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A study of more than 187,000 U.S. adults aged 50 and older found that participants with ADHD were more likely to develop dementia or cognitive impairment than those without the diagnosis. The observational findings, published in JAMA Psychiatry, show an association rather than proof that ADHD causes dementia.
A study led by researchers at the University of Pittsburgh School of Medicine found that adults aged 50 and older with ADHD had a higher observed risk of developing dementia or mild cognitive impairment than adults without ADHD. The research, published October 7 in JAMA Psychiatry, also found a separate association between higher genetic risk for ADHD and dementia, but does not establish that ADHD causes cognitive decline.
The researchers analyzed health records and genetic data for more than 187,000 adults enrolled in the U.S. National Institutes of Health’s All of Us Research Program. Participants were at least 50 years old. During the study, 6.7% of those with ADHD developed dementia or cognitive impairment, compared with 3.4% of those without ADHD.
After accounting for factors including age, sex and other health conditions, the team found that participants with ADHD had more than four times the risk of developing cognitive impairment over time. The study also assessed genetic risk scores, which estimate how strongly a person’s common genetic variants are associated with ADHD. Participants in the highest genetic-risk group had a 35% greater chance of dementia than those in the lowest group.
The study reported that, among participants who developed cognitive impairment, those with a recorded ADHD diagnosis also reported worse mental health, lower quality of life and less social satisfaction than those with cognitive impairment alone. They used about 20% more health care overall during the year after diagnosis. These findings describe differences within this study population; they do not show that ADHD itself caused those outcomes.
ADHD and Later-Life Cognitive Risk
The findings matter because they add a large U.S. sample and genetic data to research examining whether ADHD is associated with cognitive aging. The overlap could help researchers identify people who may warrant closer study as they age, and it raises questions about how ADHD, other health conditions and later-life cognition interact.
However, the results are not a prediction that an individual with ADHD will develop dementia. The reported percentages are outcomes in the study groups, and the adjusted risk estimate is an association from observational data. It cannot establish cause and effect, nor does it show that treating ADHD prevents dementia. The additional health-care use and lower reported quality of life also point to possible added needs for people living with both conditions.
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How Researchers Tested the Association
The research combined two types of evidence: clinical diagnoses in health records and genetic risk scores. The authors said that seeing a similar pattern across those sources lends support to the association, while still falling short of proving causation. Genetic risk scores reflect the association of many common variants with ADHD; they do not mean that a person has a clinical ADHD diagnosis.
The team also examined whether cognitive changes preceding a formal diagnosis might have been mistaken for ADHD. Such early symptoms could make the association appear stronger if dementia-related changes were recorded first as ADHD. The researchers said the association remained statistically significant when they required an interval of at least eight years between ADHD diagnosis and cognitive impairment, making that explanation less likely to account for the full finding.
The work builds on earlier research from senior author Tharick A. Pascoal’s group, including a 2022 study linking ADHD genetic risk with Alzheimer’s-related brain changes in older adults without cognitive impairment. The authors describe the new paper as the largest study to date to combine clinical diagnoses and genetic data in the same population.
“Two different kinds of evidence are pointing in the same direction.”
— Tharick A. Pascoal, senior author and associate professor of psychiatry and neurology at the University of Pittsburgh
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Cause, Treatment and Risk Remain Open
The study does not establish why ADHD and later-life cognitive impairment were associated, or whether ADHD directly contributes to dementia risk. Although the researchers tested a longer interval between diagnosis and cognitive impairment, they cannot rule out all differences in diagnosis, health, lifestyle or other factors that might affect the results.
It is also unclear whether ADHD medications, including stimulants, affect dementia risk over time. The study does not show that medication raises or lowers that risk. Researchers also identified cardiovascular health as a possible area for further investigation because it is linked to both ADHD and dementia; whether managing those risks changes cognitive outcomes remains unanswered.
The report’s group-level findings cannot determine any one person’s future outcome. The study material does not establish how the results should change clinical care or screening, and it offers no evidence that a particular intervention prevents dementia.
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Questions for Future ADHD Studies
Researchers say further work is needed to examine the factors behind the association and test whether any are modifiable. Priorities raised by the study include evaluating ADHD medication use, cardiovascular health and the pathways that may connect ADHD with cognitive aging. The authors also say the combined health-record and genetic approach can help investigate patterns that smaller or more traditional studies may not reveal.
The paper was published in JAMA Psychiatry as “Attention-Deficit/Hyperactivity Disorder and Late-Life Cognitive Impairment” (DOI: 10.1001/jamapsychiatry.2026.3165). The source material does not identify a specific next publication date or planned clinical trial, so it remains unclear when evidence on treatment or prevention might become available.
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Key Questions
Does ADHD cause dementia?
No causal link was established. The study found an association between ADHD and later-life cognitive impairment, but observational data cannot show that ADHD causes dementia.
How many people were included in the study?
The researchers analyzed health records and genetic data from more than 187,000 adults aged 50 and older in the NIH All of Us Research Program.
What were the reported rates of cognitive impairment?
6.7% of participants with ADHD developed dementia or cognitive impairment, compared with 3.4% of participants without ADHD. These are observed rates in the study, not an individual forecast.
Did the study show that ADHD medication prevents dementia?
No. The authors identified medication effects as an unanswered research question. The study did not establish whether ADHD medicines change dementia risk.
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