Optimal management of ADHD in older adults

Terje Torgersen,1,2 Bjorn Gjervan,2,3 Michael B Lensing,4 Kirsten Rasmussen5,6 1Department of Østmarka, St Olav’s Hospital, 2Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, 3Department of Psychiatry, Helse Nord-Trondelag Hospital...

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Autores principales:	Torgersen T, Gjervan B, Lensing MB, Rasmussen K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	ADHD adults older adults pharmacotherapy central stimulants Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/b6f257821b2241a5ad036d06df771afb
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spelling	oai:doaj.org-article:b6f257821b2241a5ad036d06df771afb2021-12-02T06:09:29ZOptimal management of ADHD in older adults1178-2021https://doaj.org/article/b6f257821b2241a5ad036d06df771afb2016-01-01T00:00:00Zhttps://www.dovepress.com/optimal-management-of-adhd-in-older-adults-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Terje Torgersen,1,2 Bjorn Gjervan,2,3 Michael B Lensing,4 Kirsten Rasmussen5,6 1Department of Østmarka, St Olav’s Hospital, 2Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, 3Department of Psychiatry, Helse Nord-Trondelag Hospital Trust, Kirkegata, Levanger, 4NevSom, Norwegian Center of Expertise for Neurodevelopmental Disorders and Hypersomnias, Women and Children’s Division, Oslo University Hospital, Oslo, 5St Olav’s Hospital, Broset Center for Research and Education in Forensic Psychiatry, Trondheim, 6Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway Background: The manifestation of attention-deficit/hyperactivity disorder (ADHD) among older adults has become an interesting topic of interest due to an increasing number of adults aged 50 years and older (≥50 years) seeking assessment for ADHD. Unfortunately, there is a lack of research on ADHD in older adults, and until recently only a few case reports existed.Method: A systematic search was conducted in the databases Medline/PubMed and PsycINFO in order to identify studies regarding ADHD in adults ≥50 years.Results: ADHD persists into older ages in many patients, but the prevalence of patients fulfilling the criteria for the diagnosis at age ≥50 years is still unknown. It is reason to believe that the prevalence is falling gradually with age, and that the ADHD symptom level is significantly lower in the age group 70–80 years than the group 50–60 years. There is a lack of controlled studies of ADHD medication in adults ≥50 years, but this review suggests that many patients aged ≥50 years experience beneficial effects of pharmacological treatment. The problem with side effects and somatic complications may rise to a level that makes pharmacotherapy for ADHD difficult after the age of 65 years. Physical assessment prior to initiation of ADHD medication in adults ≥50 years should include a thorough clinical examination, and medication should be titrated with low doses initially and with a slow increase. In motivated patients, different psychological therapies alone or in addition to pharmacotherapy should be considered.Conclusion: It is essential when treating older adult patients with ADHD to provide good support based on knowledge and understanding of how ADHD symptoms have affected health, quality of life, and function through the life span. Individualized therapy for each elderly patient should be recommended to balance risk–benefit ratio when pharmacotherapy is considered to be a possible treatment. Keywords: ADHD, adults, older adults, pharmacotherapy, central stimulantsTorgersen TGjervan BLensing MBRasmussen KDove Medical PressarticleADHDadultsolder adultspharmacotherapycentral stimulantsNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2016, Iss Issue 1, Pp 79-87 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	ADHD adults older adults pharmacotherapy central stimulants Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	ADHD adults older adults pharmacotherapy central stimulants Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Torgersen T Gjervan B Lensing MB Rasmussen K Optimal management of ADHD in older adults
description	Terje Torgersen,1,2 Bjorn Gjervan,2,3 Michael B Lensing,4 Kirsten Rasmussen5,6 1Department of Østmarka, St Olav’s Hospital, 2Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, 3Department of Psychiatry, Helse Nord-Trondelag Hospital Trust, Kirkegata, Levanger, 4NevSom, Norwegian Center of Expertise for Neurodevelopmental Disorders and Hypersomnias, Women and Children’s Division, Oslo University Hospital, Oslo, 5St Olav’s Hospital, Broset Center for Research and Education in Forensic Psychiatry, Trondheim, 6Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway Background: The manifestation of attention-deficit/hyperactivity disorder (ADHD) among older adults has become an interesting topic of interest due to an increasing number of adults aged 50 years and older (≥50 years) seeking assessment for ADHD. Unfortunately, there is a lack of research on ADHD in older adults, and until recently only a few case reports existed.Method: A systematic search was conducted in the databases Medline/PubMed and PsycINFO in order to identify studies regarding ADHD in adults ≥50 years.Results: ADHD persists into older ages in many patients, but the prevalence of patients fulfilling the criteria for the diagnosis at age ≥50 years is still unknown. It is reason to believe that the prevalence is falling gradually with age, and that the ADHD symptom level is significantly lower in the age group 70–80 years than the group 50–60 years. There is a lack of controlled studies of ADHD medication in adults ≥50 years, but this review suggests that many patients aged ≥50 years experience beneficial effects of pharmacological treatment. The problem with side effects and somatic complications may rise to a level that makes pharmacotherapy for ADHD difficult after the age of 65 years. Physical assessment prior to initiation of ADHD medication in adults ≥50 years should include a thorough clinical examination, and medication should be titrated with low doses initially and with a slow increase. In motivated patients, different psychological therapies alone or in addition to pharmacotherapy should be considered.Conclusion: It is essential when treating older adult patients with ADHD to provide good support based on knowledge and understanding of how ADHD symptoms have affected health, quality of life, and function through the life span. Individualized therapy for each elderly patient should be recommended to balance risk–benefit ratio when pharmacotherapy is considered to be a possible treatment. Keywords: ADHD, adults, older adults, pharmacotherapy, central stimulants
format	article
author	Torgersen T Gjervan B Lensing MB Rasmussen K
author_facet	Torgersen T Gjervan B Lensing MB Rasmussen K
author_sort	Torgersen T
title	Optimal management of ADHD in older adults
title_short	Optimal management of ADHD in older adults
title_full	Optimal management of ADHD in older adults
title_fullStr	Optimal management of ADHD in older adults
title_full_unstemmed	Optimal management of ADHD in older adults
title_sort	optimal management of adhd in older adults
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/b6f257821b2241a5ad036d06df771afb
work_keys_str_mv	AT torgersent optimalmanagementofadhdinolderadults AT gjervanb optimalmanagementofadhdinolderadults AT lensingmb optimalmanagementofadhdinolderadults AT rasmussenk optimalmanagementofadhdinolderadults
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Optimal management of ADHD in older adults

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