ADHD Linked to Significantly Increased Dementia and Cognitive Decline Risk, Study Finds

A common neurodevelopmental disorder, attention deficit hyperactivity disorder (ADHD), may be associated with a substantially increased risk of dementia or mild cognitive impairment (MCI), according to a new study. The research, led by the University of Pittsburgh School of Medicine and involving more than 187,000 adults aged 50 and older, found that individuals with ADHD had a more than fourfold increased risk after adjusting for age, gender, and other health conditions.

The observational study analyzed electronic health records and genetic information from participants in the U.S. National Institutes of Health All of Us Research Program. Cognitive impairment was observed in 6.7% of participants with ADHD, compared to 3.4% of those without the disorder, nearly doubling the rate. Furthermore, individuals with the highest genetic susceptibility to ADHD showed a 35% greater risk of dementia compared to those with the lowest susceptibility.

Researchers acknowledged that the findings, published in JAMA Psychiatry, indicate an association and do not definitively prove that ADHD causes dementia. "This doesn’t prove that ADHD causes dementia, but seeing the same pattern show up independently in medical records and in people’s genes gives us greater confidence that the association is not simply an artifact of how ADHD gets diagnosed," stated senior author Tharick A. Pascoal, associate professor of psychiatry and neurology at Pitt. "Two different kinds of evidence are pointing in the same direction."

Experts note that some symptoms of ADHD can overlap with those of cognitive decline, making differentiation challenging. "It might [be] that keeping on top of health issues and getting to the doctor is more difficult for them," said Dr. Elizabeth Landsverk, a geriatric medicine and dementia expert not involved in the study. She suggested that difficulties with organization, common in ADHD, could contribute to a higher risk of cognitive impairment, alongside potential neurological differences. The study also indicated that people with ADHD utilized health resources 20% more frequently, which could reflect a correlation with managing health conditions.

Landsverk advised that persistent problems with memory, focus, organization, or managing daily tasks, such as paying bills or taking medications correctly, warrant professional evaluation. Changes in judgment, mood, or social behavior might be more indicative of dementia than ADHD.

While the study highlights a potential link, Landsverk emphasized that individuals can take steps to reduce their overall dementia risk. These include maintaining a healthy weight, avoiding smoking and excessive alcohol consumption, staying physically active, and managing blood pressure, cholesterol, and diabetes. A largely plant-based diet and at least 30 minutes of daily exercise can also contribute to better cognitive aging and improved mood and focus.