Carr Rachel H, Eom Gina D, Brown Eric E
Department of Psychiatry, University of Toronto, Toronto, Canada.
Campbell Family Mental Health Research Institute and Division of Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Canada.
J Alzheimers Dis. 2024;98(3):773-792. doi: 10.3233/JAD-230904.
Attention-deficit/hyperactivity disorder (ADHD), a common neurodevelopmental condition now recognized to persist into older adulthood, has been postulated to be a risk factor for neurocognitive disorders given the overlap in clinical features and neurobiology, as well as the complex interplay between ADHD and known risk factors for dementia. Studies have emerged assessing this relationship, but there has not yet been a comprehensive systematic review addressing this topic.
To assess whether ADHD is a risk factor for neurocognitive disorders and to explore possible mechanisms for such an association.
A systematic review of the literature was conducted using Medline, Embase, and PsycINFO from inception until June 4, 2023. Studies were included if they assessed whether or how ADHD may be a risk factor for neurocognitive disorders. Studies were excluded if they were not primary literature, not published in a peer-reviewed journal, not in English, and/or used non-human subjects. Study quality was assessed using the QualSyst tool.
Sixteen studies met inclusion criteria. Seven studies found a positive association between ADHD and neurocognitive disorders (all-cause dementia in four studies, Alzheimer's disease in three studies, Lewy body dementia in two studies, and mild cognitive impairment in one study). Four studies did not find an association. Five studies pertained to possible mechanisms for an association, including genetics, with minimal significant findings.
ADHD may be a risk factor for certain neurocognitive disorders, although the evidence base is limited, and the absolute risk is small. Possible explanations include genetic and lifestyle factors.
注意力缺陷多动障碍（ADHD）是一种常见的神经发育疾病，目前已被认为会持续到成年后期。鉴于临床特征和神经生物学存在重叠，以及ADHD与已知痴呆风险因素之间复杂的相互作用，ADHD被假定为神经认知障碍的一个风险因素。已有研究开始评估这种关系，但尚未有针对该主题的全面系统综述。
评估ADHD是否为神经认知障碍的风险因素，并探讨这种关联的可能机制。
使用Medline、Embase和PsycINFO对从创刊至2023年6月4日的文献进行系统综述。如果研究评估了ADHD是否或如何可能成为神经认知障碍的风险因素，则纳入研究。如果研究不是原始文献、未发表在同行评审期刊上、不是英文的，和/或使用非人类受试者，则排除研究。使用QualSyst工具评估研究质量。
16项研究符合纳入标准。7项研究发现ADHD与神经认知障碍之间存在正相关（4项研究涉及全因性痴呆，3项研究涉及阿尔茨海默病，2项研究涉及路易体痴呆，1项研究涉及轻度认知障碍）。4项研究未发现关联。5项研究涉及关联的可能机制，包括遗传学，但显著发现极少。
ADHD可能是某些神经认知障碍的风险因素，尽管证据基础有限，且绝对风险较小。可能的解释包括遗传和生活方式因素。
