A new study led by the University of Pittsburgh School of Medicine has found that attention deficit hyperactivity disorder is associated with a more than fourfold increased risk of dementia or mild cognitive impairment in adults aged 50 and older. The research, which analyzed electronic health records and genetic data from over 187,000 participants in the U.S. National Institutes of Health All of Us Research Program, highlights a significant link between the neurodevelopmental disorder and cognitive decline later in life.
The observational study revealed that cognitive impairment was present in 6.7% of participants with ADHD, compared to 3.4% of those without the disorder. After adjusting for variables such as age, gender, and other health conditions, the risk for individuals with ADHD rose to more than four times that of their peers. The findings were published on Oct. 7 in JAMA Psychiatry.
Senior author Tharick A. Pascoal, an associate professor of psychiatry and neurology at the University of Pittsburgh, noted that the study demonstrates an association rather than a causal relationship. Pascoal stated in a press release that observing the same pattern in both medical records and genetic data provides greater confidence that the link is not merely an artifact of how ADHD is diagnosed. "Two different kinds of evidence are pointing in the same direction," Pascoal said.
Genetic analysis further supported these findings. Participants with the highest genetic susceptibility to ADHD exhibited a 35% greater risk of dementia than those with the lowest susceptibility. Guilherme Bauer-Negrini, a co-first author and postdoctoral associate in biomedical data science at Pitt, explained that combining genetic information with long-term health records allows researchers to identify patterns that might otherwise remain invisible. Bauer-Negrini suggested this approach could help investigate what drives the association and whether specific factors can be modified to support healthier cognitive aging.
Dr. Elizabeth Landsverk, a geriatric medicine and dementia expert who is not involved in the study, offered context on how ADHD might influence cognitive outcomes. She noted that individuals with ADHD often face challenges with organization, which can make managing health issues more difficult. Landsverk pointed out that people with ADHD had a 20% higher incidence of utilizing health resources, suggesting that difficulties with focus and task completion may lead to missed appointments or unmanaged conditions like high blood pressure. "It goes back to nature versus nurture," Landsverk said, emphasizing that these challenges become more pronounced as individuals age past 50.
Distinguishing between ADHD symptoms and early cognitive decline can be challenging due to overlapping signs such as forgetfulness or disorganization. Landsverk advised that persistent struggles with day-to-day tasks, such as paying bills or managing medications, warrant professional evaluation. However, she emphasized that modifiable lifestyle factors remain critical in reducing overall dementia risk. These include maintaining a healthy weight, avoiding smoking and excessive alcohol consumption, staying physically active, and controlling blood pressure, cholesterol, and diabetes.