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Neuropsychological deficits in adults age 60 and above with attention deficit hyperactivity disorder

Published online by Cambridge University Press:  23 March 2020

L.B. Thorell ,
Y. Holst ,
H. Chistiansen ,
J.J.S. Kooij ,
D. Bijlenga  and
D. Sjöwall
L.B. Thorell*
Affiliation:
Department of Clinical Neuroscience, Karolinska Institutet, Nobels Väg 9Stockholm, Sweden, 171 77
Y. Holst
Affiliation:
Department of Clinical Neuroscience, Karolinska Institutet, Nobels Väg 9Stockholm, Sweden, 171 77
H. Chistiansen
Affiliation:
Clinical Child and Adolescent Psychology, Department of Psychology, Philipps University, Gutenbergstr. 18Marburg, Germany, 35032
J.J.S. Kooij
Affiliation:
PsyQ, Psycho-medical programs, Expertise Center Adult ADHD, Reinierszkade 197The Hague, The Netherlands, 2593 HR
D. Bijlenga
Affiliation:
PsyQ, Psycho-medical programs, Expertise Center Adult ADHD, Reinierszkade 197The Hague, The Netherlands, 2593 HR
D. Sjöwall
Affiliation:
Department of Neuroscience, Karolinska Institutet, Retzius väg 8Stockholm, Sweden, 171 77
*
*Corresponding author. Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels Väg 9, 17165 Solna, Sweden. E-mail address:lisa.thorell@ki.se (L.B. Thorell).
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Abstract

Objective:

Neuropsychological deficits are of major importance in ADHD, yet no previous studies have assessed clinically referred samples of older adults. The authors compared older adults with ADHD (60–75 years) with both younger adults with ADHD (18–45 years) and older healthy controls with regard to various neuropsychological deficits.

Methods:

Well-established tests were used to investigate working memory, inhibition, switching, planning, fluency, and speed of processing. Self-ratings of executive functioning and delay-related behaviors were also included. Both variable-oriented and person-oriented analyses were conducted.

Results:

Older adults with ADHD differed from controls with regard to working memory, inhibition, switching, and delay-related behaviors. In comparison to younger adults with ADHD, they performed at a similar level with regard to working memory and planning, but significantly better with regard to inhibition, switching, fluency, speed of processing, and delay aversion. Despite several significant group differences relative to controls, person-oriented analyses demonstrated that a majority of older adults with ADHD performed within the average range on each test and 20% showed no clear deficit within any neuropsychological domain.

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.

Keywords

ADHDNeuropsychology
Type
Original article
Information
European Psychiatry , Volume 45 , September 2017 , pp. 90 - 96
Copyright
Copyright © European Psychiatric Association 2017

