January 16, 2022
The current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) requires evidence of symptom onset before age 12 to make a diagnosis of ADHD in adults.
A recently published clinical review questions the appropriateness of this criterion in older adults 50 years old and above. It sets forth several reasons:
On the other hand, the reason for the early onset criterion is to avoid any confusion with early neurodegenerative diseases such as Alzheimer's or Lewy body dementia, which have overlapping symptoms.
The authors suggest a possible fix:
It is unethical, the authors suggest, to deny care to older, presently undiagnosed adults, given the demonstrated poor outcomes associated with untreated ADHD.
Manu J. Sharma, Sasha Lavoie, Brandy L. Callahan, "A Call for Research on the Validity of the Age-of-Onset Criterion Application in OlderAdults Being Evaluated for ADHD: A Review of the Literature in Clinical andCognitive Psychology," American Journal of Geriatric Psychiatry (2020),https://doi.org/10.1016/j.jagp.2020.10.016.