The Science Behind Diagnosing and Treating ADHD in Older Adults (with David Goodman, M.D.)

Older adults have unique needs and characteristics – including age-related cognitive changes, co-existing psychiatric and medical conditions, and more – that influence evaluation and treatment for ADHD. To better serve this population, clinicians must anticipate and understand these myriad factors. In this hour-long ADDitude webinar, Dr. David Goodman will explain the nuances of diagnosing and treating ADHD in older adults.

4:01 "Why Is ADHD in Older Adults a Concern?"
9:31 The Life Transition Model Identifies Sensitive Transition Periods
10:23 Childhood Diagnosis vs. Adult Diagnosis
18:21 Neuropsychological Studies
19:50 Comorbidity in ADHD Adults Aged ≥50 years
21:51 Psychopharmacological Treatment of ADHD in Adults Aged 50+
23:06 Drug-Approved Ages for Stimulants
26:09 Treatment Guidelines
31:30 ADHD Medication Sequencing
32:12 Side Effects With Stimulant Medication
33:39 Psychotherapy
36:10 Takeaway Points






38:17 Q&A

Related Resources

3. Is It ADHD, or Is It Age?

4. eBook: "Secrets of the ADHD Brain"

[tbainbridge]

ADHD has ruined my life for 40 years, the damage is immense. I wonder if I can fix it despite and have some happiness before I die.

[katella]

I will be 69 yrs old in a couple of weeks. All my life I've had something like a sensory overload with the only option for me being withdrawal. As a result i was described as shy, inconsistent, antisocial, depressed, avoidant, excentric, strange, weird, incompetent, lazy, etc. Now I live alone and have found that I am unable to consistently do what needs to be done. My house is always a mess, as is my garden. My hobbies rarely get attention. I do manage to give my animals the care they need, but am unable to do the same for myself. I have always needed a great deal of downtime. Now I spend hours every day just lying down doing nothing while the work piles up. I can't force myself to attend to anything but the simplest paperwork. My life is just sliding past, when in fact life conditions are better for me now than they've ever been. Ihave been on antidepressants for many years but I don't feel that i am depressed. I feel like I just don't have any energy.

[jakebrookesactor]

I thought I was mentally challenged my whole life. After I was diagnosed with ADHD and started taking medicine, the real me came out: I became an actor. This is from spending my whole life introverted and having an immense amount of shyness.

[ANNEMARGARET]

Very informative, extremely validating. I finally went to see a psychiatrist at age 56, only a couple of years prior did I start to suspect that maybe I had ADHD. I had an idea in my mind of what ADHD was so it never occurred to me that I may have it… But once I explored the possible symptoms… I realized I’ve had it my whole life and things that have happened in my life, and the way I am now make such more sense!

[dianaNfernando]

Just got a diagnosis today of ADHD as a woman of 50 yrs of age. This was so helpful. Thank you so much.

[ANNEMARGARET]

I really didn’t notice the symptoms until later in life just thought that’s how I was… didn’t go to college, it’s now as a post menopausal woman who is divorced, with a house, and a teenaged daughter, I realized I couldn’t handle it all… but didn’t understand why

[patriciajump]

This is so excellent for older patients. I am 72, and although now I am back on generic Adderall and doing okay, there was a miserable five years preceeding this point. Most or all of the turmoil was due to estrogen changes and diagnostic inaccuracies just like you are talking about, plus ineffective and sometimes detrimental medication. It feels like I just am always waiting for the other shoe to drop, where something will change and some doctor won't listen or else does listen but still doesn't know how or doesn't want to help me.

[flowersunshinemtn]

I’ve experienced and read about ADHD becoming more obvious for women in menopause. I’m now looking back and I see adhd throughout my life but it did not negatively impact —I had a lot of good coping skills and a hi iq but it is very negatively impacting for past five years! I’ve also read about the challenge of dx adhd in hi achieving kids. I’d say I was a hi achiever and post grad I’ve very underperformed and either avoided jobs requiring what I’m unable to do or failed at jobs with too much responsibility and need for follow through and detail work.
It seems to me that menopause made me lose all my exec fxn and coping skills. Seems more likely to be ADHD revealed than just aging. I’m YOUNG, at 55.

