Attention Deficit Hyperactivity Disorder (ADHD) in Elderly Adults

While typically associated with children, attention deficit hyperactivity disorder (ADHD) is prevalent in the elderly. ADHD in seniors is often misdiagnosed or even overlooked as a possible condition for several reasons. In this post, we review what you need to know about ADHD in the elderly, including ADHD symptoms in seniors, diagnosing ADHD in older adults, and treating ADHD in older people.

Symptoms of ADHD in Older Adults

Hyperactivity does not diminish as we age. In fact, ADHD symptoms may flare or grow more pronounced after midlife. ADHD symptoms in seniors include:

• Poor time management
• Difficulty planning and/or completing tasks
• Disorganization
• Excessive fidgeting
• Forgetfulness
• Impatience
• Impulsivity
• Inability to sit quietly for long
• Restlessness
• Talking too much or overtalking others
• Trouble relaxing

It is important to note that ADHD may manifest differently in older adults assigned female at birth. In perimenopause—the initial onset of menopause—ADHD symptoms can become more severe. As the body stops producing estrogen, it can affect dopamine levels, which impact memory, movement, motivation, mood, attention, and more. Already present mood swings, anxiety, depression, and/or an inability to focus can become more exacerbated during this phase of life.

Diagnosing ADHD in Seniors

ADHD in aging is complicated. There is little research on how ADHD affects older adults and there is no standardized diagnostic test for older populations. If an aging adult was not diagnosed with the condition as a child, it is unlikely they will be diagnosed as an older adult. Additionally, older adults with undiagnosed symptoms of ADHD may have developed coping strategies to mask symptoms of hyperactivity or inattentiveness over the years.

Clinicians may misdiagnose ADHD as mild cognitive impairment or dementia. However, there is no scientific evidence of a connection between dementia and ADHD. If you are concerned that you or a senior loved one may have ADHD, it is best to consult a doctor who specializes in ADHD identification, diagnosis, and treatment.

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Treatment of ADHD in the Elderly

Medication is often the first line of defense to treat ADHD in the elderly. ADHD medications often contain stimulants that boost neurotransmitters that help improve focus. As with all medications, there are potentially harmful side effects; stimulants can increase the risk of cardiac problems. In these instances, a provider may provide nonstimulant medications that are effective but do not take effect as quickly as stimulant-based treatments.

Unlike children, older adults are typically on multiple medications, introducing the possibility of negative drug interactions that can cause other, and potentially much more serious, problems. As well, our ability to tolerate medications can change, so it is important to work closely with your doctor to ensure a medication-based treatment is both effective and safe.

There are several treatment strategies that do not require medication. Your doctor may recommend education, time management or organization training, psychological counseling, or a combination of these. While counseling itself may not “cure” ADHD, a good counselor can provide helpful tools for impulse and anger management, time management, relationship-building, and better self-esteem.

Although diagnosing ADHD in the elderly can be challenging, a range of treatment methods exist that make it easier to successfully live with and manage ADHD.