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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 mild cognitive impairment. The observational findings show an association, not proof that ADHD causes cognitive decline; researchers also found a link with genetic risk for ADHD.
Adults with ADHD were more likely to develop dementia or mild cognitive impairment than adults without a documented ADHD diagnosis in a study of more than 187,000 U.S. participants aged 50 and older. Published October 7 in JAMA Psychiatry, the research also linked higher genetic risk for ADHD with a greater chance of dementia, but it does not establish that ADHD causes cognitive decline.
Researchers led by the University of Pittsburgh School of Medicine examined health records and genetic data from adults enrolled in the National Institutes of Health’s All of Us Research Program. During the study, 6.7% of participants 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 researchers reported that adults with ADHD had more than four times the risk of developing cognitive impairment over time.
The team also calculated an ADHD genetic risk score based on common genetic variants. This measure reflects genetic association with ADHD; it is not the same as a clinical diagnosis. Participants in the highest genetic-risk group had a 35% greater chance of dementia than those in the lowest-risk group. The study report did not provide a time window or absolute risk for that comparison in the supplied material, so it should not be read as a 35-percentage-point increase.
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 people with dementia alone. They used about 20% more health care overall in the year after diagnosis, according to the study report. These comparisons describe outcomes within the study population; they do not show that ADHD itself caused the differences.
ADHD and Later-Life Cognitive Health
The results add to research examining whether ADHD is associated with cognitive aging, and the study brings together clinical records and genetic information in a large U.S. group. Seeing associations in both types of data gives researchers another reason to investigate possible links, but it does not identify a mechanism or prove that changing ADHD symptoms or treatment would alter dementia risk.
The findings may also matter for care after a cognitive impairment diagnosis. The study’s reports of lower quality of life and higher health-care use among people with both conditions point to a need for research into their support needs. They do not, on their own, establish which services would help or whether the differences apply to every person with ADHD.
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How Researchers Tested the Link
The study builds on earlier work from senior author Tharick A. Pascoal’s research group. A 2022 study linked genetic risk for ADHD with Alzheimer’s-related brain changes in older adults who had no cognitive impairment. The new work extends that line of research by examining recorded ADHD diagnoses alongside genetic data in the same population.
Douglas Teixiera Leffa, a co-author who recently completed his psychiatry residency at UPMC, said the research reproduced a pattern observed in studies from other countries and added genetic evidence. The authors describe the current study as the largest and most comprehensive to date to combine clinical diagnoses and genetic data in one population. The analysis is observational, so it can identify associations but cannot establish cause and effect.
One possible explanation is that early dementia symptoms could sometimes be mistaken for ADHD before a formal cognitive diagnosis. The researchers tested this possibility by requiring at least eight years between an ADHD diagnosis and cognitive impairment; the association remained statistically significant. That finding makes this explanation less likely to account for the entire association, but does not rule it out completely.
“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
Cause, Treatment and Risk Remain Unknown
The findings do not show that ADHD causes dementia, nor do they establish that every adult with ADHD faces the same level of risk. The study report gives the percentages for participants with and without ADHD and an adjusted risk estimate, but the supplied material does not specify the follow-up duration or provide details needed to translate those estimates into an individual’s absolute risk.
Researchers also do not yet know whether ADHD medications, including stimulants, affect dementia risk over time. The authors raised cardiovascular health as another area to examine because it has been linked to both ADHD and dementia, but they did not show that cardiovascular management would prevent cognitive impairment. The possibility of early dementia symptoms being mistaken for ADHD is less likely to explain the full result given the eight-year analysis, but remains a consideration.
Research Questions After the Findings
The authors say further work is needed to identify what may drive the association and whether any contributing factors can be changed. Potential questions include how ADHD treatment relates to later cognitive outcomes and whether cardiovascular health helps explain part of the observed relationship. No medication or prevention effect was established in this study.
The paper, “Attention-Deficit/Hyperactivity Disorder and Late-Life Cognitive Impairment,” was published in JAMA Psychiatry on October 7, 2026. The next evidence will need to clarify the study’s findings across populations and over time. For now, the results are a research signal rather than a basis for predicting an individual’s future health.
Key Questions
Does ADHD cause dementia?
No causal link was established. The study found an association between ADHD and later cognitive impairment, but its observational design cannot show that ADHD causes dementia.
How many participants developed cognitive impairment?
The study report says 6.7% of participants with ADHD developed dementia or cognitive impairment, compared with 3.4% of participants without ADHD. Those figures describe this study’s participants, not an individual prediction.
What did the genetic-risk analysis find?
Participants in the highest ADHD genetic-risk group had a 35% greater chance of dementia than those in the lowest-risk group. A genetic risk score reflects associations with common genetic variants and is not a diagnosis.
Can ADHD medication prevent dementia?
The study did not test whether ADHD medication prevents dementia. The authors identified the relationship between treatments, including stimulants, and later cognitive outcomes as a question for future research.
Could early dementia symptoms have been mistaken for ADHD?
That is one possible explanation the researchers considered. The association remained statistically significant when they required at least eight years between an ADHD diagnosis and cognitive impairment, making mistaken early symptoms less likely to explain the full result.
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