Is it Dementia or Adult ADHD?

Ginny is a 58-year-old widow who struggles each day with where she puts her keys, her cell phone, her purse, and even sometimes her coffee cup after she fills it with coffee. She often has trouble following conversations, and after about 15 minutes, she doesn’t remember much of what was said at all.

After observing his mother’s bouts of forgetfulness, Ginny’s son Trevor became very concerned and insisted that she make an appointment with a neurologist immediately. Trevor was diagnosed with attention deficit hyperactivity disorder (ADHD) as a child, but since his mother was already in her late 50’s, his internet research pointed him to concerns that she could be in the beginning stages of dementia and, of course, he became alarmed.

During the examination, the doctor asked Ginny about her school days as a teenager. She recalled that she had trouble paying attention to the teacher, did poorly on tests because she couldn’t sit still, and was always forgetful when it came to her keys, remembering people’s names, and knowing where her car was parked. After interviewing her extensively, and noting the presence of patterns of impairment that spanned throughout her lifetime and her son’s diagnosis of ADHD, the doctor did not think Ginny had dementia. He diagnosed her with ADHD! She was surprised that she didn’t realize this about herself until now, and relieved that he didn’t think she had dementia.

Adult ADHD vs. Dementia

Once seen as a disorder affecting mainly children and young adults, it has been found that ADHD can last throughout one’s lifetime (with 30% to 70% of children with ADHD continuing to have symptoms when they grow up.) In addition, people who were never diagnosed as kids may begin to develop more obvious symptoms in adulthood. Many adults, such as Ginny in our example, don’t realize they have ADHD, leaving them mystified about why they are so forgetful all of a sudden.

To explore further, let’s look at the symptoms of adult ADHD versus the symptoms of dementia, to see how they are different.

Symptoms of Adult ADHD

• Running Late: Adults may be chronically late for work or important events.
• Risky Driving: One of the hallmarks of ADHD is difficulty keeping your mind on the task at hand. Studies show that people with ADHD are more likely to speed, have accidents, and lose their drivers’ licenses.
• Distraction: Adults with ADHD may have trouble prioritizing, starting, and finishing tasks. They tend to be disorganized, restless, and easily distracted. Some people with ADHD have trouble concentrating while reading.
• Outbursts: Adults with ADHD may have problems with self-control. This can lead to difficulty controlling anger, impulsive behaviors, and blurting out rude or insulting thoughts.
• Hyper Focus: Some adults with ADHD can focus intently on things they enjoy or find interesting. But they struggle to pay attention to tasks that bore them. The trouble is that many tasks necessary for success in everyday life are dull, from making a grocery list to filing documents at work. People with ADHD tend to put off boring tasks in favor of more enjoyable activities.

Symptoms of Dementia

You will see from the list below that dementia is very different, and far more severe than ADHD. According to the Alzheimer’s Association, while symptoms of dementia can vary greatly, at least two of the following core mental functions must be significantly impaired to be considered dementia:

• Memory: In the earlier stages of dementia, memory loss and confusion may be mild, while in the later stages, memory loss becomes far more severe.
• Communication and language:  In the early stages of dementia, the person’s communication may not seem very different or he or she might repeat stories or not be able to find a word. As the disease progresses, it can get a lot worse with easily losing train of thought, having difficulty organizing words logically, and more.
• Ability to focus and pay attention: Although functionally separate from memory, problems with attention can also impact on a person with dementia’s ability to learn or recall information.
• Reasoning and judgment: The ability to exercise judgment, weigh facts, and organize and sequence information is progressively affected.
• Visual perception: As there are many different stages involved in the seeing process, various types and combinations of mistakes can occur including illusions (distortion of reality), misperceptions (distorted information), and misidentifications (distinguishing between a son, husband, or brother may become difficult.)For more details on dementia and Alzheimer’s symptoms, please visit the Alzheimer’s Association Website. 

ADHD May be Overlooked in Seniors

According to Dr. Thomas Brown, associate director of the Yale Clinic for Attention and Related Disorders at the Yale School of Medicine, “Most doctors are not thinking of ADHD as a characteristic of somebody who is 60 or over.” Hence, the condition may be overlooked in the 80-year-old who has trouble staying engaged at the senior center, despite a lifelong history of inattention. “They figure it’s just cognitive decline from aging” or diagnose depression or anxiety in such patients, which may or may not be the case, he said.

Can ADHD Cause Dementia?

Adults with symptoms of ADHD are more than three times as likely as other adults to develop Lewy Body Dementia (LBD) later in life, according to new research from Argentina. LBD symptoms include cognitive impairment, in addition to visual hallucinations, fluctuation in cognition, and motor abnormalities similar to those in Parkinson’s disease patients.

To conduct the study, researchers evaluated 360 patients with dementia — 109 had LBD and 251 had a non-LBD type of dementia — comparing them with 149 healthy people matched by sex, education, and age. They looked at how often ADHD symptoms had been reported earlier in the person’s life. In patients who were too impaired to answer, they got information from an informant who had known the patient for at least 10 years and had information from a close relative who knew the patient in childhood.

They found:

• A whopping 47.8% of those with LBD had previous ADHD symptoms.
• Only 15.2% of those with other types of dementia had previous ADHD symptoms.

A U.S.-based expert cautions that although the study found an association between ADHD symptoms and Lewy Body Dementia, that it is not necessarily a cause and effect. “It may be that both of these disorders are linked to some other risk factor that is common for both,” says James B. Leverenz, MD. Other experts believe that these studies are inherently flawed, as people must recall their histories or those of loved ones, and that the next step is replication of the findings by other researchers.

Adult ADHD or Something Else?

If you are often restless and have trouble concentrating, don’t jump to the conclusion that you have ADHD. These symptoms are also common in other conditions. Poor concentration is a classic sign of depression. Restlessness or anxiety could indicate an overactive thyroid or anxiety disorder. And, as you can see from the distinctions listed above, forgetfulness could be a sign of dementia. Your health care provider can investigate whether these conditions could be causing your symptoms instead of — or in addition to – ADHD. So if you are concerned, be sure to check with your doctor.
If you or a loved one has ADHD.

Common conditions that can coexist with ADHD include learning disabilities, Oppositional Defiant Disorder, Conduct Disorder, Anxiety and Depression, and Bipolar Disorder. The term “special needs” is used to collectively define those persons that require assistance due to physical, mental, behavioral, or medical disabilities or delays, including those mentioned. If your loved one has special needs that impact his or her independence, find out more about Special Needs Trusts, a vehicle that provides assets from which a disabled person can maintain his or her quality of life, while still remaining eligible for needs-based programs, such as Medicaid, that will cover basic health and living expenses.

If you or a loved one has dementia

Persons with dementia and their families face special legal and financial needs. At The Law Firm of Evan H. Farr, P.C., we are dedicated to easing the financial and emotional burden on those suffering from dementia and their loved ones.  We help protect your family’s assets while maintaining your loved one’s comfort, dignity, and quality of life by maintaining eligibility for vital government benefits such as Medicaid and Veterans Aid and Attendance.

Fairfax Dementia Planning: 703-691-1888
Fredericksburg Dementia Planning: 540-479-1435
Rockville Dementia Planning: 301-519-8041
DC Dementia Planning: 202-587-2797