Attention Deficit Hyperactivity Disorder Symptoms and Cognitive Decline in the Late-Life Cohort of Diabetic Patients

Background: Attention Deficit/Hyperactivity Disorder (ADHD) has not been well studied in older adults. Although majority of adults with ADHD have at least one lifetime psychiatric co-morbidity including anxiety, mood disorder and substance use disorder, the association with cognitive decline is not well understood. As well as the influence of ADHD on self-management of chronic disease, like diabetes, in elderly. In our study we examined relationships between ADHD symptoms, cognitive function and glycemic control in older-age (60–85 years) diabetic adults.

Methods: Total number of 250 elderly diabetic patients, enrolled with Leumit Health Services, underwent screening for ADHD, mood disorder and cognitive decline. ADHD symptoms were assessed using the Adult ADHD Self-Report Scale (ASRS). Symptoms of depression, general anxiety and cognitive dysfunction were assessed using the Patient Health Questionnaire (PHQ), Generalized Anxiety Disorder Questionnaire (GAD) and Montreal Cognitive Assessment (MoCA) respectively.

Results: ASRS screening revealed relatively high ADHD prevalence among elderly diabetics- 7.2%. Patients with ADHD were slightly younger, mean age was 67.7 years(CI 61.3; 73.9) vs. 73.2 (CI 72.3; 74.6).Although, higher ADHD symptoms were slightly associated with poorer cognitive performance this association wasn't statistically significant. Mean MoCA score was 21.2(18.6; 23.8) vs. 23.6(CI 22. 24.4) respectively. Patients with higher ASRS score have poorer glycemic control: HgbA1c was 8.9(CI 8.2; 9.5) vs. 7.5(CI 7.4; 7.6) respectively and had increased risk for hospitalization-risk ratio 1.27(CI 0.30; 4.6).

Conclusion: ADHD prevalence is relatively high among elderly diabetic patients and associated with poor glycemic control and higher risk for hospitalization.