Is It ADHD or Dementia, Senior Adult?

Is Attention Deficit Hyperactivity Disorder in aging adults normal?  Or could it be something else entirely?  Older adults are sharing questions and concerns with their primary care physicians about memory loss, and difficulty completing tasks.  …

Is Attention Deficit Hyperactivity Disorder in aging adults normal?  Or could it be something else entirely?  Older adults are sharing questions and concerns with their primary care physicians about memory loss, and difficulty completing tasks.  There are so many different ways aging affects the brain. Sometimes it may just be a simple mild cognitive impairment to normal aging and dementia. However, there could be another reason, such as ADHD. Some seniors could have ADHD and never knew about it.  It could have slipped through the cracks as a child and been misdiagnosed. This is why older patients need a complete medical history work up, so their doctor can get a full broad picture of past medical problems that run in their family. But first, let’s discuss what ADHD in older adults may look like.

What ADHD Looks Like in Seniors

When someone pictures ADHD in Seniors, you may see a bunch of unfinished tasks, confusion, or bewilderment.  A person who does not understand what is going on or happening to them.  They might pace, overthink things, Start a task, stop, start another task, then stop and go back to the first task. They might never finish either task, or finish both simultaneously.  They could have a problem multitasking, or be really good at multitasking. It just depends on each person’s own symptoms. Research has shown that symptoms may start to be noticeable to others by the time the older adult is 60 years of age; however, sometimes earlier. 

The Symptoms of Adult ADHD

Seniors may also feel disorganized, not understanding which task to do first and what to do last. This can cause them to have an inability to focus, meaning they easily get distracted and confused. Seniors with ADHD may also become discouraged. Because of some of the above symptoms, seniors may also leave tasks unfinished.  Some symptoms are shared with other disorders, such as bi-polar and dementia, which could make getting the right diagnosis hard to pin down. This can lead to getting prescribed the wrong medication, which could lead to more problems in the future. Mood swings, poor time management, forgetfulness, or trouble sleeping are also common. Some older adults with ADHD may experience incoherent communication and trouble relaxing. 

Below are more common symptoms seniors with ADHD may experience: 

  • Brain going “blank” periodically
  • Difficulty maintaining order within their homes
  • Forgetting words or names
  • Interrupting others
  • Misplacing items
  • Difficulty learning new things
  • Talking too much, often without realizing it
  • Trouble following conversations
  • Difficulty maintaining relationships or keeping in touch with others
  • Struggles in keeping to a budget or making ends meet
  • Dealing with a lifetime of poor money management

ADHD in Older Women

ADHD affects both men and women in different ways; especially for women in their late 40s to early 50s who are approaching menopause. This time in their life it is called perimenopause, which could last approximately four to five years. For someone with ADHD, their symptoms may become more severe at this time. Estrogen levels will start to plunge, causing the reduction of egg producing and your periods less frequent. Low Estrogen levels can also affect Dopamine levels, which can lead to higher chances of mood swings, depression, and anxiety. Women may also find it hard to focus during this time as well. Women who have not had a period in 12 months are then in menopause. Sometimes menopausal women may experience cognitive declines, which is another symptom of ADHD in women. If you are experiencing any of these symptoms, contact your primary care provider for the right treatment and medication. Counseling is also recommended. 

Concerns of Adult ADHD within the medical community

ADHD is growing in numbers in those over 60 years of age and medical professionals are becoming aware of the problem. One reason for this developing disorder in seniors could be cognitive delays. However, many doctors seldom consider cognitive complaints of their older patients and do not always offer ADHD screenings. In fact, only one in five memory disorder clinics actively screen for ADHD in older adults. Some individuals who have ADHD all their life could develop dementia even earlier than those who just develop dementia without the signs of ADHD. 

Another concern is prescribing stimulants commonly used to treat ADHD in young people; it can cause cardiovascular conditions to occur or worsen for in older adults. Examples of ADHD stimulants are Adderall, Dexedrine and Ritalin. Some professionals suspect there is a link to chronic use of these stimulants can trigger chronic diseases such as dementia, or even Parkinson’s disease, which increases the chance of Adult ADHD. It is also believed that the longer a person takes stimulants, such as the ones mentioned above, the higher the chance of developing brain damage or brain failure when you are older in age. 

Other Things You Should Know about ADHD

For some, Attention-deficit hyperactivity disorder can affect the whole life of a person who has been diagnosed with it. It does usually show up in young children first, but as we can see, it can affect older adults as well, depending on their life habits, medications, or family history. Many doctors do not look at family history too often when it comes to ADHD; however, it can be a factor. Many symptoms of ADHD, such as inattention or incoherent thinking, may also look more like a stroke or dementia. Some adults may notice symptoms of their own after a family member becomes diagnosed with the disorder. 

Coexisting conditions

 If you have ADHD, then you could have other developmental challenges. ADHD does not cause these; however, they may occur because of the ADHD, making treatment more challenging. These may include mood disorders, depression, or bipolar disorder. Anxiety can also lead a person to be overwhelmed with worry, nervousness or other symptoms. Other psychiatric disorders, such as personality disorders, intermittent explosive disorder, and substance use disorders can occur. Learning disabilities may lead to lower academic scores on testing or lower intelligence and education expected for their age. Other learning disabilities may develop, including understanding and communication problems.

