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A study published in JAMA Psychiatry found that adults with ADHD in a U.S. research cohort had higher rates of dementia or cognitive impairment than those without ADHD. The observational findings, supported by a separate genetic-risk analysis, show an association—not proof that ADHD causes dementia.
A study led by researchers at the University of Pittsburgh School of Medicine found that adults with attention-deficit/hyperactivity disorder (ADHD) were more likely to develop dementia or other cognitive impairment later in life than adults without ADHD. Published October 7 in JAMA Psychiatry, the analysis included health records and genetic data from more than 187,000 people aged 50 and older, but it does not establish that ADHD causes dementia.
Researchers reported that 6.7% of participants with ADHD developed dementia or cognitive impairment, compared with 3.4% of participants without ADHD. After accounting for age, sex and other health conditions, the team found that the ADHD group had more than four times the risk of developing cognitive impairment over time, according to the study report. The analysis drew on participants enrolled in the National Institutes of Health’s All of Us Research Program.
The study also examined genetic risk scores, which estimate how strongly a person’s common genetic variants are associated with ADHD. People in the group with the highest ADHD genetic risk had a 35% greater chance of developing dementia than those in the group with the lowest risk. This result concerns a comparison between genetic-risk groups; it does not mean that a genetic score diagnoses ADHD or predicts an individual’s outcome.
Among participants who developed cognitive impairment, those with a recorded ADHD diagnosis also reported worse mental health, lower quality of life and less social satisfaction than those with cognitive impairment alone. They used about 20% more health care overall in the year after diagnosis. These are group-level findings from the study, not evidence that every person with both conditions will have the same experience.
ADHD and Later-Life Care Needs
The findings add evidence that ADHD may be relevant to cognitive aging and to the needs of people who receive a dementia or cognitive-impairment diagnosis. The reported differences in quality of life and health-care use suggest that co-occurring ADHD could matter for support and care planning, although the study does not establish why these differences occurred.
The genetic analysis offers a second kind of evidence alongside medical records. The researchers said that seeing a similar pattern in diagnoses and genetic risk makes it less likely that the association is explained solely by how ADHD is identified. Still, an observational association cannot show that ADHD itself is the cause, and the results do not establish that treatment or other interventions prevent dementia.
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How the Study Tested the Link
The research team combined health-record diagnoses and genetic data within the same large U.S. participant group. That approach let the researchers compare later cognitive outcomes for people with a documented ADHD diagnosis and examine whether ADHD-associated genetic variation showed a related pattern. The paper is titled “Attention-Deficit/Hyperactivity Disorder and Late-Life Cognitive Impairment.”
The study builds on prior work from senior author Tharick A. Pascoal’s research group. The source report says a 2022 study linked genetic risk for ADHD with Alzheimer’s-related brain changes in older adults who had no apparent cognitive impairment. The new analysis extends that line of research by examining clinical diagnoses and genetic information together in a larger sample.
Researchers also tested whether early dementia symptoms being mistaken for ADHD could explain the association. According to the report, the result remained statistically significant when the team required at least eight years between ADHD diagnosis and cognitive impairment onset. That timing analysis makes misclassification a less complete explanation, but it does not rule out other sources of bias or establish a causal pathway.
“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
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Cause, Treatment and Risk Remain Open
The study establishes an association, not causation. Researchers have not shown whether ADHD contributes directly to dementia risk, whether shared health or biological factors influence both, or whether other differences among participants help explain the results. The size of the reported adjusted association also does not provide an individual person’s absolute likelihood of developing dementia.
The report identifies several unresolved questions. It is not known whether ADHD medicines, including stimulants, change dementia risk over time, or whether managing cardiovascular health could affect the association. The study also cannot show that treatment for ADHD prevents cognitive impairment. Its results apply to the participants and measures analyzed; further research is needed to determine how well they generalize to other populations.
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Research Into Modifiable Factors
The researchers say the next step is to investigate what may account for the observed relationship, including possible cardiovascular or other health factors, and whether any are changeable. Future work would also need to test medication-related questions over time rather than infer treatment effects from this analysis. No prevention strategy or treatment benefit was demonstrated in the study.
For now, the report adds a large U.S. data set to research on ADHD and cognitive aging, while leaving the mechanism and clinical implications unsettled. The article does not recommend changes to ADHD treatment based on these results; decisions about individual care remain a matter for patients and qualified health professionals.
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Key Questions
Does ADHD cause dementia?
The study does not prove that ADHD causes dementia. It found an association between an ADHD diagnosis and later cognitive impairment, with a similar pattern in an analysis of genetic risk.
How many participants were included?
The researchers analyzed health records and genetic data from more than 187,000 adults aged 50 and older in the NIH All of Us Research Program.
What were the reported rates?
Dementia or cognitive impairment was reported in 6.7% of participants with ADHD and 3.4% of those without ADHD. These are the observed proportions in this study, not an individual forecast.
Can ADHD medication lower dementia risk?
The study did not answer whether ADHD medicines, including stimulants, affect dementia risk. The researchers identified medication effects as an open question for future research.
Does the genetic finding mean someone will develop dementia?
No. The genetic-risk score measured the association of common variants with ADHD, and the study compared dementia chances across higher- and lower-risk groups. It does not provide a certain prediction for an individual.
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