Does ADHD at 74 make cognitive decline hard to distinguish?

Question

Hi doctor,

I am a 74-year-old man with ADHD (attention deficit hyperactivity disorder) and sometimes struggle figuring out what is ADHD versus normal aging. I have always been distractible and forgetful, but lately I question whether some memory problems are simply getting older or something else.

I still lose track of conversations and misplace things, but now I am more aware of cognitive changes because of age, too.

Does ADHD in older adults make cognitive decline or normal aging changes harder to recognize, and how do doctors usually tell the difference?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand the concern.

It can be challenging to distinguish between long-standing ADHD (attention deficit hyperactivity disorder) symptoms and age-related cognitive changes, especially in older adults. Many symptoms of ADHD, such as

Forgetfulness.
Distractibility.
Losing track of conversations.
Difficulty organizing tasks.
Frequently misplacing items.

All these can look similar to the early signs of cognitive decline.

The key difference is that ADHD symptoms are usually lifelong and have been present since childhood or early adulthood. In contrast, cognitive decline typically involves a noticeable worsening of memory and thinking abilities compared to a person's previous level of functioning.

With increasing age, the chances of mild or major cognitive decline and dementia increase significantly.

Warning signs that may suggest cognitive decline include

Difficulty managing finances.
Getting lost in familiar places.
Repeatedly asking the same questions.
Forgetting the names of close relatives or friends.
Struggling with daily activities.
Having trouble planning or making decisions.

Doctors usually differentiate the two conditions by taking a detailed history, assessing when symptoms started, and evaluating whether there has been a recent decline. Cognitive screening tools such as the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) can be very helpful. Additional tests may be recommended if needed.

I hope this information helps you.

Thank you.