An underdiagnosed condition in older adults could pose driving hazards

Key points:

• Research found that significant functional impairment and health issues associated with ADHD may persist throughout the lifespan, yet ADHD has been largely understudied in older adults

• ADHD was associated with a 102 percent increased risk of traffic ticket events in older drivers

• The social and economic burden of ADHD in Australia is estimated to be over $20 billion dollars per year

In a study on the prevalence of attention-deficit/hyperactivity disorder, commonly referred to as ADHD, researchers found that older adult drivers with the condition are at a significantly elevated crash risk compared to their counterparts.

Older adult drivers were more than twice as likely as their counterparts without ADHD to report being involved in traffic ticket events and vehicular crashes.

Study participants were active drivers aged 65 to 79 years who were enrolled during 2015 and 2017 in the Longitudinal Research on Ageing Drivers — LongROAD project. Of the 2,832 drivers followed for up to 44 months through in-vehicle data recording devices and annual assessments, 75 had ADHD. The data analysis was performed between July of 2022 and August, 2023.

Guohua Li, MD, DrPH, senior author of the study and professor of epidemiology at Columbia Public Health, said the study made two notable contributions to research on healthy ageing.

“The research fills a gap in epidemiologic data on ADHD among older adults and provides compelling evidence that older adult drivers with ADHD have a much higher crash risk than their counterparts without ADHD.”

ADHD was associated with a seven percent increased risk of hard-braking events, a 102 percent increased risk of self-reported traffic ticket events and a 74 percent increased risk of self-reported vehicular crashes.

Lead author Yuxin Liu, MPH, said that greater awareness of and treatment for older adults with the condition was needed.

“Our findings suggest that effective interventions to improve the diagnosis and clinical management of ADHD among older adults are warranted to promote safe mobility and healthy ageing,” Liu said.

Approximately one in every 20 Australians has ADHD

ADHD Australia has stated that 75 percent of people with ADHD remain undiagnosed

World-leading experts have also cautioned that people over the age of 50 have been ‘overlooked’ by doctors for diagnosis and treatment.

In the peer-reviewed journal Expert Review of Neurotherapeutics, researchers reviewed almost 100 studies to determine how common ADHD is among older adults. According to the report, clinicians face a significant challenge because some medical conditions that older adults experience have symptoms that are similar to ADHD symptoms. For instance, memory decline that occurs during menopause can be confused with ADHD.

The team’s analysis supported the theory that ADHD is linked with mental health issues, increased death rates and illnesses, such as cardiovascular disease and dementia.

“Our analysis concludes that better approaches are urgently required to screen and diagnose people aged from around age 50 to 55,” said lead author Dr Maja Dobrosavljevic from the University of Orebro, in Sweden.

“As we gain deeper insights into the challenges faced by older adults living with ADHD, a comprehensive and tailored approach is crucial for their well-being.

“We therefore urge the medical community, researchers and policymakers to collaborate in refining diagnostic criteria, treatment guidelines and research initiatives that are inclusive of all age groups affected by ADHD.”

Do you live with ADHD? If so, how do you feel about driving and have you ever had an accident on the road? Let the team at Talking Aged Care know and subscribe to the newsletter to learn more!

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