Kooij J J Sandra, Michielsen Marieke, Kruithof Henk, Bijlenga Denise
a PsyQ Psycho-Medical Programs , Expertise Center Adult ADHD , The Hague , The Netherlands.
c Department of Psychiatry , VUMc , Amsterdam , The Netherlands.
Expert Rev Neurother. 2016 Dec;16(12):1371-1381. doi: 10.1080/14737175.2016.1204914. Epub 2016 Jul 4.
ADHD is an often heritable, neurodevelopmental disorder with a prevalence of 4-5% in children and adults and about 3% in older adults. The disorder in older adults (> 55 years) is accompanied by similar comorbidities such as anxiety and depression, and social impairment as in younger age groups. Areas covered: An overview of the literature on diagnostic assessment, differential diagnosis, and treatment of older adults with ADHD is described. Case studies show that stimulant treatment is beneficial for ADHD in old age, but randomized controlled trials are lacking. Stimulant treatment has been studied in depression and even dementia in older adults, and seems safe with active cardiovascular risk management. In this paper, a proposal for diagnostic assessment and treatment is described for ADHD in older adults, including differential diagnosis with other psychiatric and neurocognitive disorders. Expert commentary: Regarding the organization of mental health, professionals in geriatric psychiatry need to be trained in assessment and treatment of ADHD in older age. Lifespan ADHD clinics may help patients of all ages to receive better specialized care.
注意力缺陷多动障碍（ADHD）是一种常具有遗传性的神经发育障碍，在儿童和成人中的患病率为4%-5%，在老年人中约为3%。老年（>55岁）患者的该疾病伴有与年轻人群体中类似的共病，如焦虑和抑郁，以及社交障碍。涵盖领域：描述了关于老年ADHD患者诊断评估、鉴别诊断和治疗的文献综述。案例研究表明，兴奋剂治疗对老年ADHD患者有益，但缺乏随机对照试验。兴奋剂治疗已在老年抑郁症甚至痴呆症中进行研究，并且在积极进行心血管风险管理的情况下似乎是安全的。本文描述了针对老年ADHD患者的诊断评估和治疗建议，包括与其他精神和神经认知障碍的鉴别诊断。专家评论：关于心理健康的组织，老年精神病学专业人员需要接受老年ADHD评估和治疗方面的培训。全生命周期ADHD诊所可能有助于各年龄段患者获得更好的专科护理。
