Currently Viewing:
American Professional Society of ADHD and Related Disorders

Psychologist Barkley Says Life Expectancy Slashed in Worst Cases for Those With ADHD

Allison Inserro
Using a large database created by a center for actuarial studies, a psychologist and researcher is positing that people with the worst cases of attention-deficit/hyperactivity disorder (ADHD) will see a 25-year reduction in life expectancy, according to a presentation made Saturday at the annual meeting of the American Professional Society of ADHD and Related Disorders.
Using a large database created by a center for actuarial studies, a psychologist and researcher is positing that people with the worst cases of attention-deficit/hyperactivity disorder (ADHD) will see a 25-year reduction in life expectancy, according to a presentation made Saturday at the annual meeting of the American Professional Society of ADHD and Related Disorders (APSARD).

The implications of this pilot, by Russell A. Barkley, PhD, clinical professor of psychiatry at the Virginia Commonwealth University Medical Center, are that primary care providers are dealing with this issue in their adult patient population, whether they realize it or not, he said during a session called Health Outcomes of ADHD: Do They Adversely Impact Life Expectancy?

During his talk, Barkley noted several earlier studies that support his underlying hypothesis, explaining that ADHD is linked to lower conscientiousness, and decreased child conscientiousness is associated with earlier death by all causes.1,2

Other studies have found an increased risk for suicide3—adults with ADHD are 1.8-times more likely to die within any 4-year period than the general population—and that the risk of mortality doubles as a child with ADHD transitions to adulthood.4

That makes sense, Barkley said, as “you are moving into more domains of risk.”

He also cited other studies that have found those with ADHD are more likely to have a less healthy diet, more likely to be overweight and eat impulsively, more likely to be obese, and that females are more likely to have a higher risk of eating disorders.

To arrive at his conclusion about reduced life expectancy, he used an existing cohort of ADHD patients he and his colleague, Mariellen Fischer, PhD, department of neurology, Medical College of Wisconsin, have been following for years.

The longitudinal cohort includes 158 patients who were diagnosed with hyperactive (H) child syndrome in 1978-1980, when they were 4 to 11 years of age.

They were matched with 81 control (C) children from the same schools and neighborhoods. Participants were mostly males (83%-94%).

Most children were re-evaluated at mean ages of 15 (C = 78%, H = 81%), 21 (C = 93, H = 90%), and currently at 27 years (C = 93%, H = 85%).

To be currently considered as having persistent ADHD (H+ADHD), participants had to have 4+ symptoms on either DSM-IV symptom list and 1+ domains of impairment (out of 8) by self-report (n = 55). 

Remainder (n = 80) were grouped as H-ADHD, with 3 or fewer symptoms of ADHD, labeling them as nonpersistent into adulthood.

Barkley and his team entered mean data for each group into the Healthy Life Expectancy Data Calculator, which was launched last year by the Goldenson Center for Actuarial Research at the University of Connecticut. The calculator measures how many predicted years one has left to live, based on algorithms. It measures both total years and healthy years.

Variables were:
  • Male
  • Age 27 years (mean for all groups)
  • Mean height for group (5 feet 10 inches for all 3 groups)
  • Mean income (always $25,000–$50,000 categorization)
  • Type 2 diabetes (always No)
  • Current health (Good; options: poor, fair, very good, and excellent)
  • Driving accidents (always 0; options: 1 per year or 2-plus per year)
Fixed variables were adjusted for each group (C, H+, H-) in analysis of typical (average) group comparison:
  • Mean weight for group (194, 209, and 205, respectively)
  • Diet (Good for controls, fair for both ADHD groups)
  • Sleep (8+ hours per night for controls, <5 for H+ group, and 5-8 for H–; sleep concerns were 14%, 52%, and 32%, respectively)
  • Variables [binary] adjusted for analysis of worst- and best-case scenarios
  • Education (non-HS, HS, college, or graduate school)
  • Current smoker (No or Yes)
  • Alcohol use (No [rarely] or Yes [used mean drinks per week for group])
  • Diet (Good for controls, fair for both ADHD groups)
  • Regular exercise (No [rarely] or Yes [3-4 days per week]; other options: 1-2 days per week, 5+ days week)


 
Copyright AJMC 2006-2019 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up