Is it Aging or is it ADHD? What ADHD Can Look Like in Older Adults

By Jessica Flannery, PhD

ADHD Management

Grey-haired mature caucasian woman meditating at home

Did I forget what I was doing because I’m getting older, or did I forget because of my ADHD? As we age, sometimes it can be difficult to disentangle a regular sign of aging from a symptom of ADHD. Although ADHD is not a disorder believed to appear in later adulthood, symptoms can feel more prominent at different stages of life. As signs of aging increase, it’s possible common signs of aging can mimic or even worsen symptoms of ADHD. Understanding if it’s aging or ADHD can be particularly difficult for people that may have never been diagnosed with ADHD. In fact, older adults are more likely to be underdiagnosed with ADHD, particularly adult women

Cognition and Aging 

ADHD symptoms can be difficult to differentiate from some expected level of memory or attentional decline with aging, particularly for generations that were often not diagnosed with ADHD as a child. While aging can inevitably bring about alterations in cognition, the impact can vary across cognitive domains. For example, speech and language are types of cognition that are generally preserved with age. In contrast, processing speed, attention, and executive functioning are types of cognition that do typically decline with age. Importantly, these same areas of cognition that slow a bit as people age—processing speed, attention, and executive functioning— are the ones that can influence ADHD symptoms!
Some signs of normal aging that overlap with or mimic signs of ADHD in older adults:

Cognitive AreaNaturally Declines with AgeAssociated Challenges with ADHDSigns of Aging May Worsen ADHD Symptoms
Executive Function: A set of cognitive processes responsible for goal-directed behavior, such as planning, organizing, problem-solving, inhibiting impulses, and regulating emotions.YesYesNo
Processing Speed: The measure of how quickly someone can perceive, understand, and respond to incoming information or stimuli.YesYesNo
Working Memory: Temporarily holding and manipulating information needed to execute tasks.YesYesNo
Prospective Memory: The ability to remember to perform intended actions or tasks in the future, at a specific time or in a specific context.YesYesNo
Source Memory: The ability to remember where you learned information. Was it from a friend or from a news program?YesNoYes
Declarative or “Explicit” Memory: The ability to recall facts, events, and concepts.YesNoYes
Spontaneous Recall: The ability to retrieve information from memory without prompts or choice options.YesNoYes
Divided Attention: The ability to focus on and process multiple tasks or stimuli simultaneously.YesYesNo
Selective Attention: The ability to focus on specific stimuli while ignoring other stimuli.YesYesNo
Speech Discrimination: The ability to distinguish what someone said from background noises.YesNoYes
Hearing: The ability to hear sounds of different pitches and loudness.YesNoYes

Note: All these cognitive areas that can naturally decline with age can also mimic or worsen symptoms of ADHD. While ADHD is not associated with speech difficulties or hearing loss, difficulties distinguishing or hearing sounds can mimic or worsen signs of ADHD, such as difficulty sustaining attention or remembering information from a conversation. ADHD difficulties with sustained attention can also mimic or worsen age-related changes in source memory, declarative memory, and spontaneous recall.

Treatment Considerations

Not everyone will experience the same symptoms of aging or ADHD, or the same severity or impairment of symptoms. If you are experiencing some of these symptoms, consult with your healthcare provider to better understand which symptoms may be ADHD, aging, or a combination. You may just think it’s all normal aging that you cannot change. But sometimes ADHD can make these symptoms worse or harder. Older adults are less likely to have been previously diagnosed with ADHD as a child, making this distinction more difficult. We cannot change aging, but we can help manage ADHD symptoms. If you are experiencing untreated or undiagnosed symptoms of ADHD, some symptoms could improve. 

About the Author

  • Jessica E. Flannery, PhD is the Associate Director of Clinical Science at Akili. She is a clinical licensed psychologist, an ADHD-Certified Clinical Services Provider (ADHD-CCSP), and a developmental social neuroscientist. She has published over 50 peer-reviewed articles, received prestigious fellowships and awards and is a prior TEDx speaker.