ADHD is the second most prevalent psychiatric diagnosis among adults, but few, if any, clinicians receive training in the evaluation and treatment of this dimensional condition. Critically left behind are women and people over 60 — two underrepresented groups in ADHD care — given the field’s persistent focus on young boys.

This is why more than half of women with ADHD received their diagnosis in adulthood, despite the condition having a childhood onset. Likewise, we know very little about seniors with ADHD, as most longitudinal studies on ADHD stop in early adulthood. That said, studies put diagnosis rates at 2% in people over 60, though the share is likely much higher.

How can clinicians better identify ADHD in these groups? Russell Ramsay, Ph.D., outlined professional recommendations in his July 2026 ADDitude webinar, “Recognizing ADHD in Women and Older Adults: Differentiating and Diagnosing Mature Symptoms.” Here are our main takeaways:

ADHD in Seniors: Consider Persistence

To account for confounding factors like cognitive decline, menopause, and other age-related conditions, Ramsay recommends looking for continuation of symptoms and executive functioning issues over time — one of the clearest indicators of ADHD.

That said, symptoms rarely cause consistent impairment across time. “ADHD is a dimensional syndrome,” he said, noting that people who present in the senior years for an evaluation may have had subthreshold ADHD in childhood and adulthood. That is, they may have shown core, clinically significant symptoms of the condition while not meeting the full diagnostic count outlined by the Diagnostic and Statistical Manual of Mental Disorders(DSM).

[Read: Distinct Diagnostic and Treatment Considerations for ADHD in Older Adults]

The clinical interview is key for establishing persistence, including self and observer forms as well as school records and work evaluations. Other tools and strategies for professionals include:

• The Barkley Quick-Check for Adult ADHD — a nine-item screening tool that identifies highly predictive symptoms. Seniors need only endorse five symptoms instead of the typical six recommended for adults.
• Mental state examinations (e.g., working memory tests) to assess for cognitive impairments. Severe neurological decline, not ADHD, is associated with more errors in responses.

ADHD in Women: Reverse Diagnosis Often Tells the Story

Many women are only diagnosed with ADHD after first seeking help for another condition or issue, like an eating disorder, anxiety, depression, fatigue, or overwhelm. Ramsay suggests that clinicians who specialize in these areas should screen female patients for ADHD practically by default.

In clinical interviews, masking of executive functioning challenges and the degree to which women try to “hold it all together” should also be assessed. “Even if someone is high achieving, I want to hear how they achieved it, Ramsay said. “Behind the scenes, what were the compensatory mechanisms?”

[Read: “Women Need Better, More Accurate Diagnostic Tools for ADHD”]

Telling ADHD Apart From Everything Else

Given ADHD’s overlap with other conditions and high comorbidity rates, clinicians can tell if ADHD is present by considering the persistence of executive functioning challenges. That is, is executive dysfunction present even during fluctuations of other issues?

A granular review of symptoms can also help tease apart conditions. A person may say they’re distracted, for example, but it may be because of intrusive thoughts related to OCD, not because of inattention rooted in ADHD. Patients themselves can also be great discerners of their symptoms.

For more insights on identifying ADHD in women and older adults, including what makes for a comprehensive evaluation, watch the full webinar at additu.de/072826

Signs of ADHD: Next Steps

• Read: ADHD Does Not Diminish with Age. Its Diagnostic Clarity Does.
• Read: The State of Adult ADHD Today
• Read: How the DSM-5 Fails People with ADHD — and a Better Way to Diagnose
  

ADDITUDE IS HUMAN
Artificial intelligence does not create or edit any written content published by ADDitude. Our editorial team is 100% human, and our mission is simple: listen to and serve our readers with hand-crafted, expert-informed resources. To support ADDitude, please consider subscribing. Your readership and support help make our commitment possible. Thank you.

Within the next decade, adults age 65 or older will outnumber children in the U.S. for the first time in American history. As this older population ages, doctors will surely face this question more often: Are my symptoms signs of normal aging? Dementia? ADHD? Or something else?

The answer is rarely straightforward. ADHD, mild cognitive impairment, dementia, and other conditions that cause cognitive complaints (like perimenopause) can and do occur concurrently, said David W. Goodman, M.D., during his June 2026 ADDitude webinar, “Poor Memory and Attention Late in Life: Is It ADHD or Dementia?”

