Prevalence of attention-deficit/hyperactivity disorder in older adults: A systematic review and meta-analysis

Maja Dobrosavljevic; Carmen Solares; Samuele Cortese; Henrik Andershed; Henrik Larsson

doi:10.1016/j.neubiorev.2020.07.042

Prevalence of attention-deficit/hyperactivity disorder in older adults: A systematic review and meta-analysis

Neurosci Biobehav Rev. 2020 Nov:118:282-289. doi: 10.1016/j.neubiorev.2020.07.042. Epub 2020 Aug 12.

Authors

Maja Dobrosavljevic¹, Carmen Solares², Samuele Cortese³, Henrik Andershed², Henrik Larsson⁴

Affiliations

¹ School of Medical Sciences, Örebro University, Södra Grev Rosengatan 30, SE-703 62 Örebro, Sweden. Electronic address: maja.dobrosavljevic@oru.se.
² School of Law, Psychology and Social Work, Örebro University, Fakultetsgatan 1, SE-701 82, Örebro, Sweden.
³ Centre for Innovation in Mental Health, School of Psychology, Life and Environmental Sciences, University of Southampton, SO17 1BJ, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, SO16 6YD, UK; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK; National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre NG7 2UH, UK; New York University Child Study Center, New York, NY, 10016, USA.
⁴ School of Medical Sciences, Örebro University, Södra Grev Rosengatan 30, SE-703 62 Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.

PMID: 32798966
DOI: 10.1016/j.neubiorev.2020.07.042

Abstract

There is a significant knowledge gap in research on Attention-Deficit/Hyperactivity Disorder (ADHD) in older adults. Via a systematic review and meta-analysis, we aimed to investigate the prevalence of ADHD in older adults, considering different assessment methods. We searched five electronic databases up to June 26, 2020. We identified 20 relevant studies with 32 datasets providing a total sample size of 20,999,871 individuals (41,420 individuals with ADHD). The pooled prevalence estimates differed significantly across assessment methods: 2.18 % (95 % CI = 1.51, 3.16) based on research diagnosis via validated scales, 0.23 % (0.12, 0.43) relying on clinical ADHD diagnosis, and 0.09 % (0.06, 0.15) based on ADHD treatment rates. Heterogeneity was significant across studies for all assessment methods. There is a considerable number of older adults with elevated levels of ADHD symptoms as determined via validated scales, and the prevalence of treated ADHD is less than half of the prevalence of clinically diagnosed ADHD. This highlights the need for increased awareness of ADHD clinical diagnosis and treatment in older adults.

Keywords: Attention-deficit/hyperactivity disorder; Meta-analysis; Older adults; Prevalence; Systematic review.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Aged
Attention Deficit Disorder with Hyperactivity* / epidemiology
Databases, Factual
Humans
Prevalence