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Senile ADHD

Attention disorders—including AHDH—are one of the most common mental health issues in the United States. According to recent estimates, more than six million U.S. children (9.4%) have been diagnosed with attention-deficit/hyperactivity disorder (ADHD). [1]

While ADHD and other attention disorders tend to be associated primarily with children, adults of any age—including seniors—can also struggle with this condition. In fact, research suggests that around 4.4% of U.S. adults have an attention disorder. [2]

While ADHD can affect adults of any age, there’s very little research on how it impacts those who are well past middle age, i.e., the senior or older adult population. Because there’s no standardized screening for ADHD in seniors, it’s often more difficult to diagnose older adults with ADHD. Unless the person received an ADHD diagnosis when they were young, they are not likely to get one as an adult.

Also, research has confirmed that seniors with ADHD experience a unique cluster of symptoms that overlap with and are often mistaken for normal signs of aging. [3] As a result, ADHD is frequently misdiagnosed, and the symptoms are mismanaged in people over the age of 60. If memory and focus problems are plaguing a person at midlife or beyond, it could be undiagnosed ADHD. [4]

For people interested in learning more about ADHD in seniors—and the treatment options available for themselves or a loved one—the sections below provide vital information.

Topics covered include how to identify ADHD in older adults, how ADHD affects older women differently than men, and a range of treatment possibilities including transcranial magnetic stimulation (TMS)—a cutting-edge drug-free therapy that has shown great promise.

What is ADHD?

Attention deficit/hyperactivity disorder—or ADHD for short—is a neuropsychiatric and neurodevelopment disorder that typically begins in childhood and continues throughout a person’s life. [5]

Neuropsychiatry deals with behavioral or psychiatric disorders in people with neurological conditions. Neurodevelopmental disorders have to do with the functioning of the brain and neurological system. A person with ADHD has differences in brain development and brain activity that affect their capacity to concentrate, their ability to sit still, and their self-control.

ADHD symptoms can seriously disrupt a person’s school, work, family, and social relationships. Tasks that require calmness, focus, and sustained attention tend to be very challenging for children or adults with an attention disorder. If ADHD is left untreated, it can hamper a child’s social and educational growth, interfere with an adult’s ability to pursue their life goals, and tarnish the “golden years” of older adults.

Three Major ADHD Symptoms

In order to diagnose ADHD, counselors, psychiatrists, and other mental health professionals use the criteria described in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). [6]

According to the DSM-5, ADHD has three major symptoms, which are:

Inattention—not being able to concentrate or stay focused.
Hyperactivity—an excessive movement that is not appropriate to the setting.
Impulsivity—hasty actions that occur without appropriate forethought.

Depending upon which symptoms are most prevalent, an individual may be diagnosed with an inattentive type of ADHD or with a hyperactive/impulsive type of ADHD. If both sets of symptoms are present, they will be diagnosed with a combined type of ADHD.

Do People Outgrow ADHD?

Is it likely for a child who has been diagnosed with ADHD to eventually outgrow the disease? While this was once commonly believed, recent research suggests that it’s generally not true.

When symptoms of ADHD first appear in childhood, it’s very common for them to continue into adulthood. Although there may be periods during which the disorder goes into remission, 90% of children with ADHD continue to experience at least some symptoms as adults. [7]

ADHD in Seniors

Symptoms of attention-deficit/hyperactivity disorder may flare up in a person’s midlife or elder years. This is because ADHD symptoms can intermingle with—and often be confused with—age-related cognitive decline and physical health challenges. In addition, the lack of daily structure that often accompanies retirement may exacerbate certain ADHD symptoms.

Older Adult ADHD Symptoms

The symptoms of ADHD can look quite different during the various stages of a person’s lifetime. With the transitions from childhood to adolescence, to young adulthood and midlife, and then to the senior years—ADHD symptoms tend to shift and change. While there will be some overlap, what ADHD looks like in a young child and what it looks like in an older adult are likely to be quite distinct.

For instance, older adults with ADHD tend to struggle most with attention, memory, and planning. They may have a hard time finishing projects or consistently recalling information. They may frequently become distracted during conversations—finding it hard to stay focused. And they may find it challenging to cultivate and/or maintain relationships. [8]

Older adults who have recently retired—and so no longer have a well-defined and consistent workday structure—may experience an exacerbation of ADHD symptoms. This is akin to children or young adults with ADHD losing the structure of the school day, either during summer vacation or after graduating. During their retirement years, seniors may experience challenges with time management or procrastination—perhaps accompanied by feelings of guilt or anxiety.

