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Artigos Científicos

segunda-feira, 20 junho 2016 19:07

ADHD in old age: a review of the literature and proposal for assessment and treatment

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J. J. Sandra Kooij1, Marieke Michielsen2, Henk Kruithof3, Denise Bijlenga4

1
PsyQ Psycho-Medical Programs, Expertise Center Adult ADHD, The Hague, The Netherlands; Department of Psychiatry, VUMc, Amsterdam, The Netherlands
2
PsyQ Psycho-Medical Programs, Expertise Center Adult ADHD, The Hague, The Netherlands
3
Clinical Elderly Department, Parnassia Group, The Hague, The Netherlands
4
PsyQ Psycho-Medical Programs, Expertise Center Adult ADHD, The Hague, The Netherlands

Journal Expert Review of Neurotherapeutics

04 Jul 2016


Abstract:

Introduction: ADHD is an often heritable, neurodevelopmental disorder with a prevalence of 4–5% in children and adults and about 3% in older adults. The disorder in older adults (> 55 years) is accompanied by similar comorbidities such as anxiety and depression, and social impairment as in younger age groups.

Areas covered: An overview of the literature on diagnostic assessment, differential diagnosis, and treatment of older adults with ADHD is described. Case studies show that stimulant treatment is beneficial for ADHD in old age, but randomized controlled trials are lacking. Stimulant treatment has been studied in depression and even dementia in older adults, and seems safe with active cardiovascular risk management. In this paper, a proposal for diagnostic assessment and treatment is described for ADHD in older adults, including differential diagnosis with other psychiatric and neurocognitive disorders.

Results: Regarding the organization of mental health, professionals in geriatric psychiatry need to be trained in assessment and treatment of ADHD in older age. Lifespan ADHD clinics may help patients of all ages to receive better specialized care.

Conclusions The results are in line with models of heterogeneity that have identified different neuropsychological subtypes in ADHD as well as a subgroup of patients without any clear neuropsychological deficits. For older adults with ADHD, it will be important to assess their functioning across time as normal aging is related to memory decline and these patients could therefore end up with severe deficits as they grow older, which in turn could have serious negative effects on daily life functioning.

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