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References

Castellanos, FXSonuga-Barke, EJMilham, MPTannock, RCharacterizing cognition in ADHD: beyond executive dysfunction. Trends Cogn Sci 2006;10(3):117–123.CrossRefGoogle ScholarPubMed
Boonstra, AMOosterlaan, JSergeant, JABuitelaar, JKExecutive functioning in adult ADHD: a meta-analytic review. Psychol Med 2005;35(8):1097–1108.CrossRefGoogle ScholarPubMed
Michielsen, MSemeijn, EComijs, HCVan de Ven, PBeekman, ATFDeeg, DJH, et al.The prevalence of attention-deficit/hyperactivity disorder in older adults in the Netherlands. Br J Psychiatry 2012;201(4):298–305.CrossRefGoogle ScholarPubMed
Guldberg-Kjär, TJohansson, BOld people reporting childhood AD/HD symptoms: retrospectively self-rated AD/HD symptoms in a population- based Swedish sample aged 65-80. Nord J Psychiatry 2009;63(5):375–382.CrossRefGoogle Scholar
Michielsen, MComijs, HCSemeijn, EJBeekman, ATFDeeg, DJHKooij, JJSThe comorbidity of anxiety and depressive symptoms in older adults with attention-deficit/hyperactivity disorder: a longitudinal study. J Affect Disord 2013;148(2–3):220–227.CrossRefGoogle Scholar
Michielsen, MComijs, HCAartsen, MJSemeijn, EJBeekman, ATFDeeg, DJH, et al.The relationship between ADHD and social functioning and participation in older adults in a population-based study. J Atten Disord 2015;19(5):368–379.CrossRefGoogle Scholar
Solanto, MExecutive function deficits in adults with ADHD. In: Barkley, RA editors. Attention-deficit hyperactivity disorder: handbook for diagnosis and treatment, 4th Ed., New York, NY: Guildford Press; 2015.Google Scholar
Sonuga-Barke, EJPsychological heterogeneity in AD/HD–a dual pathway model of behavior and cognition. Behav Brain Res 2002;130(1–2):29–36.CrossRefGoogle Scholar
Holst, YThorell, LBNeuropsychological functioning in adults with ADHD and adults with other psychiatric disorders: the issue of specificity. J Atten Disord 2017;21(2):137–148.CrossRefGoogle Scholar
Clare, SHelps, SSonuga-Barke, EJThe Quick Delay Questionnaire: a measure of delay aversion and discounting in adults. Atten Defic Hyperact Dis 2010;2(1):43–48.CrossRefGoogle ScholarPubMed
Jackson, JNMacKillop, JAttention-deficit/hyperactivity disorder and monetary delay discounting: a meta-analysis of case-control studies. Biol Psychiatry Cogn Neurosci Neuroimaging 2016;1(4):316–325.CrossRefGoogle ScholarPubMed
Semeijn, EJKorten, NCMComijs, HCMichielsen, MDeeg, DJHBeekman, ATF, et al.No lower cognitive functioning in older adults with attention-deficit/hyperactivity disorder. Int Psychogeriatrics 2015;27(9):1467–1476.CrossRefGoogle ScholarPubMed
Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 5th ed., Washington DC: APA, American Psychiatric Association; 2013.Google Scholar
Lovejoy, DWBall, JDKeats, MStutts, MLSpain, EHJanda, L, et al.Neuropsychological performance of adults with attention deficit hyperactivity disorder (ADHD): diagnostic classification estimates for measures of frontal lobe/executive functioning. J Int Neuropsychol Soc 1999;5(3):222–233.CrossRefGoogle ScholarPubMed
Nigg, JTWillcutt, EGDoyle, AESonuga-Bark, EJCausal heterogeneity in attention-deficit/hyperactivity disorder: do we need neuropsychologically impaired subtypes?. Biol Psychiatry 2005;57(11):1224–1230.CrossRefGoogle ScholarPubMed
Das, DCherbuin, NEasteal, SAnstey, KJAttention deficit/hyperactivity disorder symptoms and cognitive abilities in the late-life cohort of the PATH through life study. Plos One 2014;9(1):e86552.CrossRefGoogle ScholarPubMed
Kooij, JJSFrancken, MHDiagnostic interview for ADHD in adults 2.0 (DIVA 2.0). Adult ADHD. Diagnostic assessment and treatment Amsterdam: Pearson; 2010Google Scholar
Barkley, RAMurphy, KRAttention-deficit hyperactivity disorder: a clinical workbook New York: Guilford; 1998CrossRefGoogle Scholar
Brown, TEBrown Attention-Deficit Disorder Scales: manual San Antonio: The Psychological Corporation; 1996Google Scholar
Ward, MFWender, PHReimherr, FWThe Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. Am J Psychiatry 1993;150(6):885–890.Google ScholarPubMed
Kessler, RCAdler, LAmes, MDemler, OFaraone, SHiripi, E, et al.The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med 2005;35(2):245–256.CrossRefGoogle Scholar
Sheehan, DVLecrubier, YHarnett-Sheehan, KJanvas, JWeiller, EBonara, LI, et al.The Mini International Neuropsychiatric Interview (M.I.N.I): the development and validation of a structured diagnostic interview. J Clin Psychiatry 1998;59(Suppl. 20):22–33.Google Scholar
Wechsler, DWechsler Adult Intelligence Scale, 4th ed., San Antonio, TX: The Psychological Corporation; 2008.Google Scholar
Folstein, MFolstein, SEMcHugh, PR“Mini-Mental State” a practical method for grading the cognitive state of patients for the clinician. J Psych Res 1975;12(3):189–198.CrossRefGoogle ScholarPubMed
Delis, DKaplan, EKramer, JDelis-Kaplan executive function system San Antonio, TX: The Psychological Corporation; 2001Google Scholar
Thorell, LBSjöwall, DMies, GScheres, AQuick Delay Questionnaire: reliability, validity, and relations to functional impairments in adults with ADHD. Psychol Assess. http://dx.doi.org/10.1037/pas0000421.CrossRefGoogle Scholar
Holst, YThorell, LB. Adult Executive Functioning Inventory (ADEXI): reliability, validity, and relations to ADHD. Int J Methods Psych Res. http://dx.doi.org/10.1002/mpr.1567.CrossRefGoogle Scholar
Thorell, LBNyberg, LThe Childhood Executive Functioning Inventory (CHEXI): a new rating instrument for parents and teachers. Dev Neuropsychol 2008;33(4):536–552.CrossRefGoogle ScholarPubMed
Toplak, MWest, MStanovich, RPractitioner review: do performance-based measures and ratings of executive function assess the same construct?. J Child Psychol Psychiatry 2013;54(2):131–143.CrossRefGoogle ScholarPubMed
Barkley, RAFischer, MPredicting impairment in major life activities and occupational functioning in hyperactive children as adults: self-reported executive function (EF) deficits versus EF tests. Dev Neuropsychol 2011;36(2):137–161.CrossRefGoogle ScholarPubMed
Hoaglin, DCIglewicz, BFine tuning some resistant rules of outlier labeling. J Am Stat Ass 1987;82(400):1147–1149.CrossRefGoogle Scholar
Cohen, JStatistical power analysis for the behavioral sciences, 2nd edn., Hillsdale, NJ: Erlbaum; 1988.Google Scholar
Green, LFry, AFMyerson, JDiscounting of delayed rewards: a life-span comparison. Psychol Sci 1994;5(1):33–36.CrossRefGoogle Scholar
Li, YBaldassi, MJohnson, EWeber, EComplementary cognitive capabilities, economic decision making, and aging. Psychol Aging 2013;28(3):595–613.CrossRefGoogle ScholarPubMed
Drobetz, RMaercker, AFortsmeier, SDelay of gratification in old age: assessment, age-related effects, and clinical implications. Aging Clin Exp Res 2012;24(1):6–14.Google ScholarPubMed
Bell-McGinty, SPodell, KFranzen, MBaird, ADWilliams, MJStandard measures of executive function in predicting instrumental activities of daily living in older adults. Int J Ger Psychiatry 2002;17(9):828–834.CrossRefGoogle ScholarPubMed
Salthouse, TAA selective review of cognitive aging. J Int Neuropsychol Soc 2010;16(5):754–760.CrossRefGoogle ScholarPubMed
Shaw, PStringaris, ANigg, JLeibenluft, EEmotion dysregulation in attention deficit hyperactivity disorder. Am J Psychiatry 2014;171(3):276–293.CrossRefGoogle ScholarPubMed
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