Attention-Deficit/Hyperactivity Disorder in Psychiatric Outpatients Aged 65 and Over: Prevalence, Impulsivity, and Clinical Outcomes

Objectives Our study examined the prevalence of childhood and adult ADHD in older adults from clinical and control groups, focusing on impulsivity and psychiatric comorbidities.Methods The sample included 261 participants aged 65 years and older. ADHD diagnoses were established through DSM-5–based structured clinical interviews (SCID-5), supported by standardized self-report measures (ASRS, WURS) and corroborative collateral information from relatives when available (89% of the clinical group), reflecting routine diagnostic practice in older adults. Sociodemographic variables were assessed and compared across groups.Results Adult ADHD was diagnosed in 9.7% of the clinical group and 1.5% of controls. Probable childhood ADHD (WURS ≥ 36) was identified in 22.5% of clinical participants. Individuals with ADHD had significantly higher attentional impulsivity scores. Within the clinical group, probable childhood ADHD was associated with increased rates of suicide attempts, legal problems, and traffic violations. In multivariable analysis, ADHD diagnosis independently predicted higher impulsivity levels after controlling for age, sex, and education (p = .003).Conclusions ADHD is associated with clinically relevant impulsivity and behavioral risks in older psychiatric patients, underscoring the importance of considering ADHD in geriatric psychiatric assessments.Clinical Implications Routine assessment of attentional impulsivity may improve ADHD recognition in older psychiatric patients