499- ADHD in Older Adults: Clinical Guidance and Implications
Apr 23, 2024
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David W. Goodman discusses ADHD in older adults, highlighting the possible link to dementia. He explores the complexities of diagnosing and treating ADHD in adults over 50, emphasizing the importance of recognizing comorbidities and ensuring safe treatment options. The podcast also addresses challenges in diagnosing ADHD in older adults and managing symptoms with medication, including insights on perimenopause in older women.
ADHD in older adults is often overlooked, despite common occurrence and distinct symptoms that manifest differently, posing challenges in diagnosis.
Evaluation for ADHD in older adults requires assessing coexisting medical conditions like depression and cognitive decline for accurate diagnosis and treatment.
Medication treatment for ADHD in older adults should consider individual responses, side effects, and cardiac conditions, with stimulants and non-stimulants showing efficacy in improving cognitive function and emotional regulation.
Deep dives
Diagnosis and Treatment Challenges in Older Adults with ADHD
Diagnosing and treating ADHD in older adults poses challenges as current US Clinical Guidelines do not address evaluating, diagnosing, and treating adults, especially those over 50. Individuals often face barriers as providers rarely evaluate older adults for ADHD despite reporting cognitive concerns like memory problems and mood changes.
Prevalence and Presentation of ADHD in Older Adults
Recent research shows that ADHD is prevalent in older adults, with a rate of about 3% in the United States. Symptoms often manifest differently in adults over 50, where impairments may not show up until later in life, leading to challenges in diagnosis. Despite its common occurrence, the disorder is often overlooked, with memory clinics failing to consider ADHD symptoms in those complaining of cognitive difficulties.
Evaluation and Diagnosis of ADHD Symptoms in Older Adults
Evaluating older adults for ADHD involves considering various medical conditions that can contribute to cognitive difficulties, such as depression, age-related cognitive decline, and menopause-related cognitive changes. Differential diagnosis and assessing coexisting disorders are vital in accurately identifying ADHD symptoms, especially in individuals over the age of 50.
Adapting Medication Treatment for ADHD in Older Adults
Medication treatment for ADHD in older adults requires careful consideration of side effects, medical conditions, and individual responses. Stimulant medication can be safely prescribed for older adults with cardiac conditions, with adjustments made based on tolerance, side effects, and potential drug interactions. Non-stimulant medications may also be considered, although data on their efficacy in older adults is limited.
Improving Emotional Regulation and Memory with ADHD Medication
ADHD medications, both stimulants and non-stimulants, have been found to improve memory, attention, focus, as well as emotional regulation in individuals with ADHD. Emotional dysregulation, a common symptom in ADHD, may significantly benefit from medication treatment, enhancing cognitive function and overall quality of life for older adults.
David W. Goodman, M.D., discusses the emerging research on ADHD after age 50, including the disorder's possible association with dementia, the diagnostic process, and safe treatment options for older adults.
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