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ADHD Linked With Hiked Risk of Lewy Body Disease
Evi Arthur
Evi Arthur
Attention-deficit/hyperactivity disorder (ADHD) was associated with an increased risk of Lewy Body disease (LBD), according to results from a recent prospective observational cohort study published in The American Journal of Geriatric Psychiatry.
“The results, far from being conclusive, help to open up research to define more clearly whether ADHD represents an incipient form of dementia, a risk factor or less likely a Phenotypic Mimic,” authors noted. “The fact that ADHD in our study was associated with a variety of LBD features not related to dopaminergic pathways makes us think about the possibility that the relationship between both entities is more complex and still unknown.”
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The study included 161 participants with ADHD and 109 without ADHD, and was conducted at the Italian Hospital Medical Care Program (IHMCP) and the Association Lewy Body Disease (ALBA) in Buenos Aires, Argentina. Patients were between 45 and 70 years old and had visited one of the clinics for cognitive complaints or health checkups. The risk of dementia and LBD was estimated with Kaplan-Meier analysis. Participants were followed for 15 years and had a “control visit” once a year.
By the end of follow-up, 31 participants in total developed dementia: 27 in the ADHD group and 4 in the control group. Dementia with Lewy bodies was the most common type (N = 20) of which 19 were in the ADHD group. The prevalence of nonamnestic MCI was higher, with 67.1% of participants with ADHD (N = 108) and 17.4% (N = 19) of controls. The hazard ratios for dementia and LBD in the multivariate adjusted model were 3.33 (95% CI; 1.0915 to 10.1699) and 54.54 (95% CI; 7.4849 to 397.5028), respectively in the ADHD group.
Authors noted that study results cannot be generalized to all patients with ADHD due to the recruitment methods used and the lack of inclusion of vascular risk factors in the multivariate analysis. Additionally, the small sample size and the exclusion of patients receiving pharmacological treatment for ADHD could limit the findings.
“Future studies should determine if ADHD represents a prodromal phase of the disease or if it is a risk factor. The connection between ADHD and dementias, in general, seems to be related more to comorbidity with depression than to shared pathophysiological mechanisms,” authors concluded. “The fact that ADHD in our study was associated with a variety of LBD features not related to dopaminergic pathways makes us think about the possibility that the relationship between both entities is more complex and still unknown.”
