ADHD News & Research

Study: Older Drivers with ADHD Have More Car Accidents

The risk of car accidents, traffic tickets, and hard-braking events is elevated among adults aged 65 to 79 with ADHD, according to a new cohort study.

October 24, 2023

Older drivers with ADHD face an elevated risk for receiving traffic tickets, slamming on the breaks, and having car crashes, according to new research published in Jama Network Open. 1

Car crashes were 74% more likely, traffic tickets were 102% more likely, and hard-breaking events were 7% more likely among adults aged 65 to 79 with ADHD than they were among neurodivergent drivers of the same age, according to a cohort study lead by researchers at Columbia University Mailman School of Public Health. Adult drivers with attention deficit were more than twice as likely to report being involved in traffic ticket events (22 vs. 10 per million miles driven).

Despite the aging U.S. driver population and the increasing prevalence of ADHD in adults, research on ADHD and driving safety primarily studies adolescents and young adults. “Symptoms of ADHD, such as inattentiveness and impulsivity, could affect daily functioning and driving performance throughout the life span,” wrote the authors of this new study, advocating for more research.

“Young adults with ADHD tend to overestimate their driving ability and performance since this disorder can lead to diminished self-assessment and awareness,” the authors continued. “Older adults with ADHD might have similar issues in evaluating their own driving behaviors due to impaired executive functioning, thus leading to higher driving risks. Drivers with ADHD may have difficulty remaining alert and have a decreased reaction time, resulting in a higher likelihood of collision with obstacles.”2,3

ADHD symptoms in seniors are commonly mistaken for and overlap with typical signs of aging, often leading to misdiagnosis and mismanaged treatment. 4 The Columbia University study’s findings highlight the need to improve ADHD diagnosis and treatment for older adults.

“The current Diagnostic and Statistical Manual of Mental Disorders for ADHD only specify the threshold or the number of applicable symptoms for diagnosis in children, adolescents, and adults, without giving special consideration to older adults,” the authors wrote. “Given its association with driving safety alone, ADHD in older adults merits greater attention.”

Kathleen Nadeau, Ph.D., a psychologist who has conducted studies on older adults with ADHD and written the book Still Distracted After All These Years: Help and Support for Older Adults with ADHD (#CommissionsEarned) agrees.

“The status quo is not working for older patients with ADHD; we need new protocols,” she said. “Drastic clinical changes must take place to improve outcomes for underdiagnosed, undertreated, and overlooked older adults. Doctors face unique challenges when managing ADHD in this population, so professionals must take equally specialized steps to diagnose better, treat, and understand seniors with ADHD.”

The Columbia University research team collected data from active drivers enrolled in the Longitudinal Research on Aging Drivers (LongROAD) project for the study. They followed participants for up to 44 months using in-vehicle data recording devices and annual assessments. Of the 2,832 drivers studied, 2.6% had ADHD. That percentage increased to 7.2% among older adults with anxiety or depression.

View Article Sources

1 Liu, Y., Chihuri, S., Mielenz, T.J., et al. (2023). Motor Vehicle Crash Risk in Older Adult Drivers With Attention-Deficit/Hyperactivity Disorder. JAMA Netw Open. 6(10):e2336960. 10.1001/jamanetworkopen.2023.36960

2 Barkley, R.A. (2004) Driving Impairments in Teens and Adults with Attention-Deficit/Hyperactivity Disorder. Psychiatr Clin North Am. 27(2):233-260. doi:10.1016/S0193-953X(03)00091-1

3 Biederman, J., Fried, R., Monuteaux, M.C., et al. (2007). A Laboratory Driving Simulation for Assessment of Driving Behavior in Adults with ADHD: A Controlled Study. Ann Gen Psychiatry. 6(1):4. doi:10.1186/1744-859X-6-4

4 Sibley, M.H. (2021). Diagnosing ADHD in Older Adults: Critical Next Steps for Research. Am J Geriatr Psychiatry. 29(7):679-681. doi:10.1016/j.jagp.2020.11.012