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ADHD in Older Adults

Reviewed by Neha Pathak, MD on March 22, 2021

Attention deficit hyperactivity disorder isn’t just for kids. It’s true that ADHD mostly affects children, and 4.4% of adults under the age of 44 have it, too. But some older adults -- those who are already retired or close to it -- likely deal with ADHD as well. Unfortunately, there’s not much research on how this mental disorder affects adults who are well past middle age.

Experts believe there might be several reasons behind this. For one, it’s hard to diagnose older adults with ADHD. There’s no standardized screening for it. If you didn’t get a diagnosis when you were young, you’re not likely to get one as an adult. Plus, seniors with undiagnosed ADHD symptoms may have developed coping strategies over many decades. This may mask commonly known symptoms like “hyperactivity” or “inattentiveness.”

Things You Should Know

ADHD is a lifespan disorder that can affect your overall quality of life. At least two-thirds of people diagnosed with ADHD at a young age continue to have symptoms into adulthood. But doctors don’t learn to look for ADHD in people over 60. They’re more likely to look for other causes of inattention and fuzzy thinking, like dementia or stroke.

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ADHD is also hereditary. You’re nine times more likely to get it if a close relative has it. Many older adults first notice their own ADHD symptoms only when a family member, like a child or grandchild, gets a diagnosis.

But if you have ADHD, your symptoms won’t fade much as you age. In fact, one study says it might get worse if you have:

  • Normal age-related changes in brain health
  • Bad physical health
  • Lost your day-to-day structure after retirement

As you grow older with ADHD, how you express your symptoms may change. Your symptoms can include:

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

ADHD in Older Women

ADHD affects older women differently. This is especially true for women in their late 40s or early 50s in the years leading up to menopause. This time, called perimenopause, may take around 4 years. Your ADHD symptoms may become severe over these years.

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During this time, your estrogen levels dip steadily until you stop producing eggs and your periods become infrequent. Menopause happens when you’ve not had a period for 12 months.

When estrogen, a hormone responsible for reproduction, drops in your body, it also affects your dopamine levels. Dopamine is a brain chemical that’s already low in those with ADHD. This can lead to a spike in mood swings, feelings of depression and anxiety, and inability to focus for very long.

If you’re going through perimenopause or menopause and notice severe ADHD symptoms, tell your doctor about it.

Treatment Options

Medications are the first line of treatment for older adults with ADHD.

Doctors most often prescribe stimulants for ADHD. These boost brain chemicals called neurotransmitters to improve focus. For people who can’t take stimulants or don’t benefit from them, doctors try other nonstimulant medicines. These may bring benefits but don’t work as quickly.

You might have to try different drugs and doses to find the one that suits your best. As you age, your ability to tolerate drugs safely may change. New drugs could also interact with any medications you already take to treat other conditions.

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Experts say there needs to be more research on the long-term effects of ADHD medicine in older adults. In the meantime, if you notice any side effects, tell your doctor about them as soon as possible. If it’s a medical emergency, call 911 or seek medical attention right away.

Your doctor may also suggest a combination of nondrug strategies, such as:

  • Education about your condition
  • Skills training, for example, in organization and time management
  • Psychological counseling

Psychological counseling can be especially useful. It can give you the tools to cope with your ADHD symptoms better. It may help you:

  • Feel better about yourself
  • Improve your relationships with family and friends.
  • Control your temper
  • Control your impulses
  • Manage your time
  • Get organized

These treatments can’t cure ADHD, but they can help you manage your symptoms and improve your quality of life.

What Can You Do?

For an accurate ADHD diagnosis, you need to see a doctor. You can start with your primary care doctor or a therapist.

If you think you have ADHD symptoms, it’s never too late to get a diagnosis and treatment. Try to find a specialist who is familiar with ADHD, especially in older adults.

WebMD Medical Reference

Sources

SOURCES:

CHADD: “Changing Estrogen Levels Affect Women’s ADHD Symptoms—Part Three,” “It’s Not A “Senior Moment”—It’s ADHD,” “Managing Medication.”

Mayo Clinic: “Adult attention-deficit/hyperactivity disorder (ADHD).”

AJMC: “5 Things About ADHD in Older Adults You May Not Know.”

Medlineplus.gov: “Attention-deficit/hyperactivity disorder.”

Dove Medical Press: “Optimal management of ADHD in older adults.”

Adhdcoaches.org: “ADHD in Older Adults: Really?”

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