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A study published in JAMA Psychiatry found that adults with ADHD had higher rates of dementia or cognitive impairment than adults without ADHD in a sample of more than 187,000 people aged 50 and older. The observational findings, supported by a separate genetic-risk analysis, do not show that ADHD causes dementia.
A study led by researchers at the University of Pittsburgh School of Medicine found that adults with attention-deficit/hyperactivity disorder (ADHD) were more likely to develop dementia or other cognitive impairment later in life than adults without ADHD. The analysis covered more than 187,000 adults aged 50 and older; its findings show an association, not proof that ADHD causes dementia.
Published in JAMA Psychiatry, the study used health records and genetic information from participants in the U.S. National Institutes of Health’s All of Us Research Program. Among participants with ADHD, 6.7% developed dementia or cognitive impairment, compared with 3.4% of those without an ADHD diagnosis. The researchers said that after accounting for factors including age, sex and other health conditions, ADHD was associated with more than four times the risk of cognitive impairment over time.
The team also examined genetic risk scores, which estimate how strongly a person’s common genetic variants are associated with ADHD. Participants in the highest ADHD genetic-risk group had a 35% greater chance of developing dementia than those in the lowest group, according to the report. This analysis included people whether or not they had received a formal ADHD diagnosis; it does not establish that genetic risk itself causes dementia.
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 without ADHD. They used about 20% more health care in the year after their diagnosis. The study reports these differences as group-level findings and does not show what caused them.
ADHD May Shape Cognitive Aging
The findings add evidence that ADHD may be relevant to cognitive health in later life, a question that matters to adults with ADHD, their families and clinicians. The genetic analysis and medical-record results point in a similar direction, which researchers say makes the association worth further investigation. But neither result establishes a direct biological pathway from ADHD to dementia, or shows that an individual with ADHD will develop cognitive impairment.
The reported differences in quality of life and health-care use also suggest that people living with both conditions may have needs beyond cognitive symptoms alone. If future research confirms those patterns, clinicians and health systems may need to pay closer attention to mental health and social support for this group. The current study does not test a screening program or establish that any particular intervention prevents dementia.
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How the Study Tested the Link
The researchers combined two kinds of evidence: recorded ADHD diagnoses and subsequent cognitive outcomes in health data, and participants’ inherited genetic variants associated with ADHD. Using both approaches allowed the team to examine whether the pattern was limited to people whose ADHD had been formally diagnosed. The study builds on earlier work from senior author Tharick A. Pascoal’s lab, including a 2022 study that linked genetic risk for ADHD with Alzheimer’s-related brain changes in older adults without diagnosed cognitive impairment.
The authors described the new analysis as the largest and most comprehensive to date to combine clinical diagnoses and genetic data in the same population for this question. It is also consistent with research in other countries, according to co-author Douglas Teixiera Leffa. The paper, by Guilherme and colleagues, was published in JAMA Psychiatry with DOI 10.1001/jamapsychiatry.2026.3165.
“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 and Treatment Remain Unknown
The study does not show that ADHD causes dementia, and it does not establish why the conditions were associated. An alternative explanation is that early, undetected dementia symptoms could sometimes be mistaken for ADHD before a cognitive diagnosis is made. The researchers said the association remained statistically significant when they required at least eight years between an ADHD diagnosis and the onset of cognitive impairment, making that explanation less likely to account for the entire finding. It does not rule it out completely.
The report also leaves open whether ADHD medication, including stimulants, changes later dementia risk, and whether managing cardiovascular health could affect the association. The reported findings do not answer those questions. As with any observational analysis, the results may also be affected by factors the study did not measure or fully account for.
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Research Needed on Risk Factors
Further research will be needed to test possible explanations for the association and determine whether any factors can be changed to support healthier cognitive aging. The study’s authors identified ADHD medication use and cardiovascular health as questions for future investigation; they did not report that either reduces dementia risk.
For now, the paper adds an association for researchers to examine, not a new prevention recommendation. The source material does not describe a planned follow-up trial or a timetable for additional results. Studies that track participants over time and examine potential mechanisms will be needed to clarify how the findings should inform care.
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Key Questions
Does ADHD cause dementia?
No causal link was proven. The study found that ADHD was associated with a higher rate of later cognitive impairment, but an observational study cannot establish that ADHD causes dementia.
How many people were included in the study?
The analysis included more than 187,000 adults aged 50 and older enrolled in the NIH’s All of Us Research Program. The source report does not give the exact number of participants with an ADHD diagnosis.
What difference did the researchers report?
Dementia or cognitive impairment was recorded in 6.7% of participants with ADHD, compared with 3.4% of participants without ADHD. The researchers also reported more than four times the risk after adjusting for several factors; this is a study-level association, not a prediction for any one person.
Did the study find that ADHD medication prevents dementia?
No. The study did not determine whether ADHD medications affect dementia risk. The authors identified medication use as a question for future research.
Could early dementia symptoms have been mistaken for ADHD?
The researchers said this is one possible explanation. The association remained statistically significant when the analysis required at least eight years between ADHD diagnosis and cognitive impairment, which makes misdiagnosis less likely to explain the full result but does not rule it out.
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