Objective:This study aimed to investigate the association between adults with ADHD and the risk of developing dementia. Method: Utilizing National Health Insurance Research Database of Taiwan, ADHD patients were identified and compared with age- and gender-matched controls (1:3). Results: Of the study participants, 37 (5.48%) developed dementia compared with 81 (4.0%) in the control group. Cox proportional hazards regression analysis revealed that the study participants were more likely to develop dementia. The crude hazard ratio (HR) is 3.418 (95% confidence interval [CI] = [2.289, 5.106], p < .001), and adjusted HR is 4.008 (95% CI = [2.526, 6.361], p < .001) in risk of developing dementia after adjusted for age, gender, comorbidities, geographical area of residence, urbanization level of residence, and monthly income. Conclusion: Adults with ADHD have a 3.4-fold risk of developing dementia, and other large or national data sets should be explored to support the current findings.
AloscoM. L.FedorA. F.GunstadJ. (2014). Attention deficit hyperactivity disorder as a risk factor for concussions in NCAA division-I athletes. Brain Injury, 28, 472-474.
2.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
3.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
4.
BalintS.BitterI.CzoborP. (2015). [Neurobiological correlates of cognitive flexibility in ADHD-A systematic review of the literature]. Psychiatria Hungarica, 30, 363-371.
5.
Ben-ItzhakR.GiladiN.GruendlingerL.HausdorffJ. M. (2008). Can methylphenidate reduce fall risk in community-living older adults? A double-blind, single-dose cross-over study. Journal of the American Geriatrics Society, 56, 695-700.
6.
BiedermanJ.SpencerT. (1999). Attention-deficit/hyperactivity disorder (ADHD) as a noradrenergic disorder. Biological Psychiatry, 46, 1234-1242.
7.
ChangC. Y.ChenW. L.LiouY. F.KeC. C.LeeH. C.HuangH. L.. . . LinY. R. (2014). Increased risk of major depression in the three years following a femoral neck fracture—A national population-based follow-up study. PLoS ONE, 9(3), e89867
8.
ChangZ.LichtensteinP.D’OnofrioB. M.SjolanderA.LarssonH. (2014). Serious transport accidents in adults with attention-deficit/hyperactivity disorder and the effect of medication: A population-based study. JAMA Psychiatry, 71, 319-325.
9.
ChenM. H.ChenY. S.HsuJ. W.HuangK. L.LiC. T.LinW. C.. . . BaiY. M. (2015). Comorbidity of ADHD and subsequent bipolar disorder among adolescents and young adults with major depression: A nationwide longitudinal study. Bipolar Disorders, 17, 315-322.
10.
ChenM. H.SuT. P.ChenY. S.HsuJ. W.HuangK. L.ChangW. H.. . . BaiY. M. (2014). Higher risk of mood disorders among adolescents with ADHD and asthma: A nationwide prospective study. Journal of Affective Disorders, 156, 232-235.
11.
ChengC. L.KaoY. H.LinS. J.LeeC. H.LaiM. L. (2011). Validation of the National Health Insurance Research Database with ischemic stroke cases in Taiwan. Pharmacoepidemiology and Drug Safety, 20, 236-242.
12.
ChienW. C.ChungC. H.LinF. H.YehC. B.HuangS. Y.LuR. B.. . . TzengN. S. (2017). The risk of injury in adults with attention-deficit hyperactivity disorder: A nationwide, matched-cohort, population-based study in Taiwan. Research in Developmental Disabilities, 65, 57-73.
13.
Chinese Hospital Association. (2000). ICD-9-CM English-Chinese Dictionary. Taipei, Taiwan: Chinese Hospital Association Press.
14.
ChouI. C.LinH. C.LinC. C.SungF. C.KaoC. H. (2013). Tourette syndrome and risk of depression: A population-based cohort study in Taiwan. Journal of Developmental & Behavioral Pediatrics, 34, 181-185.
15.
ChuangC. S.LinC. L.LinM. C.SungF. C.KaoC. H. (2013). Migraine and risk of dementia: A nationwide retrospective cohort study. Neuroepidemiology, 41, 139-145.
16.