As a person grows older, the expression of their ADHD symptoms may change. While each individual will have a unique symptom profile, the following symptoms appear quite frequently in older adults with ADHD:

Feeling restless or impatient
Being easily distracted
Being disorganized
Forgetfulness
Leaving tasks unfinished
Problems focusing on a task
Physical, verbal, and/or emotional hyperactivity
Having trouble relaxing
Poor time management
Being late
Difficulty starting a task
Interrupting others
Angry outbursts
Mood swings
Difficulty prioritizing activities
Extreme impatience
Impulsivity or recklessness
Excessive fidgeting
Talking too much
Interrupting others
Trouble following conversations
Inability to sit quietly for long
Low frustration tolerance
Losing or misplacing items
Forgetting words or names
Brain going “blank” every now and again
Difficulty learning new things
Problems maintaining relationships

Challenges for Older Adults with ADHD

Attention deficit/hyperactivity disorder can negatively impact the lives of older adults in a variety of ways. Some of the biggest challenges faced by seniors with ADHD include the following:

* Not getting things done. Struggles with procrastination, lack of self-discipline, or inability to follow through with a plan of action.

* Having “Swiss-cheese memory.” Having a memory that—while not consistently failing—is no longer entirely dependable. Certain things are easy to remember, but others slip through the cracks.

* Experiencing out-of-control emotions. Feeling agitated or irritable more often than in the past; struggling with anxiety or other mood disorders.

* Having time-management issues. Problems establishing and maintaining a daily routine; or making and following through with planned activities or meetings.

* Enduring the remnants of hyperactivity. Feeling restless, on edge, or fidgety; talking too much; or having random thoughts swirling in mind.

* Social awkwardness. Feeling misunderstood or judged, missing social cues, interrupting or speaking impulsively.

ADHD in Older Women

Because of hormonal changes associated with perimenopause, ADHD affects older women differently than it does older men. These changes typically occur for women in their mid-40s to early-50s. And ADHD symptoms may become more severe during these years. [9]

During perimenopause, estrogen levels within a woman’s body decrease steadily. The decreasing estrogen levels negatively impact short-term memory and the ability to concentrate—contributing to the “brain fog” described by many women during perimenopause. With estrogen levels plummeting in this way, even ADHD stimulant medication may become ineffective in relieving ADHD symptoms.

When estrogen levels decrease, it also affects dopamine levels. Dopamine is one of the feel-good neurotransmitters—a chemical in the brain that plays a role in motivation, reward, and the experience of pleasure. Since dopamine already tends to be low in people with ADHD, a perimenopause-related dip can result in more intense mood swings, feelings of depression and anxiety, and an inability to focus among older women with ADHD.

ADHD Treatment

What treatments are available for senior ADHD?

Within the western medical community, pharmaceutical medications are often the first line of treatment for children or adults diagnosed with ADHD. These medicines are of two general types: stimulants and non-stimulant. While these medicines can sometimes be effective at reducing ADHD symptoms, there are side effects—some of which are of special concern for older adults.

Medications for ADHD

Most prescription ADHD medications come in tablet, capsule, or liquid form, which the person takes by mouth. Stimulant and non-stimulant varieties of ADHD medications affect the brain in slightly different ways.

Stimulant medicines increase the levels of the neurotransmitters dopamine and norepinephrine within the brain. These brain chemicals enhance an individual’s ability to stay focused and motivated—so increasing their levels can help to ease the symptoms of a person struggling with ADHD.

Common brand names of stimulant ADHD medications include Ritalin, Adderall, Focalin, Concerta, and ProCentra.

Nonstimulants are a newer variety of ADHD medicine. Non-stimulant ADHD medicines work by increasing the levels of the neurotransmitter norepinephrine in the brain. Some common brand names of non-stimulant medications include Strattera, Qelbree, Intuniv, and Kapvay.

The Problem with ADHD Medication

While ADHD medications may reduce symptoms for some people, they may also be entirely ineffective. These medicines may fail to significantly reduce symptoms and/or may have debilitating side effects that are as bad as or even worse than the ADHD symptoms.

Some common side effects of ADHD medications include:

Headache
Weight loss
Mood changes
Sleep problems
Upset stomach
Decreased appetite
Growth delay
Exacerbated tic disorder
Blood pressure and heart rate changes

Some of the side effects of ADHD medications may affect older adults in potentially dangerous ways. For instance, as a person ages, their ability to tolerate drugs safely is likely to change. And newly added drugs may interact with other medicines they also take to treat other conditions.

Seniors must also consider the cardiac risks of ADHD medications. These risks include the potential for increased blood pressure and heart rate, along with damage to the heart’s conduction system, including the increased risk of an arrhythmia (irregular heartbeat). These ADHD side effects are particularly relevant for people with a history of heart problems. [10]

Other Strategies to Manage ADHD

There are a variety of self-care and lifestyle changes that can help manage the symptoms of ADHD. These non-drug strategies include:

Psychological counseling
Neurofeedback
Mindfulness training
Organizational skills training
Time management training

Psychological therapy, in particular, can be especially useful for cultivating tools to more skillfully relate to ADHD symptoms. A skilled counselor—utilizing modalities such as cognitive behavioral therapy, dialectical behavior therapy, mindfulness-based cognitive therapy, music therapy, or art therapy—can effectively help a person with ADHD:

Keep their temper in check
More effectively control their impulses
Reduce anxiety
Feel better about themselves
Improve their relationships with family and friends
Manage their time and increase productivity
Get organized—with lists, alarms, daily planners, calendars
Enhance life satisfaction

Additionally, lifestyle strategies such as these can be useful in managing ADHD symptoms at home:

* Exercise regularly. Physical activity increases the level of neurotransmitters such as dopamine, norepinephrine, and serotonin—which can help alleviate ADHD symptoms. So, exercising daily is one of the best ways for older adults struggling with ADHD to feel better.

