Struggling with attention and organization as you age? It could be ADHD, not dementia

As we get older, occasional forgetfulness may become more worrisome. Is this the start of dementia, or are we just stressed? Has the loss of structure due to retirement led to this change? Or could we be suffering from another illness, maybe the same illness as our son or granddaughter, who also struggle with attention and organization?

What are the symptoms of ADHD in older adults?

Although the diagnosis of ADHD (attention deficit hyperactivity disorder) is often associated with school-age children, this condition may persist throughout adulthood and into old age. Older adults with ADHD struggle with attention, memory, and planning. They may struggle with finishing projects or remembering information consistently, and they may become distracted during conversations and experience difficulty maintaining relationships. When older adults lose the structure of employment, they may experience an exacerbation of symptoms, similar to when young adults with ADHD lose the structure of school. During retirement older adults may start to re-experience challenges with time-management and procrastination, which may result in feelings of anxiety or guilt.

Is it normal aging or ADHD?

When people share concerns with their doctor about their memory, attention, or difficulty completing tasks, they may receive a diagnosis of mild cognitive impairment (MCI), a stage between normal aging and dementia. However, older adults with ADHD may never have received a diagnosis of ADHD, especially if they had learned skills to compensate during their lifetime. To help doctors differentiate between mild cognitive impairment and ADHD in old age, the timing of symptoms and family history can provide good clues (after ruling out potential medical causes, such as thyroid or seizure disorders).

ADHD is one of the most heritable disorders in medicine, so having children, grandchildren, or siblings with this diagnosis should increase a doctor’s suspicion that their patient’s symptoms may be the result of ADHD. Understanding a patient’s timeline of symptoms is also crucial, as symptoms must have occurred in childhood to make the diagnosis of ADHD. Screening tools in adults may also be useful, such as the ADHD Self-Report Scale, although a positive screen doesn’t always mean you have ADHD.

What are effective treatments for ADHD in older adults?

The most effective medications for the treatment of ADHD in older adults are stimulant medications such as methylphenidate or dextroamphetamine. These medications provide significant benefit to older adults, as well as children and younger adults. However, in older adults doctors must also consider the cardiac risks of these medications, including increased blood pressure and heart rate, as well as a potential increase in the risk of an irregular heartbeat, particularly in people with known heart blockage.

Nonmedication options are also valuable to help a person create structure and learn organization tools, such as use of a daily planner, alarms, and lists. Therapists or coaches can help older adults with ADHD through the use of behavioral therapies, which may lead to improved time and money management, increased productivity, reduced anxiety, and higher life satisfaction.

What can you do in addition to getting medical treatment?

If you suspect your symptoms may be the result of ADHD, especially if a close family member has received this diagnosis, do not hesitate to ask your primary care physician for a referral to a specialist with expertise in the diagnosis and management of ADHD in older adults. In addition, the following strategies can be useful in managing symptoms at home.

Exercise regularly. Physical activity increases brain neurotransmitters, such as dopamine, norepinephrine, and serotonin, which can affect attention.

Improve sleep. Set up a bedtime routine, avoid caffeine after noon, and try to avoid electronic devices within an hour of bedtime.

Enlist the help of others. Family members and other supports may help with creating structure and simplifying tasks.

Set reminders. Calendars, alarms, written notes, and lists can provide additional assistance in remembering tasks.

Related Information: Confronting Adult ADHD

Comments:

  1. Rose-Marie williams

    I have this condition as do both my grandsons. Daughter seems to have grown out of the symptoms she once had except for dyslexia. I think both my brother’s and my sister’s grandsons have it along with 1 of my nephews. I have not found a pill that helps me

  2. William Rasmussen

    I find it so difficult knowing that I am having mental faculty problems. I tried getting help through cognitive therapy. Unfortunately the mental health facilities that I was going to wasn’t much help, which exacerbated my insecurities. I realize that it could have been all of my interpretation, however I felt that my therapists were not reaching me. I used to take great care of my finances. Now I don’t balance my checkbook nor do I reconcile my credit card statements any longer. I keep saying I’m going to do it but I no longer do. I keep my house somewhat neat but my cleaning is less and less frequent. Being alone doesn’t help. Most of the time I feel stuck and I keep digging a deeper hole. I try crawling out of the hole but unfortunately the sides are too high I can’t grasp onto anything. When I do get a foothold it collapses and I slide back down to the bottom.

  3. Lonette

    Thank You,
    This makes a lot of sense to me. I had what they called back then
    an issue with paying attention or ADD.
    While in class I was very easily distracted and exhausting to my teachers.
    This continued and I compensated all of my adult life for it.
    It never occurred to me until reading this blog, this is probably what is still going on.
    I will speak with my primary physician about this..
    Again, thank you!

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