CorteseS.FerrinM.BrandeisD.BuitelaarJ.DaleyD.DittmannR. W.. . . European ADHD Guidelines Group. (2015). Cognitive training for attention-deficit/hyperactivity disorder: Meta-analysis of clinical and neuropsychological outcomes from randomized controlled trials. Journal of the American Academy of Child & Adolescent Psychiatry, 54, 164-174.
17.
CoulthardE.Singh-CurryV.HusainM. (2006). Treatment of attention deficits in neurological disorders. Current Opinion in Neurology, 19, 613-618
18.
CraigF.MargariF.LegrottaglieA. R.PalumbiR.de GiambattistaC.MargariL. (2016). A review of executive function deficits in autism spectrum disorder and attention-deficit/hyperactivity disorder. Neuropsychiatric Disease and Treatment, 12, 1191-1202.
19.
DalsgaardS.LeckmanJ. F.MortensenP. B.NielsenH. S.SimonsenM. (2015). Effect of drugs on the risk of injuries in children with attention deficit hyperactivity disorder: A prospective cohort study. Lancet Psychiatry, 2, 702-709.
20.
DalsgaardS.LeckmanJ. F.NielsenH. S.SimonsenM. (2014). Gender and injuries predict stimulant medication use. Journal of Child and Adolescent Psychopharmacology, 24, 253-259.
21.
DeberdtW.ThomeJ.LebrecJ.KraemerS.FregenalI.Ramos-QuirogaJ. A.ArifM. (2015). Prevalence of ADHD in nonpsychotic adult psychiatric care (ADPSYC): A multinational cross-sectional study in Europe. BMC Psychiatry, 15, 242
22.
DopfnerM.BreuerD.WilleN.ErhartM.Ravens-SiebererU. (2008). How often do children meet ICD-10/DSM-IV criteria of attention deficit-/hyperactivity disorder and hyperkinetic disorder? Parent-based prevalence rates in a national sample—Results of the BELLA study. European Child & Adolescent Psychiatry, 17(Suppl. 1), 59-70.
23.
FuhJ. L.WangS. J. (2008). Dementia in Taiwan: Past, present, and future. Acta Neurologica Taiwanica, 17, 153-161.
24.
GauS. S.ChongM. Y.ChenT. H.ChengA. T. (2005). A 3-year panel study of mental disorders among adolescents in Taiwan. The American Journal of Psychiatry, 162, 1344-1350.
25.
GolimstokA.RojasJ. I.RomanoM.ZurruM. C.DoctorovichD.CristianoE. (2011). Previous adult attention-deficit and hyperactivity disorder symptoms and risk of dementia with Lewy bodies: A case-control study. European Journal of Neurology, 18, 78-84.
26.
GoulardinsJ. B.RigoliD.LicariM.PiekJ. P.HasueR. H.OosterlaanJ.OliveiraJ. A. (2015). Attention deficit hyperactivity disorder and developmental coordination disorder: Two separate disorders or do they share a common etiology. Behavioural Brain Research, 292, 484-492.
27.
Ho ChanW. (2010). Taiwan’s healthcare report 2010. The EPMA Journal, 1, 563-585.
28.
HuangS. W.WangW. T.ChouL. C.LiaoC. D.LiouT. H.LinH. W. (2015). Osteoarthritis increases the risk of dementia: A nationwide cohort study in Taiwan. Scientific Reports, 5, Article 10145.
29.
IlieG.VingilisE. R.MannR. E.HamiltonH.ToplakM.AdlafE. M.. . . CusimanoM. D. (2015). The association between traumatic brain injury and ADHD in a Canadian adult sample. Journal of Psychiatric Research, 69, 174-179.
30.
LaheyB. B.PelhamW. E.ChronisA.MassettiG.KippH.EhrhardtA.. . . LeeS. S. (2006). Predictive validity of ICD-10 hyperkinetic disorder relative to DSM-IV attention-deficit/hyperactivity disorder among younger children. Journal of Child Psychology and Psychiatry, 47, 472-479.
31.
LeeM. J.YangK. C.ShyuY. C.YuanS. S.YangC. J.LeeS. Y.. . . WangL. J. (2016). Attention-deficit hyperactivity disorder, its treatment with medication and the probability of developing a depressive disorder: A nationwide population-based study in Taiwan. Journal of Affective Disorders, 189, 110-117.
