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A study of more than 187,000 U.S. adults aged 50 and older found that participants with ADHD were more likely to develop dementia or cognitive impairment than those without ADHD. The researchers also found an association with genetic risk for ADHD, but say the findings do not establish that ADHD causes dementia.
A study led by researchers at the University of Pittsburgh School of Medicine found that adults aged 50 and older with attention-deficit/hyperactivity disorder (ADHD) had a higher rate of later-life dementia or cognitive impairment than participants without ADHD. Published October 7 in JAMA Psychiatry, the analysis also found an association between higher genetic risk for ADHD and dementia, but it does not show that ADHD causes dementia.
The researchers analyzed health records and genetic data for more than 187,000 adults enrolled in the National Institutes of Health’s All of Us Research Program. Among participants with ADHD, 6.7% developed dementia or cognitive impairment, compared with 3.4% of those without a documented ADHD diagnosis. After adjusting for factors including age, sex and other health conditions, the team reported that participants with ADHD had more than four times the risk of developing cognitive impairment over time.
The study also examined participants’ genetic risk scores for ADHD, which reflect associations between common genetic variants and ADHD, whether or not someone had received a formal diagnosis. Participants in the highest-risk group had a 35% greater chance of developing dementia than those in the lowest-risk group. This is an association between genetic risk and outcomes in this study; it does not mean that an individual’s genetic score predicts whether they will develop dementia.
Among participants who developed cognitive impairment, those with a coexisting ADHD diagnosis reported worse mental health, lower quality of life and less social satisfaction than those with cognitive impairment alone. They also used about 20% more health care overall in the year after diagnosis, according to the report. These findings describe differences within the study group and do not establish why they occurred.
ADHD and Later-Life Cognitive Health
The findings add evidence that ADHD may be relevant to cognitive aging and dementia research, rather than being considered only in childhood or early adulthood. The combination of clinical records and genetic data offers researchers two ways to examine the observed relationship, and the genetic result may help guide studies into possible shared factors.
For readers, the results are not a reason to assume that having ADHD will lead to dementia. The study reports a higher rate among the ADHD group, not a certainty for any person, and it does not establish a cause or show that a particular intervention prevents cognitive decline. The quality-of-life and health-care findings also point to potential support needs for people managing both ADHD and cognitive impairment, though further work is needed to explain those differences.
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How Researchers Tested the Association
The study draws on the NIH’s All of Us Research Program, which provides health records and genetic information from a large U.S. participant group. Researchers compared later-life cognitive outcomes for people with and without recorded ADHD, then considered whether ADHD-related genetic risk showed a similar pattern. They adjusted the clinical analysis for several characteristics, including age, sex and other health conditions.
The researchers said the results build on earlier work from senior author Tharick A. Pascoal’s group, including a 2022 study linking ADHD genetic risk with Alzheimer’s-related brain changes in older adults without cognitive impairment. The new paper, by Guilherme Bauer-Negrini and colleagues, is published as “Attention-Deficit/Hyperactivity Disorder and Late-Life Cognitive Impairment” in JAMA Psychiatry. Prior research provides context, but does not by itself confirm the cause of the association reported here.
“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. Two different kinds of evidence are pointing in the same direction.”
— Tharick A. Pascoal, senior author and associate professor of psychiatry and neurology at the University of Pittsburgh
Cause and Prevention Remain Unknown
The study does not establish whether ADHD itself contributes to dementia risk, or whether other factors help explain the relationship. The researchers noted one possible complication: early, undetected dementia symptoms might sometimes be mistaken for ADHD before a cognitive diagnosis is made. The association remained statistically significant when the team required at least eight years between ADHD diagnosis and cognitive impairment, making that explanation less likely to account for the whole finding, but not resolving the question of causation.
The analysis also does not answer whether ADHD medication, including stimulants, changes later dementia risk. Nor does it show whether managing cardiovascular health—which the researchers say is linked to both ADHD and dementia—could reduce risk. The reported group differences should not be taken as an individual prognosis; further research is needed to clarify how the association applies across different people and circumstances.
Research Into Modifiable Factors
The study authors say further work is needed to investigate what may drive the association and whether any contributing factors can be changed. Questions include the potential relationship between ADHD treatment, cardiovascular health and cognitive outcomes. The source report does not give a timeline for those studies or describe a planned clinical trial.
For now, the published results add an observational finding for researchers to test in future work. They do not establish new prevention guidance or show that changing ADHD treatment alters dementia risk. The next step is to clarify the mechanisms behind the association and determine whether the patterns hold as evidence accumulates.
Key Questions
Does ADHD cause dementia?
The study does not prove that ADHD causes dementia. It found an association between ADHD and later-life dementia or cognitive impairment, but the reason for that relationship remains uncertain.
How many people were included in the study?
The researchers analyzed health records and genetic data from more than 187,000 adults aged 50 and older enrolled in the NIH’s All of Us Research Program.
What difference did researchers find between the groups?
6.7% of participants with ADHD developed dementia or cognitive impairment, compared with 3.4% of participants without ADHD. The adjusted analysis reported more than four times the risk over time for the ADHD group; this is a study-level finding, not an individual prediction.
Did ADHD medication affect dementia risk?
The study did not answer whether ADHD medicines, including stimulants, change later dementia risk. The researchers identified this as a question for future research.
What did the genetic analysis show?
Participants with the highest genetic risk scores for ADHD had a 35% greater chance of developing dementia than those with the lowest scores. The score reflects genetic associations and is not a diagnosis or a certain forecast for an individual.
Source: rss
