Study: Diagnosis of ADHD may shorten lifespan

Key takeaways:

• Life expectancy reductions for men and women with ADHD were 6.78 years and 8.64 years, respectively, compared with the general population.
• This is likely due to modifiable factors, researchers wrote.

Adults in the United Kingdom with an ADHD diagnosis appear to have shorter lifespans compared with the general population, likely due to unmet health support and treatment needs, according to a study in The British Journal of Psychiatry.

“On average, people with diagnosed ADHD experience more physical and mental health problems, including cardiovascular disease and associated risk factors,” Elizabeth O’Nions, PhD, an epidemiologist at Bradford Institute for Health Research, and colleagues wrote. “They are also at a higher risk of suicide than people not diagnosed with ADHD.”

Prior research has shown that adults with ADHD are more likely to die prematurely, although no study to date has used mortality data to examine reduced life expectancy, the researchers wrote.

In a retrospective cohort study, the researchers sought to calculate the life-expectancy deficit for adults with diagnosed ADHD using primary care health record data from 792 general practices in the U.K. between 2000 and 2019. They identified 30,039 adults with diagnosed ADHD, along with 300,390 controls matched by age, sex and primary care practice, from more than 9.5 million people contributing eligible person-time.

The primary outcome was all-cause death. The researchers estimated age-specific mortality rates using Poisson regression, as well as life expectancy at age 18 years for those diagnosed with ADHD using a period life table method.

According to the results, the estimated reduction in life expectancy for adults with diagnosed ADHD compared with the general population was 6.78 years (95% CI, 4.5-9.11) for men and 8.64 years (95% CI, 6.55-10.91) for women.

The total life expectancy estimate for men with diagnosed ADHD was 73.26 years (95% CI, 71.06-75.41) vs. 80.03 years (95% CI, 79.34-80.74) for matched men. For women with ADHD, the estimate was 75.15 years (95% CI, 72.99-77.11) compared with 83.79 years (95% CI, 83.12-84.44) for matched women.

The researchers stated their belief that this would result not from ADHD itself, but instead by factors such as smoking, unmet mental and physical health support as well as unmet treatment needs.

Data further showed that mortality rates increased exponentially with age, with the researchers estimating that men with ADHD were 1.89 (95% CI, 1.62-2.19) times as likely to die during follow-up compared with their matches, while women with ADHD were 2.13 (95% CI, 1.79-2.53) times as likely to die compared with theirs.

Similar to previous findings, diagnoses of common physical and mental health conditions were also found to be more common in the ADHD cohort vs. matched controls.

“The present findings suggest that there is an urgent need for initiatives to address unmet support needs,” O’Nions and colleagues wrote. “This may include approaches to improve awareness of physical and mental health conditions that are more common in people with ADHD and promotion of timely access to mental health support.”