ADHD News & Research

ADHD May Reduce Life Expectancy by As Much As 13 Years

Childhood ADHD may more drastically shorten a patient’s life expectancy than any other single health threat including high cholesterol, obesity, and alcohol or tobacco use. This is according to a new study by Russell Barkley, Ph.D., who determined that the risk factors associated with childhood ADHD may decrease longevity by up to 13 years.

November 20, 2018

High cholesterol, body-mass index, and substance use – these are the major risks to patient longevity most closely monitored by physicians. And, according to Russell Barkley, Ph.D., this list is missing one key metric: childhood ADHD.

In fact, Barkley says ADHD is the Number One factor affecting mortality for the people who have it. In other words, ADHD is not just a mental health issue; it’s a significant public health problem.

During a presentation at the 2018 CHADD Conference in St. Louis, Missouri last week, Barkley demonstrated the complex ways attention deficit disorder (ADHD or ADD) can shorten a patient’s life span. Barkley’s research team used data from a longitudinal study that followed a large group of predominantly white, male patients with ADHD from childhood through adulthood in Milwaukee, Wisconsin. The team uncovered a set of distinct risk factors — and adverse outcomes — during each developmental stage. These ADHD-related risk factors spanned cognitive, family, peer, educational, occupational, financial, sexual, driving, and health-related domains.

The researchers then used an actuarial database calculator from the University of Connecticut (UConn) to determine exactly how each risk factor may translate into years of lost longevity.The results of this analysis showed that expected life span is reduced by nearly nine healthy years (eight years overall), for those who had ADHD in childhood when compared to a control group.

Patients whose ADHD persisted into adulthood saw an additional five-year reduction in life expectancy. Compared to a control group, adults with ADHD could expect to have 11 to 13 years cut off their lives compared to neurotypical peers of a similar age and heath profile.

Why Does ADHD Impact Life Span So Dramatically?

Regression analyses determined that impaired behavioral inhibition was primary factor that significantly reduced life expectancy in people with childhood ADHD. This includes the following behaviors:

  • Low conscientiousness
  • Poor self-regulation
  • High impulsivity

There are two ADHD-risk genes that additionally contribute to reduced life expectancy when they occur in certain allele polymorphisms, and there is also a small effect from comorbid conditions including conduct problems and mood disorder.

How Can Physicians Help Mitigate These Risk Factors?

The ADHD-related reductions in life expectancy are impressive, but not unchangeable. Nine of the fourteen risk factors used in the UConn calculator can be altered:

  1. education
  2. hygiene practices
  3. weight
  4. nutrition
  5. exercise
  6. sleep
  7. driving risks
  8. tobacco use
  9. alcohol use

Initiatives to improve overall health will improve life expectancy going forward – if ADHD symptoms are under control first, Barkley says. Because ADHD causes underlying problems with inhibition, self-regulation, and conscientiousness, leaving the condition untreated or insufficiently treated will cause most patients to fail in their efforts to live healthier lives.

First, physicians must focus on reducing impulsivity and behavioral inhibition problems with medication or cognitive behavioral interventions. Additionally, they must broaden their assessment lens to acknowledge that patients who fail repeatedly at self-change programs should be evaluated for underlying ADHD.

The publication of the study is forthcoming in the Journal of Attention Disorders.