32.
LeeS. I.SchacharR. J.ChenS. X.OrnsteinT. J.CharachA.BarrC.IckowiczA. (2008). Predictive validity of DSM-IV and ICD-10 criteria for ADHD and hyperkinetic disorder. Journal of Child Psychology and Psychiatry, 49, 70-78.
33.
LeeY. K.HouS. W.LeeC. C.HsuC. Y.HuangY. S.SuY. C. (2013). Increased risk of dementia in patients with mild traumatic brain injury: A nationwide cohort study. PLoS ONE, 8(5), e62422
34.
LiangJ. A.SunL. M.MuoC. H.SungF. C.ChangS. N.KaoC. H. (2011). The analysis of depression and subsequent cancer risk in Taiwan. Cancer Epidemiology, Biomarkers & Prevention, 20, 473-475.
35.
LinC. C.ChouC. H.FanY. M.YinJ. H.ChungC. H.ChienW. C.. . . LeeJ. T. (2015). Increased risk of dementia among sleep-related movement disorders: A population-based longitudinal study in Taiwan. Medicine (Baltimore), 94(51), e2331
36.
LinS. J.KuoS. C.YangY. H. (2006). Appeals system and its outcomes in national health insurance in Taiwan. Annals of Pharmacotherapy, 40, 506-511.
37.
LinY. J.YangL. K.GauS. S. (2016). Psychiatric comorbidities of adults with early- and late-onset attention-deficit/hyperactivity disorder. Australian & New Zealand Journal of Psychiatry, 50, 548-556.
38.
LjungT.ChenQ.LichtensteinP.LarssonH. (2014). Common etiological factors of attention-deficit/hyperactivity disorder and suicidal behavior: A population-based study in Sweden. JAMA Psychiatry, 71, 958-964.
39.
MikolajczykR.HornJ.SchmedtN.LangnerI.LindemannC.GarbeE. (2015). Injury prevention by medication among children with attention-deficit/hyperactivity disorder: A case-only study. JAMA Pediatrics, 169, 391-395.
NewhouseP. A.KeltonM. (2000). Nicotinic systems in central nervous systems disease: Degenerative disorders and beyond. Pharmaceutica Acta Helvetiae, 74, 91-101.
42.
PotterA. S.SchaubhutG.ShipmanM. (2014). Targeting the nicotinic cholinergic system to treat attention-deficit/hyperactivity disorder: Rationale and progress to date. CNS Drugs, 28, 1103-1113.
43.
SeifanA.AssurasS.HueyE. D.MezJ.TsapanouA.CaccappoloE. (2015). Childhood learning disabilities and atypical dementia: A retrospective chart review. PLoS ONE, 10(6), e0129919
44.
SemeijnE. J.KooijJ. J.ComijsH. C.MichielsenM.DeegD. J.BeekmanA. T. (2013). Attention-deficit/hyperactivity disorder, physical health, and lifestyle in older adults. Journal of the American Geriatrics Society, 61, 882-887.
45.
ShivelyS.ScherA. I.PerlD. P.Diaz-ArrastiaR. (2012). Dementia resulting from traumatic brain injury: What is the pathology?Archives of Neurology, 69, 1245-1251.
46.
ShyuY. C.YuanS. S.LeeS. Y.YangC. J.YangK. C.LeeT. L.. . . WangL. J. (2015). Attention-deficit/hyperactivity disorder, methylphenidate use and the risk of developing schizophrenia spectrum disorders: A nationwide population-based study in Taiwan. Schizophrenia Research, 168, 161-167.
47.
SunY.LeeH. J.YangS. C.ChenT. F.LinK. N.LinC. C.. . . ChiuM. J. (2014). A nationwide survey of mild cognitive impairment and dementia, including very mild dementia, in Taiwan. PLoS ONE, 9(6), e100303.
48.
SurmanC. B.AdamsonJ. J.PettyC.BiedermanJ.KenealyD. C.LevineM.. . . FaraoneS. V. (2009). Association between attention-deficit/hyperactivity disorder and sleep impairment in adulthood: Evidence from a large controlled study. The Journal of Clinical Psychiatry, 70, 1523-1529.
