Unraveling the phenotypic expression of ADHD symptoms in middle- and older-aged adults: insights from confirmatory factor analysis of the US Health and Retirement Study.

Background Few studies have examined attention-deficit/hyperactivity disorder (ADHD) symptoms in middle- and older-aged adults. We aim to examine the phenotypic expression of ADHD symptoms in these age groups. Methods This study comprised a random sample (N  = 1,562) from the US Health and Retiremen...

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Publicado en:Psychological Medicine Vol. 55; pp. 1 - 10
Formato: research tables/charts Journal Article
Publicado: Cambridge University Press 2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2025
      vid: 55
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      pub: Cambridge University Press
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        atl: Unraveling the phenotypic expression of ADHD symptoms in middle- and older-aged adults: insights from confirmatory factor analysis of the US Health and Retirement Study.
      aug:
      sug:
        subj:
          Phenotype United States
          Attention Deficit Hyperactivity Disorder Symptoms
          Attention Deficit Hyperactivity Disorder Symptoms
          Attention Deficit Hyperactivity Disorder Familial and Genetic
          Human
          Male
          Female
          Middle Age
          Aged
          Aged, 80 and Over
          Random Sample
          United States
          Scales
          Factor Analysis
          Comparative Studies
          Impulsive Behavior
          Chi Square Test
          Confidence Intervals
          Cognition Disorders
          Dementia
          Cognition
          Depression Symptoms
          Genetic Risk Score
          Attention Deficit Hyperactivity Disorder Epidemiology
          Prediction Models
          Interviews
          Cross Sectional Studies
          Classification Algorithms
          Descriptive Statistics
          Data Analysis Software
          Psychological Tests
          Self Report
          Aging
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Background Few studies have examined attention-deficit/hyperactivity disorder (ADHD) symptoms in middle- and older-aged adults. We aim to examine the phenotypic expression of ADHD symptoms in these age groups. Methods This study comprised a random sample (N  = 1,562) from the US Health and Retirement Study 2016, a representative US sample aged 50 years and over. ADHD symptoms were assessed based on the Adult ADHD Self-Report Scale. Results In the primary analysis, 10 competing confirmatory factor analytic models of ADHD symptoms in middle- and older-aged adults were compared. The best-fitting model was hierarchical with a general ADHD factor at the apex and underneath symptom factors of inattention, hyperactivity, and impulsivity (ꭓ 2  = 319.34, df = 91.71, P  = 0.00, TLI = 0.98, CFI = 0.96, RMSEA = 0.04, 95% CI = 0.04–0.05). In complementary analyses, this model was a satisfactory fit to the data: (1) in individuals without a history of cognitive impairment or dementia, and when the general ADHD factor was specified to load on (2) cognitive function, (3) depressive symptoms (which showed adequate fit), and (4) ADHD polygenic scores, (5) in middle- and older-aged adults, and (6) when weighted to represent the US population. Conclusions These results imply a hierarchical representation of ADHD symptoms in middle- and older-aged adults consisting of a general factor at the apex with neurocognitive and genetic correlates and underneath symptom factors of inattention, hyperactivity, and impulsivity. Collectively, this model offers a novel framework to study the mechanisms of ADHD symptoms in middle- and older-aged adults and points to treatment targets.
      pubtype: Academic Journal
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        research
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        Journal Article
      ougenre: Article
    language: English
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