Additional help for those with ADHD 

For seniors that may have a family history of ADHD and are experiencing similar symptoms, it is a good idea to get a referral from your PCP. There are several strategies you can also do to manage symptoms at home. Here are some helpful tips to help manage ADHD.

  • Exercise regularly: Physical activity increases brain neurotransmitters, such as dopamine, norepinephrine, and serotonin, which are known to affect a person’s attention span.
  • Improve sleep: Seniors should set up a bedtime routine that best suits them. They should also avoid caffeine after noon and avoid electronic devices within an hour of bedtime.
  • Set reminders: Seniors can also use calendars, alarms, written notes, or creating lists to provide additional assistance to manage daily or weekly tasks. 
  • Ask family members for help: Getting support from loved ones may help in creating a structured daily plan and to achieve tasks throughout the day. 

ADHD Risk Factors

According to studies, there are a number of risk factors that may play a role in seniors who could develop ADHD. Such as blood relatives, with ADHD or other mental health disorders like parents or siblings. Also, smoking, drinking, or using drugs during a mothers pregnancy could have led inadvertently to mental health disorders. As a child, did you live in an older house or apartment building?  You could have been exposed to toxins — like lead, asbestos or mold. Lastly, premature birth can also lead to health problems like mental health disorders. 

Other risk possible risk factors include: 

  • Poor nutrition
  • Infections
  • Smoking
  • Drinking
  • Substance abuse

Managing ADHD symptoms

People with ADHD may have trouble with paying bills, keeping a work schedule, or dealing with social interactions between family and friends. However, there is hope. It is true that medication does help certain people that have ADHD, but prescription meds are not a cure all. There are other ways that adults with the disorder can still manage their lives and find help in getting through the day. Many older adults develop skills to help learn how to improve their lifestyle while living with ADHD. You may also learn to recognize your strengths or develop your own techniques on dealing with the disorder. Having a positive attitude about ADHD can also help an older adult manage their ADHD. Those who are struggling to manage their ADHD may also benefit from an ADHD Coach or mentor. 

Here are some more tips to help older adults manage their ADHD:

  • Get organized and control the clutter in your life: Set up a filing system, organize mail daily, and designate specific areas for things like keys, bills, and other items.
  • Work on time management to stay on schedule: Many ADHD seniors will lose track of time, miss deadlines, or procrastinate.  It is good to give yourself more time than you need when dealing with ADHD. Plan early and add reminders. Avoid getting sidetracked.
  • Work on money management, such as budgeting and planning: Set up autopay or a bill paying system. Use online banking for more convenience. Avoid impulse shopping. 
  • Stay focused and become productive throughout the day: Color-code your work space. Prioritize- decide what is important first, second, etc. Avoid distractions at work or home. 
  • Manage your stress levels: The best way to lower stress is by eating well, getting plenty of sleep, and exercising regularly. It can help seniors with ADHD to stay calm, while minimizing mood swings and also fight against symptoms of anxiety and depression.
  • Try meditation techniques: this will not only lower stress levels, but can also help a person resist distractions, improve their focus, and provide a way to control your emotions. 

Next Steps for Senior Patients and their Doctors

   Though the phenomenon of seniors developing Adult ADHD is new to doctors, they continuing to do research to determine the cause and treat the symptoms in each and every senior that presents itself. Many physicians may only receive 20 minutes (or less) of instruction on ADHD while in medical school; and most often the teachings are related to pediatric diagnosis and treatment instead. So misdiagnosing often occurs with older adults that shows signs of ADHD.  In some cases, there are doctors that never encountered adult ADHD. 

To all the seniors struggling with ADHD or other mental illnesses, follow the recommended treatments above consult with your primary care physician. Many seniors may also have Bipolar or dementia as well. Plus, there are many other conditions that occur because of symptoms of Adult ADHD. Each case can be debilitating to individuals, especially older adults over than fifty-five. Some might experience these at a younger age.  It just depends on certain factors, such as your family medical history. The moment an older adult starts to notice signs of ADHD, they should go see their PCP immediately. Seniors who develop ADHD or other mental conditions needs to be observed properly and make sure the medications they are on are safe. Those with severe ADHD may be eligible for certain health care benefits and programs. Depending on their age, seniors with ADHD may also qualify for in home care, hospice, or nursing assistance. 

The good news is that our world is adapting to the changes within the mental health communities and older adults with ADHD are finding resources and support much easier. Every case of adult ADHD will always be different. Some need assistance for life, while others can still work, even into their 80s. Some will face relationship challenges that continue throughout life. Research shows that there is a greater likelihood for ADHD individuals end up alone, due to a higher-than-average divorce rate among families affected by ADHD. The medical community is working on finding links between ADHD and cognitive declines, and becoming more aware of appropriate treatment practices for both. Medical professionals are also working to find better diagnostic tools to determine these affects on seniors. Research is always moving forward and those with ADHD can still live a fulfilling life.