The bottom line? Cognitive complaints in older adults should not be dismissed as age-related decline or neurodegeneration. But it takes skilled clinicians to make sense of a complicated diagnostic picture. Read on for our takeaways from Goodman’s webinar on ADHD in older adults.

Why ADHD Is Difficult to Recognize in Older Adults

Clinician blindness, prejudice, and inexperience certainly help explain why ADHD is overlooked in older adults. But the clinical picture invariably clouds as we age, complicating medical care. From perimenopause and vitamin B12 deficiency to hypothyroidism and anxiety, multiple medical issues overlap with ADHD over time and require careful examination — a nearly impossible task given the paucity of professional clinical guidance for this population.

Some clinicians resort to neuropsychological testing to clarify the diagnostic picture; Goodman advises against this. “Test results tell you about deficits,” he said. “They don’t tell you what the diagnosis is.”

[Read: Inadequate Diagnosis and Treatment of ADHD After Age 60]

Cognitive Difficulties Are Not Synonymous with ADHD

Many older adults conflate cognitive symptoms with ADHD. While some cognitive deficits overlap, signs like the following do not point to ADHD. (They may point to dementia.):

• Trouble finding words when speaking
• Difficulty following conversations
• Progressive worsening of difficulties

ADHD is a stable condition that doesn’t worsen over time. “The experience of ADHD may be worse if the demands start to increase and exceed your ability to compensate,” Goodman said.

[Read: ADHD in Older Adults – Distinct Diagnostic and Treatment Considerations]

One Telltale Sign of ADHD? Environmental Response

It’s not enough to rely on a patient’s recollection or perception of impairment. Environmental and contextual information can help. Take, for instance, an older patient undergoing an ADHD who remembers struggling in school.

“What I’m looking for is the patient’s recollection of childhood symptoms and whether there was an environmental response,” Goodman said. “Did teachers recognize that you were struggling and were making allowances for you? That means the environment recognized that your impairments were such that they needed to make accommodations.”

It’s Never Too Late for Treatment

For older patients with multiple psychiatric conditions, the goal is to treat one without worsening the others. This may mean that ADHD isn’t always the first to be treated, as stimulants used to treat ADHD can actually worsen other psychiatric conditions if those aren’t stabilized.

Many newly diagnosed older adults wonder about the usefulness of treating their ADHD after a lifetime without intervention. “I will tell you having treated people in their 60s and 70s and even early 80s — they are grateful to realize they have a disorder that can be treated,” Goodman said. “There is a psychotherapy of grief about the loss of opportunities during the course of one’s life, but there is also a resurrection of self-image because you come to realize the difference between who you are and what you have.”

For more insights on ADHD, mild cognitive impairment, dementia, and more, watch Dr. Goodman’s full webinar at additu.de/061626

ADHD in Older Adults: Next Steps

• Free Download: A Guide to ADHD in Older Adults
• Read: ADHD and Age-Related Cognitive Changes: Known (and Unclear) Connections
  
• Read: Is It Worth Seeking an ADHD Diagnosis After 50?

ADDITUDE IS HUMAN
Artificial intelligence does not create or edit any written content published by ADDitude. Our editorial team is 100% human, and our mission is simple: listen to and serve our readers with hand-crafted, expert-informed resources. To support ADDitude, please consider subscribing. Your readership and support help make our commitment possible. Thank you.

Sometimes I really hate my ADHD. I hate how it makes me perfectionistic, stubborn, and inattentive. Or how it makes me unable to sit still and prone to attempt too many things at once.

Yet sometimes (and more often than not) I love my ADHD and all it’s given me in my 77 years. (I was diagnosed in my 60s.) I love how it makes me creative and an out-of-the-box thinker. I love that it gives me hyperfocus, boundless energy, and tenacity.

But on January 2, 2026, I really hated my ADHD.

The Lows of ADHD

On that day, I tripped on my morning walk and faceplanted onto the sidewalk. I couldn’t stop my momentum and fell into a terrifying plunge that was over before I knew what hit me. There I was, sprawled out on the sidewalk like a snow angel face down, arms and legs outstretched. Tears rolled down my face. I was in shock, stunned and confused and, for one of the few times in my ADHD life, speechless.

