People who show attention-deficit/hyperactivity disorder (ADHD) traits in childhood are more likely to experience physical health problems and health-related disability by midlife, according to a large longitudinal study led by researchers at University College London (UCL). Using data based on following patients for more than 40 years, the researchers found that higher levels of ADHD traits at age 10 were associated with a greater number of physical health conditions, increased odds of multimorbidity, and higher levels of physical health–related disability by age 46. The team’s findings are published in JAMA Network Open.
“Here we have added to the concerning evidence base that people with ADHD are more likely to experience worse health than average across their lifespan,” said senior author Joshua Stott, PhD, a professor of aging and clinical psychology at UCL. “People with ADHD can thrive with the right support, but this is often lacking, both due to a shortage of tailored support services but also because ADHD remains underdiagnosed, particularly in people in midlife and older, with needs unaddressed.”
The study uses information from the 1970 British Cohort Study, a nationally representative, population-based research project of individuals born in England, Scotland, and Wales during a single week in 1970.
People with ADHD often experience differences in how they focus attention, manage their impulses, plan tasks, and organize time. These differences can affect education, employment, and access to health care, shaping long-term health outcomes. While it begins in childhood, evidence shows that ADHD often continues into adulthood.
The UCL researchers analyzed data from 10,930 participants who had complete data on key ADHD variables who were followed from birth to age 46. ADHD traits were assessed at age 10 using a validated, dimensional measure using parent and teacher questionnaires, regardless of whether a person ever received a formal ADHD diagnosis. Physical health outcomes at age 46 were based on self-reported conditions, including migraine, back problems, cancer, epilepsy, and diabetes, as well as physical multimorbidity, defined as having two or more co-occurring conditions. Physical health–related disability was defined by limitations either in their work or daily activities.
Analysis of the data showed that higher ADHD traits in childhood were associated with more physical health conditions by midlife and a 14% increase in the odds of multimorbidity. Among those people who likely had ADHD in childhood, whether formally diagnosed or not, 42.1% had two or more physical health conditions at age 46, compared with 37.5% of those without ADHD.
“This cohort study found that high ADHD traits in childhood were associated with poorer physical health outcomes in midlife, with health risk factors explaining part of this association,” the researchers wrote. The investigators noted that smoking, psychological factors, and higher body mass index within the cohort partially explained the link, but after accounting for these direct health-related associations remained.
The findings have implications for clinical care and public health since people with ADHD are more likely to experience stressful life events, social exclusion, and delayed access to health screening and medical care. Stott said these factors “align with the fact that ADHD makes impulse control more difficult, the need for instant gratification and reward more intense, and is also associated with worse mental health in part due to the social disadvantage people with ADHD face.”
The researchers said that it is important clinicians are aware of the increased risk of physical health problems and disability in people with ADHD in order to proactively address contributing risk factors. Future research by the team will focus on strategies for early health screening, prevention, and interventions that can address both health behaviors and the broader social determinants of health.
