Study links childhood ADHD to increased health problems in later life
There is a growing understanding that people with attention-deficit/hyperactivity disorder (ADHD) disproportionately face a number of health challenges over the course of their lives, including metabolic disorders, cardiovascular disease, suicidal behaviour, higher rates of smoking and alcohol use, and premature death.
In a new study, researchers from UCL and the University of Liverpool have shown that children with ADHD traits at age 10 are more likely than their peers to experience physical health problems later in life.
Led by Dr Amber John at UCL, whose research is funded by the Foundation and supported by Advent*, the study is one of the largest to look at childhood ADHD traits and later health outcomes.
People with ADHD experience differences in how they focus their attention and/or increased hyperactivity and impulsivity. They can often have high energy and an ability to focus intensely on what interests them, but they may find it difficult to focus on mundane tasks. This can lead to more impulsiveness, restlessness, and differences in planning and time management, which may make it harder to succeed at school and work, leading to longer-term challenges.
ADHD begins in childhood, and although it is now understood to persist into adulthood, the condition remains under-treated in adults in the UK compared to other high-income countries.
Senior author of the JAMA Network Open-published study, Professor Joshua Stott (UCL Psychology & Language Sciences), says:
“Here we have added to the concerning evidence base that people with ADHD are more likely to experience worse health than average across their lifespan.
People with ADHD can thrive with the right support, but this is often lacking, both due to a shortage of tailored support services but also because ADHD remains underdiagnosed, particularly in people in midlife and older, with needs unaddressed.”
"Providing the right support for and meeting the needs of people with ADHD can help to improve their physical and mental health outcomes."Dr Amber John
University of Liverpool and UCL
While ADHD has long been linked to various health risks, most research to date has focused on children and young adults. Where studies have examined health outcomes for middle-aged and older adults with ADHD, they have often focused on people with a formal diagnosis. As ADHD is widely underdiagnosed, relying on diagnosis alone could skew results.
For this study, researchers analysed data from 10,930 participants of the UCL-led 1970 British Cohort Study - a large longitudinal study that has followed people from birth into middle age.
ADHD traits, regardless of diagnosis, were identified using child behaviour questionnaires completed by parents and teachers when participants were 10 years old.
The team found that people with high scores on this index of ADHD traits at age 10 were more likely to have other health conditions by age 46. In fact, they had 14% higher odds of reporting two or more physical health problems such as migraine, back problems, cancer, epilepsy or diabetes. Among those with high ADHD traits in childhood, 42% had two or more health problems in midlife, compared to 37% of those without high ADHD traits.
People with high ADHD traits at age 10 were also more likely to report physical health-related disability at age 46, defined as having problems with work or other daily activities as a result of their physical health.
These findings suggest that poorer health outcomes may be partly explained by higher rates of mental health problems, increased body mass index (BMI) and higher smoking rates among people with ADHD. Evidence also shows that people with ADHD are more likely to experience stressful life events and social exclusion, and are less likely to receive timely access to medical care.
A study published last year by the same research group reported an apparent reduction in life expectancy for adults with diagnosed ADHD, although this was not examined in the current study.
Through their latest study, the researchers add to existing evidence by highlighting the importance of a life-course perspective on ADHD and its associated health inequalities. The findings emphasise the need for both early detection and ongoing support for people with ADHD across the lifespan. They also underline the need for clinicians to be more aware of physical health problems in people with ADHD, as well as the potential barriers to attending routine screening programs like cervical cancer screening and diabetes checks.
Lead author, Dr Amber John, explains,
“It’s important to note that people with ADHD are a diverse group, with a range of different strengths and experiences, and most will lead long, healthy lives.
However, many face significant barriers to timely diagnosis and appropriate support. This is important because providing the right support for and meeting the needs of people with ADHD can help to improve their physical and mental health outcomes.
Additionally, public health strategies should consider the needs of people with ADHD, such as by making screening programmes and ongoing health monitoring more accessible for people with ADHD.”
*Advent is a leading global private equity firm, which raised £300,000 to support vital research into neglected mental health and child cancer pain.