Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
Hotchkiss Brain Institute, Calgary, Alberta, Canada.
CNS Spectr. 2019 Oct;24(5):518-525. doi: 10.1017/S1092852918001190.
It is crucial to clarify the structure of attention-deficit/hyperactivity disorder (ADHD) symptomatology in all age groups to determine how to best conceptualize this disorder across the lifespan. We tested the ADHD factor structure across adulthood and investigated independent associations with executive functions.
Data from 645 adults aged 18-59 and 233 adults aged 60-85 were drawn from the Nathan Kline Institute Rockland Sample. Participants completed the Conners Adult ADHD Rating Scale and tests of executive functioning. Invariance of the ADHD factor structure was investigated using confirmatory factor analyses. Associations with cognition were explored using multiple linear regression.
Results confirmed a bifactor model with 3 specific factors (inattention, hyperactivity, and impulsivity). Factor loadings and item intercepts were invariant across ages. Levels of hyperactivity and impulsivity were lower in older adults. Inattentive symptoms in young adults were positively related to cognitive flexibility. In older adults, ADHD symptoms predicted poorer working memory.
ADHD symptoms manifest similarly across adulthood. The lack of robust associations between ADHD symptomatology and executive functions raises concerns about the usefulness of neuropsychological measures in diagnosing adult ADHD. These results support the validity of the ADHD concept in older adults but suggest a need for age-appropriate normative criteria.
明确注意缺陷多动障碍（ADHD）在所有年龄段的症状结构对于确定如何在整个生命周期中最好地概念化这种障碍至关重要。我们在成年期测试了 ADHD 的因子结构，并研究了与执行功能的独立关联。
来自 Nathan Kline Institute Rockland 样本的 645 名 18-59 岁和 233 名 60-85 岁的成年人的数据被用于本研究。参与者完成了 Conners 成人 ADHD 评定量表和执行功能测试。使用验证性因子分析来检验 ADHD 因子结构的不变性。使用多元线性回归来探讨与认知的关联。
结果证实了一个具有 3 个特定因子（注意力不集中、多动和冲动）的双因素模型。因子负荷和项目截距在各年龄段都是不变的。老年人的多动和冲动水平较低。年轻人的注意力不集中症状与认知灵活性呈正相关。在老年人中，ADHD 症状预测工作记忆较差。
ADHD 症状在成年期表现相似。ADHD 症状与执行功能之间缺乏稳健的关联，这引发了对神经心理学测量在诊断成人 ADHD 中的有用性的关注。这些结果支持了老年人群中 ADHD 概念的有效性，但表明需要适合年龄的正常标准。
