Children who show signs of ADHD at age 10 are more likely to have physical health problems and disabilities at age 46, according to a study led by researchers at University College London (UCL) and the University of Liverpool.
The researchers say the findings likely reflect the wide range of health risks associated with attention deficit hyperactivity disorder (ADHD), along with the long-term effects of how people with ADHD are treated and supported in adulthood.
Published in JAMA Open Networkthe research is one of the largest and longest-running studies to examine how childhood ADHD traits are associated with physical health later in life.
Evidence points to lifelong health problems
Lead author Professor Joshua Stott (UCL Psychology & Language Sciences) said: “Here we have added to the worrying evidence base that people with ADHD are likely to experience poorer than average health over their lifetime.
“People with ADHD can thrive with the right support, but this is often lacking, both because of a lack of tailored support services and because ADHD remains underdiagnosed, particularly in middle-aged and older people with unaddressed needs.”
How ADHD can affect daily functioning
People with ADHD experience differences in attention along with increased levels of hyperactivity or impulsivity. Many have high energy and can focus intensely on activities that interest them, but may have difficulty concentrating on routine or less engaging tasks.
These challenges can affect planning, time management, and impulse control. Over time, this can make school and work more difficult and increase the risk of long-term social and work difficulties.
ADHD begins in childhood and, although it is now widely accepted that it often continues into adulthood, adults in the UK are undertreated compared to other high-income countries. Support services also remain limited.
Tracking health outcomes over decades
To examine the long-term effects, the researchers analyzed data from 10,930 participants in a 1970 UCL-led British cohort study that followed individuals from birth to middle age.
ADHD traits were assessed using behavioral questionnaires completed by parents and teachers when participants were 10 years old. These measures were used regardless of whether the participant ever received a formal diagnosis of ADHD.
Higher rates of chronic disease and disability
The study found that people with higher levels of ADHD traits in childhood were more likely to report physical health problems at age 46. They were 14% more likely to report two or more conditions, including migraines, back problems, cancer, epilepsy or diabetes.
Among those with elevated ADHD traits at age 10, 42% reported having at least two physical health problems by midlife. In comparison, 37% of those with lower ADHD trait scores reported the same.
Participants with higher childhood trait ADHD were also more likely to report physical health-related disability (reporting problems with work or other daily activities as a result of their physical health) at age 46.
Possible reasons for health disparities
The researchers found that poorer physical health outcomes were partially associated with higher rates of mental health problems, increased BMI, and higher rates of smoking among people with ADHD.
Previous studies have also shown that people with ADHD are more likely to experience stressful life events and social exclusion, and are less likely to receive timely medical evaluation and care.
The association between childhood ADHD traits and physical health-related disability appears to be stronger in females than in males.
Professor Stott added: “All these potential explanatory factors are consistent with the fact that ADHD makes impulse control more difficult, the need for immediate gratification and reward more intense, and is also associated with poorer mental health partly due to the social disadvantage of people with ADHD.”
Implications for promotion and public health
A separate study published last year by the same research team reported a possible reduction in life expectancy in adults diagnosed with ADHD, although this finding was not part of the current research.
Lead author Dr Amber John, who started at UCL before moving to the University of Liverpool, stressed the importance of getting the right support: “It’s important to recognize that people with ADHD are a diverse group with a range of different strengths and experiences and most will lead long and healthy lives.
“However, many face significant barriers to early diagnosis and appropriate support. This is important because providing the right support and meeting the needs of people with ADHD can help improve their physical and mental health outcomes.”
“In addition, public health strategies should consider the needs of people with ADHD, for example by making screening programs and ongoing health monitoring available for people with ADHD.”
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