reduces cognitive impairment. The reported percentages and adjusted risk estimate describe this study population and should not be treated as an individual prediction.

Research Must Test Possible Drivers

The authors say further research is needed to identify what may be driving the association and whether any contributing factors can be changed. Future studies could examine ADHD medication exposure, cardiovascular health and other possible pathways over longer periods, while separating the effects of diagnosis, genetics and shared health risks.

For now, the findings add evidence for studying ADHD in relation to cognitive aging, but they do not establish a prevention strategy or change the study’s central limitation: it identifies associations in health records and genetic data rather than testing cause or treatment. The researchers have not reported a follow-up trial or a confirmed next milestone.

Key Questions

Does ADHD cause dementia?

No. The study found an association between ADHD and later cognitive impairment, but it does not prove that ADHD causes dementia.

How large was the study?

The researchers analyzed health records and genetic data from more than 187,000 adults aged 50 and older in the NIH All of Us Research Program.

What difference did researchers find?

Dementia or cognitive impairment was recorded in 6.7% of participants with ADHD and 3.4% of those without ADHD. After adjustment for several factors, the researchers reported more than four times the risk of cognitive impairment over time for participants with ADHD. These are study findings, not a forecast for any one person.

Did ADHD medication lower dementia risk?

The study did not answer that question. The researchers said whether ADHD medicines affect dementia risk over time remains unknown.

Does a high genetic risk score mean someone will develop dementia?

No. Participants with the highest ADHD genetic risk scores had a 35% greater chance of dementia than those with the lowest scores in this study. That group comparison does not show that a high score guarantees dementia or provide an individual diagnosis.

Source: rss