Functioning and mood of older adults with elevated genetic risk for attention-deficit/hyperactivity disorder

Too little is known about the mood and functioning of older adults at elevated risk for attention deficit/hyperactivity disorder (ADHD). We aimed to examine the clinical characteristics of individuals aged 65 + years with higher polygenic risk scores (PRS) for ADHD.

A population-based cohort of 1471 dementia-free adults with median age 72 years.

We calculated the ADHD-PRS and examined its cross-sectional associations with Clinical Dementia Rating (CDR), and individual CDR domains, depression and anxiety scores, individual depression symptoms, independence in everyday activities of daily living (ADL) and instrumental ADL (IADL), self-rated health.

After adjusting for covariates, a one-unit increase in the ADHD-PRS was significantly associated with mild cognitive impairment (CDR=0.5) in the overall CDR rating and specifically in the memory and judgment/problem-solving domains. Higher ADHD-PRS was also associated with worse self-rated health and greater difficulty independently carrying out ADLs and IADLs. In exploratory item-level analyses, associations with poor appetite and difficulty focusing lost significance after False Discovery Rate (FDR) adjustment.

In this population-based sample of older adults, greater genetic risk for ADHD was associated with higher odds of mild cognitive impairment, difficulty with memory and judgment/problem-solving, worse self-rated health, difficulty in performing ADLs and IADLS, poor appetite and difficulty focusing. The presence of these difficulties in an older population highlights a need for greater recognition of the long-term impact of ADHD on cognitive and functional wellbeing across the lifespan.