ADHD in the Elderly
When I was interviewing Betty for my article, "The Many Faces of ADHD - ADHD at 85: Betty’s Profile", I did some research on ADHD and the elderly and was shocked when I found virtually nothing on the topic; just a few short informal articles.
As our population ages, so will those currently being treated for ADHD- our children, teens, and adults. What will happen once they reach their later years? And what about the folks right now, who are in their 70s, 80s and 90s, who continue to live with undiagnosed and untreated ADHD?
Surely, there must be many hundreds of thousands of seniors who have ADHD Like Betty, one would think they lived and continue to live with symptoms that cause tremendous problems that impact their daily lives. Now, with more living and working longer than ever before, these folks must be suffering in silence, ashamed of their struggles and living, like Betty, thinking they are less than capable. We know that there is a high incidence of depression in this population; could many also be challenged with an underlying ADHD as well? Hopefully, scientists, researchers and clinicians will begin to look more closely at this population and begin to identify and treat them.
There are special considerations one must take into account when evaluating and treating older adults. As one ages, cognitive functioning often declines. Clinicians will need better assessment tools to understand which symptoms would be attributed to ADHD vs other conditions seen in the geriatric population. For example, is the patient showing signs of memory loss and/or impairment of executive functioning? What is causing these problems? How long has it been a problem? How does one differentiate between ADHD and other cognitive problems often seen in aging?
In addition, as people age, they often have one or more medical problems that need to be treated with medications. Could those meds be causing side effects that mimic ADHD? And would those conditions and treatments make an underlying ADHD worse? Untreated thyroid disease, for example, can look very much like ADHD.
If an elderly person is lucky enough to be appropriately diagnosed with ADHD, how successful will treatment be? Typically, patients with a cardiac condition are not candidates for stimulant treatment and we know from research that stimulant medications appear to be the most helpful for treating ADHD. If stimulants are not appropriate, how do we treat them, medically? Sadly, the few older individuals with ADHD whom I’ve spoken with are not at all interested in taking ADHD medication. Perhaps they are set in their ways. Or maybe they worry about adding more medication to their regime.
Further, many continue to feel the stigma of “seeing a therapist” and refuse to consider counseling.
What You Can Do
If you’re an adult with ADHD or have a child with ADHD, remember that this is a condition that is highly genetic. Look at the elders in your family and see if there is ADHD in your family tree. If they might be open to talking about the possibility of having ADHD, start off with some casual discussions on how it’s impacted your or your child’s life and see if he/she “bites.” Explain how treatment has changed lives dramatically. Go slow, though.
Consider bringing your older relative to a CHADD meeting or an ADHD conference. If they like to read, purchase a book on ADHD. Driven to Distraction, by Drs. Edward Hallowell and John Ratey is a great choice. It is also available on tape.
If you’re a senior and are wondering whether your symptoms might be attributed to possible ADHD, seek out a specialist who works with adults and consider having an evaluation. Contact your primary care physician to first have a complete medical workup to rule out any medical conditions that can mimic ADHD. If you’re cleared of any, ask for a referral to psychiatrist, neurologist or other health or mental health professional that has a lot of experience evaluating adults with ADHD. If your doctor draws a blank, call your closest teaching hospital and ask for the department of psychiatry or psychology and ask for names.
You can also contact CHADD and ask the chapter coordinator in your area for names. You can also call them at 800-233-4050 to find the chapter closest to you.
In addition, you can find online directories of ADHD specialists:
Make sure you ask many questions, including how many adults with ADHD they evaluate and if they have experience working with the older population.
It’s never too lato improve your life!
Terry wrote for HealthCentral as a patient expert for ADHD.