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A study published in JAMA Psychiatry found that adults with ADHD in a U.S. cohort were more likely to develop dementia or other cognitive impairment than participants without ADHD. The observational findings also linked higher genetic risk for ADHD with dementia, but they do not establish that ADHD causes cognitive decline or show whether treatment changes risk.
A study led by University of Pittsburgh researchers found that adults with attention-deficit/hyperactivity disorder (ADHD) were more likely to develop dementia or mild cognitive impairment later in life than adults without a recorded ADHD diagnosis. The research, published in JAMA Psychiatry, analyzed health records and genetic data from more than 187,000 U.S. adults aged 50 and older; it found an association, not proof that ADHD causes dementia.
Among participants with ADHD, 6.7% developed dementia or cognitive impairment, compared with 3.4% of those without ADHD. After accounting for age, sex and other health conditions, the researchers reported that participants with ADHD had more than four times the risk of developing cognitive impairment over time. The source report does not specify the absolute risk after this adjustment, so the percentage comparison and adjusted estimate should not be treated as interchangeable.
The team also assessed genetic risk for ADHD, whether or not participants had received a formal diagnosis. Those with the highest genetic risk score had a 35% greater chance of dementia than those with the lowest score. A genetic risk score reflects the combined association of common genetic variants with a condition; it does not determine an individual’s future diagnosis.
Among people in the study who developed cognitive impairment, those also diagnosed with ADHD reported worse mental health, lower quality of life and less social satisfaction than those with cognitive impairment alone. They also used about 20% more health care overall in the year after diagnosis, according to the report. These findings describe differences within the study group and do not establish why they occurred.
How ADHD May Shape Cognitive Aging
The findings add to research into whether ADHD is associated with cognitive health in older adulthood. The study is notable because it examined both clinical diagnoses and genetic risk in a large U.S. sample, rather than relying on only one source of evidence. The two approaches showed a pattern in the same direction, which the researchers said makes the association worth further investigation.
The results may also matter to people already living with both ADHD and cognitive impairment. Their reported quality of life and health-care use suggest that this group may have distinct support needs. However, the study does not establish that ADHD directly worsens dementia symptoms, nor does it show that screening or treating ADHD prevents dementia. Clinical decisions should not be based on this association alone.
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How Researchers Tested the Association
The study used data from the National Institutes of Health’s All of Us Research Program, which includes health records and genetic information. Researchers examined adults aged 50 and older and compared outcomes for people with and without a documented ADHD diagnosis, then separately considered participants’ genetic risk scores. The design allowed the team to look for patterns across a large population, but it was not a trial assigning treatment or exposure.
One possible explanation is that early signs of dementia may sometimes be mistaken for ADHD before a cognitive diagnosis is made. The researchers tested this possibility by requiring at least eight years between an ADHD diagnosis and cognitive impairment; the association remained statistically significant. That finding makes diagnostic confusion less likely to explain the entire association, but it cannot rule out all other explanations.
The work builds on earlier research from senior author Tharick A. Pascoal’s group, including a 2022 study linking ADHD genetic risk with Alzheimer’s-related brain changes in older adults without cognitive impairment. The authors describe the new analysis as the largest to date to combine clinical ADHD diagnoses and genetic data in the same population.
“Two different kinds of evidence are pointing in the same direction.”
— Tharick A. Pascoal, senior author and associate professor of psychiatry and neurology at the University of Pittsburgh
What the Study Cannot Establish
The analysis shows an association, not that ADHD causes dementia or mild cognitive impairment. The source report does not provide enough detail to assess all possible limitations, including how ADHD and cognitive impairment were identified across health records or how representative the participants are of the wider population. The reported risk estimates also cannot by themselves predict an individual’s likelihood of developing dementia.
It remains unknown whether ADHD medications, including stimulants, alter dementia risk over time. The researchers also identified cardiovascular health as an area to investigate, since cardiovascular factors have been linked to both ADHD and dementia. The eight-year analysis reduces concern that early dementia symptoms explain the whole association, but does not eliminate other confounding factors or establish the biological pathway.
Research Questions Ahead
The next step is further research to test whether the association appears in other populations and to clarify what factors might account for it. Studies could examine ADHD treatment histories, cardiovascular health and the timing of symptoms alongside cognitive outcomes. The current findings do not show that changing medication or managing a particular risk factor will prevent dementia.
For now, the study adds evidence for researchers to investigate, rather than a change in established care. The paper was published in JAMA Psychiatry under the title “Attention-Deficit/Hyperactivity Disorder and Late-Life Cognitive Impairment.” No follow-up results or clinical recommendations were provided in the source report.
Key Questions
Does ADHD cause dementia?
No. The study found an association between ADHD and later cognitive impairment, but it cannot establish that ADHD causes dementia.
How many people were included in the study?
Researchers analyzed health records and genetic data from more than 187,000 adults aged 50 and older enrolled in the NIH All of Us Research Program.
What were the reported rates of cognitive impairment?
The report said 6.7% of participants with ADHD developed dementia or cognitive impairment, compared with 3.4% of participants without ADHD. The study also reported an adjusted risk estimate, which is a separate measure from these raw percentages.
Does ADHD medication lower dementia risk?
The study did not answer that question. Whether ADHD medications affect dementia risk over time remains unknown, according to the researchers.
Should people with ADHD change their treatment because of this study?
The findings do not establish a prevention or treatment strategy. People should discuss medical decisions with a qualified health professional rather than changing treatment based on this observational study.
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