Attention-Deficit/Hyperactivity Disorder in Childhood Is Associated with Cognitive Test Profiles in the Geriatric Population but Not with Mild Cognitive Impairment or Alzheimer's Disease
The frequency of ADHD in the aging population and its relationship to late-life cognitive decline has not been studied previously. To address this gap in our understanding, the Wender-Utah ADHD Rating scale (WURS) was administered to 310 geriatric subjects with cognitive status ranging from normal cognition to mild cognitive impairment to overt dementia. The frequency of WURS-positive ADHD in this sample was 4.4%. WURS scores were not related to cognitive diagnoses, but did show nonlinear associations with tasks requiring sustained attention. The frequency of ADHD appears stable across generations and does not appear to be associated with MCI or dementia diagnoses. The association of attentional processing deficits and WURS scores in geriatric subjects could suggest that such traits remain stable throughout life. Caution should be considered when interpreting cognitive test profiles in the aging population that exhibit signs and symptoms of ADHD, as attentional deficits may not necessarily imply the existence of an underlying neurodegenerative disease state. 1. Introduction Attention-deficit hyperactivity disorder (ADHD) is a common learning disability in children [1–7]. Symptoms of ADHD include inattention, hyperactivity, and impulsivity [2, 5]. About 1–9.5% of children are estimated to suffer from ADHD [1–3, 5, 8, 9]. Previous studies have suggested that ADHD is increasing in the United States [2, 9]. Factors including increased television and video game use and a diet defined by excessive sugar, high-fructose corn syrup, and preservatives have all been implicated as possible mechanisms leading to ADHD [4, 10–12]. Genetic predisposition to ADHD has also been suggested by several groups and could play a role beyond that of environmental factors in the development of ADHD [13–18]. The long-term consequences of ADHD in the geriatric population and the possible association of ADHD with cognitive decline in older adults are unknown. ADHD persisting into adulthood has been well documented [6, 8, 19–27]. It is possible that early learning disabilities could influence later life cognitive function and be associated with late-life neurocognitive disorders such as Alzheimer’s disease [28]. In fact, individuals with a history of ADHD have a higher prevalence of comorbid psychiatric disorders such as antisocial disorders, mood and anxiety disorders, and substance abuse disorders when they reach adulthood [20, 25]. Such comorbidity could contribute to cognitive dysfunction in older adults meeting diagnostic criteria for mild cognitive impairment (MCI), Alzheimer’s
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