We all know the red flags: misplacing house keys, searching for words, and difficulty processing thought. These are some of the signs of age-related cognitive decline and/or Alzheimer's disease, and the process is hard to witness, especially among our loved ones.
Such was the case with one elderly woman, whose daughter urged her to see someone about the problems, as explained in a recent article in the New York Times. But the symptoms didn't point to cognitive decline. Instead, Dr. David Goodman, an assistant professor in the psychiatry and behavioral sciences department at Johns Hopkins School of Medicine, offered another explanation: Attention-deficit/hyperactivity disorder, or A.D.H.D.
Once thought of as a disorder that affects only children and young adults, A.D.H.D does not fade nor disappear in adulthood, and it's very much a topic worthy of discussion. In 2012, a large, one-of-its-kind study in the Netherlands found the estimated prevalence rate of fully diagnosed A.D.H.D. in older adults was 2.8%; for less evident but symptomatic A.D.H.D. the rate was 4.2%. Younger elderly adults (60 70 years) reported significantly more A.D.H.D. symptoms than older elderly adults (71 94 years). Still, the signs and symptoms in elderly adults very closely mimic those of cognitive decline, dementia and Alzheimer's disease, making A.D.H.D. difficult to identify and diagnose.
And where does one start? Currently, there aren't any diagnostic tests for the disorder; there are only clinical assessments that can determine the diagnosis. Thus it can be easily overlooked or misdiagnosed in elderly adults, despite years of attention difficulties. Moreover, age-related cognitive decline and A.D.H.D. can work together, making it even more difficult to distinguish and treat.
If diagnosed, A.D.H.D. in elderly patients can be treated with the same drugs given to children, like Adderall or Ritalin, but both medications carry some increased health risks in older adults. If the patient has a history of high blood pressure or cardiovascular issues, a doctor must first control those before a stimulant can be added to the medication list. Still, experts urge that chalking it up to age isn't the answer, and getting an accurate diagnosis and treatment is worth it, especially in elderly adults who may have been living with the disorder since childhood.