* Get plenty of sleep. Adults with ADHD tend to have significant sleep problems that further complicate their focus and concentration. So having a regular sleep/wake cycle is another excellent strategy for helping to manage ADHD symptoms. Turn off computers, phones, tablets, gaming stations, and TVs at least an hour before bedtime. Install the free app f.lux to decrease blue light exposure during evening hours.

* Reduce or avoid caffeine. Adults with ADHD tend to use caffeine to self-medicate their ADHD. So, best to reduce or avoid caffeine intake. In particular, it’s best for a person with ADHD to avoid caffeine after noon since drinking it later in the day tends to interfere with sleep.

* Create a support network. A person struggling with ADHD is wise to enlist the support of friends and family members to help with creating structure, simplifying tasks, and maintaining meaningful relationships.

ADHD Treatment at Brain Therapy TMS

Brain Therapy TMS provides transcranial magnetic stimulation (TMS) in San Diego, California. TMS can be used to effectively treat a variety of mental health and neuropathic disorders—including attention-deficit/hyperactivity disorder—without the use of medication.

TMS is a proven breakthrough therapy that heals specific areas of the brain that are impaired by brain cell dysfunction. The end result is a significant improvement in mood, function, energy, focus, and general well-being.

Transcranial magnetic stimulation has proven effective in the treatment of childhood ADHD, teen ADHD, as well as adult ADHD. TMS treatments have proven helpful in resolving adult ADHD by:

Increasing capacity to focus on important tasks
Decreasing feelings of jitteriness and worry
Improving organizational strategies
Enhancing efficiency in work and recreation
Amplifying feelings of confidence and control

Transcranial magnetic stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of ADHD. During a TMS session, an electromagnet delivers a painless magnetic pulse that stimulates nerve cells in the region of the brain involved in the creation of ADHD symptoms. It activates regions of the brain that have decreased activity in the older adult with ADHD.

The benefits of TMS for older adults diagnosed with ADHD include:

High success rate: TMS has a considerably higher success rate than any other treatments
Medication reduction: Enables people with ADHD to entirely stop or significantly reduce ADHD medications
Non-Invasive: TMS treatment is entirely external to the body
Non-Sedative: TMS requires no sedation and is relatively painless
Minimal to No Side Effects: TMS has no side effects in the vast majority of patients

The mission of our San Diego TMS Therapy Clinic is to help adults resolve the debilitating effects of ADHD with TMS, which has been proven to be a highly effective long-term solution.

To learn more about TMS therapy and how it can support the healing of ADHD in older adults, sign up for a free consultation today.

References & Resources

[1] Data and Statistics About ADHD. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/adhd/data.html

[2] Inserro, Allison. (January 19, 2018). 5 Things About ADHD in Older Adults You May Not Know. AJMC. https://www.ajmc.com/view/5-things-about-adhd-in-older-adults-you-may-not-know

[3] Nadeau, Kathleen (July 14, 2022). A Critical Need Ignored: Inadequate Diagnosis and Treatment of ADHD After Age 60. Additude: Inside the ADHD Mind. https://www.additudemag.com/adhd-in-seniors-diagnosis-and-treatment-after-60/

[4] Barger, Theresa Sullivan (January 24, 2023). ADHD in Older Adults: Diagnosis and Treatment. AARP. https://www.aarp.org/health/conditions-treatments/info-2023/adhd-in-older-adults-symptoms-diagnosis-treatment.html

[5] Neurodevelopmental Disorders (October, 215). America’s Children and the Environment. U.S. Environmental Protection Agency. https://www.epa.gov/sites/default/files/2015-10/documents/ace3_neurodevelopmental.pdf

[6] Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association. https://www.psychiatry.org/psychiatrists/practice/dsm

[7] Sibley MH, Arnold LE, Swanson JM, et al.; MTA Cooperative Group. Variable Patterns of remission from ADHD in the multimodal treatment study of ADHD. Am J Psychiatry. https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.2021.21010032

[8] Collier, Stephanie (April 21, 2020). Struggling with attention and organization as you age? It could be ADHD, not dementia. Harvard Medical School. https://www.health.harvard.edu/blog/struggling-with-attention-and-organization-as-you-age-it-could-be-adhd-not-dementia-2020042119514

[9] Barger, Theresa Sullivan (January 24, 2023). ADHD in Older Adults: Diagnosis and Treatment. AARP. https://www.aarp.org/health/conditions-treatments/info-2023/adhd-in-older-adults-symptoms-diagnosis-treatment.html

[10] Lazare, Jaimie. ADHD in Older Adults. Today’s Geriatric Medicine. https://www.todaysgeriatricmedicine.com/news/ex_120512.shtml

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