Detection of adult attention deficit hyperactivity disorder with cognitive complaint: Experience of a French memory center

Rev Neurol (Paris). 2019 Jun;175(6):358-366. doi: 10.1016/j.neurol.2018.09.021. Epub 2019 May 2.

Abstract

Introduction: Attention deficit hyperactivity disorder (ADHD) is a frequent neurodevelopmental mental disorder. It can persist in adulthood and be expressed as a cognitive complaint.

Methods: We conducted a descriptive study in a French memory center concerning patients seen over a period of two years. All patients for whom the final diagnosis was ADHD were included. All patients benefited from standard neuropsychological tests and a psychiatric specific consultation.

Results: Thirteen patients were included with an average age of 50.2±19 years. Main complaints related to memory, attention, focusing and organizational functioning. These difficulties had negative social, professional and academic consequences. ADHD history in descendants was noted in 46% of patients. More than 20% of subjects had motor, verbal or mental restlessness. Neuropsychological assessment highlighted impaired performances in executive functions (38%), sustained attention (67%), divided attention (45%), working memory (46%) and information processing speed (75%). A psychiatric history or comorbidities were present in 85% of patients, mostly of the anxio-depressive type. The more prevalent presentations of ADHD were the combined (38%) and inattentive (38%) types.

Discussion: Adult ADHD can masquerade as a cognitive impairment, including a stable cognitive complaint from infancy to old age. Inattentive, hyperactive and impulsive symptoms change with time and become more internalized (such as concentration difficulties or mental restlessness). No neuropsychological pattern has been reported but fluctuating deficits in sustained, divided attention, working memory and information processing speed are frequently observed in adult ADHD. A specific psychiatric expertise is essential in diagnosis and care for ADHD and its commonly associated psychiatric comorbidities.

Keywords: Adult; Attention deficit hyperactivity disorder; Cognitive impairment; Neuropsychological tests; Psychiatry.

Publication types

  • Review

MeSH terms

  • Adult
  • Age of Onset
  • Aged
  • Attention Deficit Disorder with Hyperactivity / complications*
  • Attention Deficit Disorder with Hyperactivity / diagnosis*
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Cognition / physiology
  • Cognitive Dysfunction / complications*
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / epidemiology
  • Executive Function / physiology
  • Female
  • Humans
  • Male
  • Memory Disorders / complications
  • Memory Disorders / diagnosis
  • Memory Disorders / epidemiology
  • Middle Aged
  • Neuropsychological Tests*
  • Retrospective Studies