[claravitale]

I was diagnosed by a teacher friend, and treated by the Psychiatrist that treated my depression and PTSD.
I slept almost 24 hours on Concerta, even now I get drowsy sleepy, my mind so rested!!!
My self steem was nil.

[parscreationsstapp]

I got diagnosed officially at the tail end of getting my Master's degree. I was in my 40s. I feel as if my ability to learn, retain, and remember things, have diminished greatly. I have always had difficulty, so I don't know if it is, or if I worry about it more due to getting older.

[yarntoast]

On the mention of primary physicians being prescribers in the US, I have a better relationship with my primary and he is far more accessible than psychiatrists through my HMO, Kaiser. I also see that ADHD is physiological, not psychological, now that I have started medication. I’ve spent my life trying to will and think myself out of what was ultimately a missed diagnosis and my first day of stimulant medication showed me that it was never a matter of willpower, though, or trying harder.

[richardmarshall]

Thank you Doc, I hope to see you soon👍

[ANNEMARGARET]

And thank you for saying the part about distinguishing what you have with who you are. ❤️

[NotSoNormal]

I did do telehealth when I got diagnosed for adhd. And I was initially booked for an hour long apointment. I only got seen because I was getting my son seen and we seemed to have a lot in common as far as the struggles we have. Telehealth makes it much easier to have apointments. I don't have to worry about getting child care for instance. But I also went in open to what the psychiatrist had to say. I wanted screened for adhd. But I what I was after was the right diagnosis so whatever was the apropriate treatment was what I got. Since my diagnosis, I take my adhd meds daily. And I go to therapy to learn skills to manage my adhd in daily life. Pills don't give you skills after all. But they do make it easier to learn those skills that us adhd'rs struggle with. I think that a lot of women are finally being diagnosed after being overlooked in childhood. And that might account for some of the increases in diagnosises. I'm not sure why I was overlooked when my childhood symptoms seem so obvious. But when I was young a lot of people didn't think girls had adhd.

I'd say that when my meds are in my system, it almost feels like my brain has a filter when it didn't before. I can organize my thoughts more easily. And every little thing doesn't distract me any more. I also find my meds to be highly beneficial when I'm driving. I've always been anxious about driving since my ability to maintain focus on things has been suspect. But my meds make it much easier to pay attention and keep track of what's happening on the road.
There are so many little daily things that adhd effects. And I'm thankful for meds that make it easier to tackle those hurdles. And I'm thankful for therapy to teach me how to get started and through tasks that seem daunting.

[archiebunker]

Valuable information and excellent presentation.

[GliderTown]

Very helpful and informative information and not sleep inducing at all. Thank you!

[hanskraut]

Thank u for the lecture.

Everyone i recommend the adhd science channel playlist from russel barkley like crazy if ur very impressed here your head will explode once you watch that (he is cited a lot not some pseudo science guy, respected)

[johndeal]

I am 66. I've been treated for depression and anxiety all my adult life. I haven't been able to hold down jobs and ended up on disability. I believe, after watching your video, I have suffered from ADHD my entire life. My psychiatrist is not open to the idea and continues to treat me with Prozac and klonopin. I have always been ambitious but have not known what to do with my life. I can't concentrate to read a book or newspaper, as my mind just wanders off. Sometimes I think I have a brain tumor. I'm going to see a neurologist. Can he diagnose ADHD?

[johneaston]

As is the case the divergence (I avoid the term "disorder") runs in my family and my sister was diagnosed with ADHD and Aspergers decades ago before across-the-board awareness and efficacious treatment were widely available. Given a number of challenges I had in school at the time (focus, working memory, masking, etc.) I suspected I might have it as well but my incredibly stressed single-parent mother angrily and quickly shut me down. Fast forward 30 years my daughter was diagnosed in elementary school with an extreme inattentive/hyperactive presentation. Intellectually I know I should get evaluated but emotionally therapy of any type is extremely triggering for me to the point of inaction.

[johnries]

Curiously enough, I've never been able to remember sequences of digits, except by repeatedly using them (but I am diagnosed with ADHD).