My phone, the main reason for the mess I was in, was lying on the sidewalk just out of my reach. My earbuds, the other reason for my mess, were still sitting in my ears with Grupo Bip’s high-energy song “Azucar” blasting through.

[Read: The Transformative Power of an ADHD Diagnosis for Older Women]

I had become a certified Zumba instructor at 71 — thanks, ADHD — and was mentally choreographing a routine for my class later that morning. At the same time, and in my typical ADHD fashion, I was reading about an upcoming ADHD conference that had popped up on my phone. (A fact that makes my trip even more delicious.) I was lost in conference twaddle and minutia. I didn’t stand a chance.

I had been walking Maddie, my dog, like I did every morning. Now she was leaning over me, panting nervously, showering my left arm with drools and occasional wet kisses. With the help of two landscapers, who had witnessed the whole calamity, I righted myself, grabbed Maddie’s leash and made my way back home, unaware of the limp in my gait and the swelling that was growing in my knee.

It was obvious that I had messed up as soon as I walked into my living room — my knee now the size of a grapefruit — my face painted with dark red, blue, purple, and black shadows getting deeper by the moment, a testament to the severity of my collision with the sidewalk.

So it was off to the nearest urgent care center. The verdict: All the marbles in my head were intact but I had fractured my patella. The next thing I knew, my left leg was in a full knee brace.  The good news was that it wouldn’t be forever – just eight weeks. The bad news — no doing anything that involves knees, legs, or movement. Yikes!

I had been sidelined, forced to corral my excess energy, my impatience, and my restlessness. The worst of all of it was no Zumba, my indispensable go-to for managing my ADHD. Now what?

I Thought I Hated My ADHD

I thought I hated my ADHD until I realized I didn’t. It only took me 10 weeks after my fall to come to this realization. More precisely, it was on Friday, March 13. My lucky day. It was the day I was set to be freed from my knee brace and crutches. That same day, I acknowledged that, while my ADHD got me into this mess, it also helped me endure it.

You see, for the last couple of months, while my body healed, I had rediscovered and leaned into another passion: writing. Like Zumba, it helps keep my ADHD challenges in check. It’s an activity where my creativity, hyperfocus, and the best parts of me come through.

[Read: Creative Thinking Is an ADHD Specialty]

ADHD creative juices flowing, my tenacity in charge, I would start writing in the morning, before the sun came up, and late into the night, long after the sun set. What was I working on? The final draft of my memoir I had started over a year ago: Embracing Your Rollercoaster: Navigating ADHD Across a Lifetime—Challenges and Triumphs.

At the direction of my editor, I filled my final draft with “emotional resonance.” Sitting at my desk, my left leg with its knee brace propped up on a footstool, Maddie laying at my feet, I hyperfocused and wrote. In many ways, my fall — the ADHD-ness of it — had opened the floodgates of vulnerability, the kind my memoir needed. It made it easier to revisit some of the moments in my past that I might rather have forgotten. But I relived them, and I credited my ADHD for giving me the drive and determination to do so.

Like I have done so many times throughout my life, I rewrote the script. While an ADHD moment had slowed me down, it didn’t stop me. In fact, it gave me an opportunity to keep going in a different direction that allowed me to tell my story.

Over the years, I’ve learned to embrace ADHD’s “pain in the ass” and “amazing” moments. They both make up all of me, after all. I am the girl, now the older woman, who strives for flawlessness, who is persistently restless, and who burns the candle at both ends. The same person who always tilts the box to see what’s underneath, who can disappear into a task, who is curious enough to take risks, and who’s spontaneous with a crackle of energy, and a spark that refuses to dim.

Life with ADHD: Next Steps

• Read: Turning Regret Into Reset After an ADHD Diagnosis
• Read: “I’m Newly Diagnosed at 90 — and So Thankful”
• Read: “What If My Intense Drive Is Because of — Not in Spite of — My ADHD?”

ADDITUDE IS HUMAN
Artificial intelligence does not write or edit any content published by ADDitude. Our team is 100% human, and our mission is simple: listen to and serve our readers with hand-crafted, expert-informed resources. To support ADDitude, please consider subscribing. Your readership and support help make our commitment possible. Thank you.