Generally, ADHD is a neuropsychiatric childhood disorder that normally persists across one’s lifespan. Many reports estimate that anywhere between 5 percent and 8 percent of school-age kids have the disorder. However, the Center for Disease Control currently puts the figure at 11 percent. Some of the studies have relied on parents indicating that some healthcare provider told them that their child has ADHD. However, the disorder has been observed to overlap with a host of other problems, making it hard for clinicians to categorize what they are observing. The paper will focus on two experiments on the impact of ADHD symptoms on cognition. The experiments sought to determine the impact of ADHD symptoms on the cognitive abilities in older adults. The occurrence of the condition has been proven to affect individuals less as they age. However, nothing much is known regarding the disorder in late life, as much of the studies have focused on young adults. The previous research used data from middle age adults (40-44 years) and older age adults (60-64 years). The previous results indicated that the influence of ADHD symptoms on cognitive abilities was generally stronger in middle aged adults compared to old age adults. However, the experiment had its limitations. The cognition tests that were included in the PATH study were only used to indicate the various cognitive abilities. However, they were not able to measure the latent constructs of inattention and hyperactivity. The cognitive abilities emanating from the reports show that the issue is more difficult to interpret. The study sample of the two experiments was draw from the PATH Through Life Project. The mental health and ageing study was a longitudinal one, involving participants across the age groups mentioned. Both studies also used the short form of the ADHD Self Response Scale based on the diagnostic DSM-IV. The two studies also had a methodological problem in that the tests used could not explain the why some of the participants had high inattention scores and low hyperactivity scores.
Purpose of the Experiments
The two experiments were aimed at establishing the impact of ADHD symptoms on the cognitive abilities change with age. The experimenters recognized that the disorder is understudied in older adults. The two experiments focused on the links between symptoms of the disorder and cognitive abilities. The results were compared between two cohorts, middle aged and older age adults. The study population was sampled from the same population. ASRS was used to measure ADHD symptoms.
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Previous Results
During the previous experiment, extremely lower levels of ADHD symptoms of depression and anxiety were reported among the older age cohort. Of the participants in the older age cohort, the researchers found out that only 2.2 percent scored 14 or above for the ASRS. The value had been previously identified as an indicator of ADHD. On the other hand, the researchers observed that 6.1 percent of the participants in the middle age cohort scored 14 or above for the ASRS. The older age regiment had less participants who fell under the categories II to IV. This was different from the group falling under the mid ages. However, this was not the case with the cognitive test involving Spot the Word Test of verbal ability. The researchers also investigated the relationship between those diagnosed with ADHD conditions and their cognitive levels. According to the factor analysis, four latent factors were identified. The factors broadly represented information processing speed, memory, verbal memory, and executive function.
The study investigated the symptoms of ADHD in a sample of older adults drawn from a large population, with a particular focus on their effects on cognitive abilities. From the experiment, the researchers found out that the basic structure of the ASRS is actually similar in both middle age and older age adults.
Numerous conclusions can be deduced from the experiments. The first finding is that older adults reported milder symptoms of ADHD compared to the adult participants who were middle aged. The second significant finding is that the effect of symptoms of ADHD on cognitive abilities is mostly mediated through the strong link between the symptoms of depression and cognition. There were no reported major gender disparities of ADHD in all ages, an indicator that these factors exhibited similar observations.
Limitations of Previous Results
There were various limitations in the previous results. For instance, the ADHD screening criteria developed for young adults was used for older adults. The method for determining age and its relationship with ADHD prevalence showed that the indications are lesser as an individual age. Research has shown that in the DSM-5 criteria, the allowed level of determining the tests for ADHD in older people is not the same as that for younger adults. The impact of this particular change on the disease prevalence has not been investigated. This implies that the results may have been affected considerably by the inappropriateness of the criteria for diagnosing ADHD. Additionally, the cognition tests employed in the research were incorporated into the PATH study to merely serve as indicators of various kinds of cognitive ability. As such, they were not specifically designed to measure the latent constructs. This is an indication that the intellectual levels as shown in the standard factors presented in the experiments get more challenging to interpret when the indicators are less. Thus, the validity of the results may have been affected by the inability to effectively interpret the cognitive abilities represented by the latent factors.
