Clinical Presentation, Diagnosis and Treatment of Attention-Deficit Hyperactivity Disorder (ADHD) in Older Adults: A Review of the Evidence and its Implications for Clinical Care

David W Goodman; Sara Mitchell; Lauren Rhodewalt; Craig B H Surman

doi:10.1007/s40266-015-0327-0

Clinical Presentation, Diagnosis and Treatment of Attention-Deficit Hyperactivity Disorder (ADHD) in Older Adults: A Review of the Evidence and its Implications for Clinical Care

Drugs Aging. 2016 Jan;33(1):27-36. doi: 10.1007/s40266-015-0327-0.

Authors

David W Goodman^{1

2

3}, Sara Mitchell⁴, Lauren Rhodewalt⁵, Craig B H Surman^{5

6}

Affiliations

¹ Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, USA. dgoodma4@jhmi.edu.
² Adult Attention Deficit Disorder Center of Maryland, Lutherville, USA. dgoodma4@jhmi.edu.
³ Suburban Psychiatric Associates, LLC Johns Hopkins at Green Spring Stations, 10751 Falls Rd, Suite 306, Baltimore, MD, 21093, USA. dgoodma4@jhmi.edu.
⁴ Department of Neurology, Massachusetts General Hospital, 15 Parkman Street, WAC 815, Boston, MA, 02114, USA.
⁵ Clinical and Research Program in ADHD and Related Disorders, Massachusetts General Hospital, 55 Fruit Street, Warren 631, Boston, MA, 02114, USA.
⁶ Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.

PMID: 26659731
DOI: 10.1007/s40266-015-0327-0

Abstract

Although previously considered a disorder of childhood, studies in the last decade have demonstrated that attention-deficit hyperactivity disorder (ADHD) continues to impair function into adulthood and responds to pharmacotherapy. Due to age-specific changes in roles and challenges, it is possible that presentation and response to intervention may differ between older and younger adults. A literature search for papers that identified older adults with ADHD, including papers describing its epidemiology, manifestation, and treatment, was the basis for this paper. There is a paucity of data on ADHD in older adults; however, small observational studies have characterized the presence, impact, and treatment of ADHD in adults over the age of 50 years, and larger epidemiologic studies have demonstrated that ADHD symptoms exist in older adulthood. Optimal criteria for diagnosis of ADHD and methods of treating ADHD in older individuals have not been systematically explored. In light of the limited data, this review discusses considerations for differential diagnosis and safe pharmacotherapy of ADHD in older adults.

Publication types

Review

MeSH terms

Adult
Attention Deficit Disorder with Hyperactivity / diagnosis
Attention Deficit Disorder with Hyperactivity / drug therapy*
Diagnosis, Differential
Humans