Attention deficit hyperactivity disorder (ADHD) doesn’t fade as we get older, it evolves. October marks ADHD Awareness Month, a time to shed light on a neurodevelopmental condition that affects focus, impulse control and energy levels, and can continue to impact people well into later life.
For many, symptoms that once felt manageable can intensify with age, particularly as natural cognitive decline, health challenges, and retirement disrupt long-established routines. Despite this, ADHD in older adults remains under-researched, underdiagnosed, and often mistaken for other age-related conditions.
The result is a generation of older people living with untreated ADHD, facing challenges that affect their relationships, finances, and overall wellbeing. It’s time we recognised that ADHD isn’t just a childhood condition; it’s a lifelong one.
How ADHD Changes with Age
Research shows that ADHD symptoms shift throughout life. In older adults, the hyperactivity that defined childhood years may transform into restlessness or racing thoughts. Forgetfulness, disorganisation, and emotional volatility often become more pronounced, particularly when daily structure decreases after retirement.
Many describe experiencing “Swiss cheese memory”: moments when recall feels unreliable, or words and names simply vanish. Others notice difficulties staying focused, following conversations, or completing everyday tasks. These challenges can lead to frustration, social withdrawal, and feelings of inadequacy, especially for those who’ve spent decades masking their symptoms or developing coping mechanisms.
Distinguishing ADHD from cognitive decline or dementia is one of the biggest diagnostic challenges in later life. Symptoms like memory lapses, poor time management, and disorganisation can resemble mild cognitive impairment (MCI).
Because most diagnostic tools are designed for children and younger adults, older patients are often misdiagnosed. Even those with a lifelong history of attention difficulties may find their symptoms dismissed as just ageing. In reality, ADHD can coexist with cognitive decline, making a thorough and specialist assessment essential.
Clinicians should explore symptom history across the lifespan and consider family patterns since ADHD is highly hereditary, often running across generations. A diagnosis can help older adults access support that dramatically improves quality of life.
Why Diagnosis Is Often Missed
Few medical professionals are trained to recognise ADHD in adults over 60. In fact, many general practitioners receive less than half an hour of ADHD education during their entire medical training, and most of it focuses on children.
Older adults often present differently. They may not recall when symptoms began, or may have built lifestyles that hide their difficulties. Without appropriate screening tools for seniors, these individuals remain invisible to the healthcare system.
To bridge this gap, healthcare providers must learn to recognise ADHD presentations unique to later life and develop age-appropriate diagnostic frameworks. Medication remains the cornerstone of ADHD treatment, even for older adults. However, clinicians must consider factors like heart health and interactions with other medicines before prescribing stimulants. Non-stimulant medications can offer an alternative for those unable to tolerate standard treatments.
Beyond medication, psychological therapies such as cognitive behavioural therapy (CBT), coaching, and mindfulness training can help individuals manage impulsivity, improve organisation, and rebuild self-esteem. Practical strategies like maintaining structured routines, using visual reminders, and seeking support from family or carers can also make a significant difference. Regular exercise, a balanced diet, and sufficient sleep play vital roles in regulating focus and mood.
Importantly, emotional support is just as crucial. Many older adults with ADHD have lived through years of misunderstanding or self-blame. Connecting with peer support groups or mental health professionals can help foster self-acceptance and confidence.