49.
SurmanC. B.GoodmanD. W. (2017). Is ADHD a valid diagnosis in older adults?Attention Deficit Hyperactivity Disorder. Advance online publication. doi: 10.1007/s12402-017-0217-x
50.
TaiY. M.GauC. S.GauS. S.ChiuH. W. (2013). Prediction of ADHD to anxiety disorders: An 11-year national insurance data analysis in Taiwan. Journal of Attention Disorders, 17, 660-669.
51.
TaiY. M.GauS. S.GauC. S. (2013). Injury-proneness of youth with attention-deficit hyperactivity disorder: A national clinical data analysis in Taiwan. Research in Developmental Disabilities, 34, 1100-1108.
ThaparA.CooperM. (2016). Attention deficit hyperactivity disorder. The Lancet, 387, 1240-1250.
54.
ThomasR.SandersS.DoustJ.BellerE.GlasziouP. (2015). Prevalence of attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. Pediatrics, 135, e994-e1001
55.
TzengN. S.ChangC. W.HsuJ. Y.ChouY. C.ChangH. A.KaoY. C. (2015). Caregiver burden for patients with dementia with or without hiring foreign health aides: A cross-sectional study in a Northern Taiwan Memory Clinic. The Journal of Medical Sciences, 35, 239-247.
56.
TzengN. S.ChiangW. S.ChenS. Y.ChouY. C.LeeK. M.HuangS. Y.. . . KaoY.C. (2017). The impact of pharmacological treatments on cognitive function and severity of behavioral symptoms in geriatric elder patients with dementia: Pharmacological treatments on in elder patients with dementia. Taiwanese Journal Psychiatry.
57.
van StralenJ. (2016). Emotional dysregulation in children with attention-deficit/hyperactivity disorder. Attention Deficit Hyperactivity Disorder, 8, 175-187.
58.
WangH. K.LinS. H.SungP. S.WuM. H.HungK. W.WangL. C.. . . TsaiK. J. (2012). Population based study on patients with traumatic brain injury suggests increased risk of dementia. Journal of Neurology, Neurosurgery, & Psychiatry, 83, 1080-1085.
59.
WangH. Y.ChenJ. H.HuangS. Y.YehH. W.MaoW. C.ChangH. A.. . . TzengN.S. (in press). Forensic evaluations for offenders with dementia in Taiwan’s criminal courts. Journal of the American Academy of Psychiatry and the Law.
60.
WangL. J.LeeS. Y.YuanS. S.YangC. J.YangK. C.HuangT. S.. . . ShyuY. C. (2016). Prevalence rates of youths diagnosed with and medicated for ADHD in a nationwide survey in Taiwan from 2000 to 2011. Epidemiology and Psychiatric Sciences. Advance online publication. doi: 10.1017/S2045796016000500
61.
WangL. J.ShyuY. C.YuanS. S.YangC. J.YangK. C.LeeT. L.. . . LeeS. Y. (2016). Attention-deficit hyperactivity disorder, its pharmacotherapy, and the risk of developing bipolar disorder: A nationwide population-based study in Taiwan. Journal of Psychiatric Research, 72, 6-14.
62.
WangL. J.YangK. C.LeeS. Y.YangC. J.HuangT. S.LeeT. L.. . . ShyuY. C. (2016). Initiation and persistence of pharmacotherapy for youths with attention deficit hyperactivity disorder in Taiwan. PLoS ONE, 11(8), e0161061.
63.
WangY. C.ChongM. Y.ChouW. J.YangJ. L. (1993). Prevalence of attention deficit hyperactivity disorder in primary school children in Taiwan. Journal of the Formosan Medical Association, 92, 133-138.
64.
WillcuttE. G. (2012). The prevalence of DSM-IV attention-deficit/hyperactivity disorder: A meta-analytic review. Neurotherapeutics, 9, 490-499.
65.
WilliamsonD.JohnstonC. (2015). Gender differences in adults with attention-deficit/hyperactivity disorder: A narrative review. Clinical Psychology Review, 40, 15-27.
