Aging and ADHD

ADHD isn't just for kids. Here's what it's like later in life.


ADHD doesn't just affect kids or young adults. If you're an older adult who often feels distracted and disorganized and struggles to complete tasks, it may be worth finding out if you've been living with undiagnosed ADHD.

"I have patients in their 50s, 60s, and early 70s who were never diagnosed before and were prompted to consider ADHD after their child or grandchild got diagnosed. It's highly genetic," says David W. Goodman, MD, assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine and director of the Adult Attention Deficit Disorder Center of Maryland in Lutherville, Md.

Your doctor will need to take a careful history to find out whether you have ADHD or if your symptoms might be due, for example, to another medical condition.

But if you receive the correct diagnosis and pursue therapy for ADHD, you can manage your symptoms better at any age. "Effective treatment will significantly improve your daily functioning and productivity, which enhances your quality of life," Goodman tells WebMD.

Here's what you need to know about seeking treatment for ADHD later in life.

Is It ADHD, Aging, or Something Else?

Certain medical problems, drug side effects, and even changes related to aging can mimic the symptoms of ADHD.

Some women feel distracted or forgetful, for instance, during perimenopause or menopause. If menopause-related hormonal changes are the cause of those symptoms, they tend to improve over time.

People with a history of stroke or with hyperthyroidism due to Graves' disease or another condition, or who are taking thyroid medication, may also have trouble paying attention.

And a number of medications -- such as some of those used to treat high blood pressure, pain, or sleep problems -- may cause side effects like memory and concentration problems.

Though forgetfulness is a potential symptom of ADHD, it can also be a normal part of the aging process -- or a sign of a more serious disorder like mild cognitive impairment or dementia. If your memory problems started occurring relatively recently -- for instance, within the last couple of years -- then they're less likely to be due to ADHD.

In fact, ADHD always begins in childhood. So if you have ADHD as an older adult, "the symptoms would have been life-long and persistent over the course of your life," Goodman says. In addition to forgetfulness, those symptoms can include being easily distracted, disorganized, fidgety, restless, impulsive, and having trouble focusing, prioritizing, and completing tasks.

 

When to See a Doctor

"Talk with your primary care doctor if you suspect you may have ADHD and the symptoms are affecting your quality of life," says Paul Y. Takahashi, MD, a geriatrician and associate professor of medicine at Mayo Clinic College of Medicine in Rochester, Minn. Your primary care doctor may be able to evaluate you for ADHD or may refer you to a psychologist or psychiatrist for additional testing.

As part of your evaluation, you'll be asked questions about your symptoms, whether they started in childhood, and how they're impacting your current life. Your doctor will investigate whether your symptoms could be due to something other than ADHD. He or she may do neuropsychological tests and a CT scan or MRI to check for signs of cognitive decline, says Lenard Adler, MD, professor of psychiatry and child and adolescent psychiatry and director of the Adult ADHD program at the New York University School of Medicine.

If possible, ask your spouse, adult child, or even your parent (if they're able) to go with you to your evaluation. "It's important to have someone who can help provide additional observations about the symptoms and impairments that have occurred over a long period of time," Goodman says.

 

Considering Treatments

Once you've been diagnosed with ADHD, your doctor may recommend medication, psychotherapy, or a combination of both. Medications such as Adderall XR, Concerta, Focalin XR, Strattera, and Vyvanse are commonly used to treat ADHD in adults. Side effects of these drugs can include insomnia, jitteriness, decreased appetite, and weight loss. In addition, these medications can cause your heart rate and blood pressure to go up slightly.

Takahashi suggests weighing the potential benefits and risks of medication with your doctor. "The side effects from ADHD medications can be worse for older adults if they already have, for example, high blood pressure, heart disease, or problems with sleeping," he says. Also, be sure to let your doctor know if you are taking medications for other conditions, as they could interact with ADHD drugs.

A number of different types of psychotherapy are useful for treating ADHD in adults. Adler says cognitive behavioral therapy, for example, can be quite helpful when used alone or in conjunction with medication. This type of therapy focuses on changing negative thought patterns, solving problems, and developing skills to handle challenges.

 

Living Better With ADHD

In addition to exploring treatment options with a doctor, the following strategies can help older adults with ADHD manage their daily lives better:

•     Keep a daily schedule: Write out a schedule each day with tasks and appointments allocated to specific times and follow through with it. Also, break big tasks or goals into smaller steps. "People with ADHD tend to get more easily overwhelmed and to avoid things that require sustained mental effort," Goodman says. "But if you break a task down and get it done over the course of several days, it's easier."

•     Put technology to work for you: Use the alarm on your cell phone or watch, for example, to help you remember deadlines and appointments.

•     Automate tasks so you have fewer things to remember: Goodman suggests signing up, for example, for automatic prescription refills or setting up automatic bill payments so you don't have to keep track of when bills are due or risk running up late fees.

•     Reach out for support: "I strongly encourage people to share their diagnosis of ADHD with their friends and family if they feel comfortable," Takahashi says. "We all need support to keep us moving forward."

 

 

Jen Uscher - WebMD