Experiment Summary
The purpose of the research by Das et al. (2015) was to determine how the effects of ADHD symptoms on cognitive abilities change with age. The researchers analyzed the influence of ADHD symptoms on the cognitive abilities of a cohort of older adults. The regiment, which comprised older people of approximately 75 years too part in the Personality and Total Health (PATH) in a controlled environment. The study concentrated more on the association present in cognitive performance and indications of ADHD. In order to assess the ADHD symptoms, the researchers utilized the adult ADHD Self Reporting Scale (ASRS). The ADHD Self Reporting Scale demonstrated great specificity and sensitivity in clinical validation studies. This technique is often used in other fields such as epidemiology.
The PATH Through Life Project was instrumental as the subjects were obtained more easily. The study included participants from across three age groups (20-24, 40-44, and 60-64 years at baseline). The study involved four-year follow-up assessment waves for up to 20 years. The experimental sample was drawn from subjects who were chosen arbitrarily from various cities. The sample provided a representative population sample, as Australian citizens are legally required to enroll to vote. The participants who had a history of epilepsy, brain tumor, brain infection, stroke, and those whose data was missing were excluded from the study. Participants of the older age cohort were screened for probable dementia using the Mini Mental State Examination. This ensured that the participants had no case of mental illness prior to the experiment. Written informed consent from participants was obtained and they were surveyed once every four years regarding lifestyle and social factors and physical and mental health. The short form for ASRS was utilized by the researchers. The tool consists of six questions relating to the ADHD symptoms considering the diagnostic criteria of DSM-IV.
The experiment exhibited numerous findings. The first finding was that milder symptoms of ADHD were reported among older adults compared to middle aged adults. The second significant finding is that the impacts of ADHD symptoms on cognition are mostly mediated through the strong link between the symptoms of depression and cognition. There was no major difference in gender and age of the subjects who were sampled for the study of ADHD indications.
A follow-up study sought to establish the relationship between ADHD symptoms and cognitive abilities in a sample of middle age adults drawn from a large population (Das et al., 2015). The project involved the study of mental health and aging in participants drawn from three age groups; (20-24, 40-44, and 60-64 years at baseline). The study involved four-year follow up waves of assessment for up to 20 years. The experimental sample used in the experiment was arbitrarily obtained from various cities. The sample provided a representative population sample, as Australian citizens are legally required to enroll to vote. The participants who had a history of epilepsy, brain tumor, brain infection, stroke, and those whose data was missing were exempted from the study. Participants of the older age cohort were screened for probable dementia using the Mini Mental State Examination. This ensured that the participants had no case of mental illness prior to the experiment. Written informed consent from participants was obtained and they were surveyed once every four years for information on lifestyle and social factors and physical and mental health. The short form for ASRS was utilized by the researchers. The tool consists of six questions relating to the ADHD symptoms using the diagnostic criteria of DSM-IV. Cognitive assessments were run on each of the subjects. The tests included Spot the Word Test, Trail Marker Test, California Verbal Learning Test, and some Reaction Time Tasks. The researchers found out that ADHD and depression/anxiety symptoms were greatly correlated. The researchers also established that the symptoms of ADHD were closely associated with worse performance on TMT and RT tasks regardless of whether continuous or categorical classifications were used . Additionally, it was established that the influence on cognitive performance extend to study participants with symptom scores below the threshold of likely clinical diagnosis . This indicates that subclinical levels of ADHD symptoms impact the cognitive abilities.
Methodological Problems
The two studies had some methodological problems. No scientific experiments were done for those with disorders such as anxiety and depression since the subjects willingly reported to have such conditions. The first study failed to focus on the impact of ADHD symptoms on a particular cohort of participants and instead focused on two (Das et al., 2014). As a result, the findings were not conclusive. For instance, the effect of ADHD symptoms on the cognitive abilities of middle age cohort was not explored effectively. The follow-up study failed to determine why the tests used could not explain why some study participants had high inattention scores and lower hyperactive scores. This may have led to less reliable results.
Future Research
Future research should focus on the investigation of the effectiveness of age-related diagnosis and treatment in healthcare. The above experiments indicate that the ADHD screening criteria developed for young adults was used for older adults. However, the prevalence for ADHD symptoms seems to decrease as age decreases, particularly when applying the criteria developed for young adults. The effect of such a change on the prevalence of ADHD needs to be investigated further.
References
Das, D., Cherbuin, N., Easteal, S., & Anstey, K. J. (2014). Attention deficit/hyperactivity disorder symptoms and cognitive abilities in the late-life cohort of the PATH through life study. PloS one , 9 (1), e86552.
Das, D., Cherbuin, N., Anstey, K. J., & Easteal, S. (2015). ADHD symptoms and cognitive abilities in the midlife cohort of the PATH Through Life study. Journal of attention disorders , 19 (5), 414-424.
