"Can't Focus? It Might Be Undiagnosed Adult ADHD"

DAVID GREENE, HOST:

Attention deficit hyperactivity disorder, or ADHD, it's one of the most common disorders among children. But doctors are now seeing it more and more in adults - older adults over 50. Here's NPR's Patti Nieghmond.

PATTI NEIGHMOND, BYLINE: Kathy Fields (ph) is 66 years old, a former secretary and mother of two grown children. It was a number of years ago, when she was in her late 50s on a golf vacation with friends, that she started worrying her ability to think just wasn't right.

KATHY FIELDS: I could not focus. I couldn't follow, and it just - when I came home, I remember saying to my husband at that time, something's wrong with me.

NEIGHMOND: Fields worried she was having a stroke or maybe getting dementia. Her physician ruled out any physical problems and suggested she see a doctor to check her mental status. Fields went to psychiatrist David Goodman at Johns Hopkins School of Medicine, who happens to specialize in ADHD. He asked her a number of critical questions.

FIELDS: It was almost comical as I answered the questions. Can you complete a task? No. I could have four or five projects going at one time, and none of them would be complete.

NEIGHMOND: The more Fields thought about it, the more she realized this was the story of her life - and her mother's, who also never got things done, she says. Her mother was here, there, everywhere. Psychiatrist Goodman says this is typical. ADHD is genetic.

DAVID GOODMAN: Seventy-five percent of the cause of ADHD is genetic. And that translates into a lot of people in families having this disorder.

NEIGHMOND: In fact, if a parent has ADHD he says, there's a 50-50 chance their child will too. And today, that's often how older adults end up getting diagnosed, through the children.

GOODMAN: The child gets diagnosed. The adult parent gets diagnosed. And then the adult parent scratches their head and thinks about their own mother and father and says, well, you know, my mom was kind of always like this. She was scattered. She picked us up late at school. She would miss teacher conferences. She would forget to pack my lunch. And then you get a picture that, gee, grandmom was like this. And that's the genetic link. It came from grandmom to mom and then down to daughter.

NEIGHMOND: Most older ADHD patients were never diagnosed as children, Goodman says. That's because they grew up in the '50s and '60s, when there was little awareness about ADHD. But once diagnosed, he says, medication to help calm and focus the brain works just as well for them as it does for children. Now, for adults of course, the problem is not disruptive behavior or keeping up in school. It's an inability to focus, which can mean inconsistency, being late to meetings or just having problems managing day-to-day tasks.

GOODMAN: They may overpay bills. They pay underpay bills. They may pay bills late. They may forget about bills.

NEIGHMOND: Goodman says adults with ADHD are more likely than others to lose a job and more likely to file for bankruptcy. An ADHD diagnosis, he says, can be a huge relief.

GOODMAN: People will say, well, look, if you've had this your whole life and you're now 65, why bother getting it diagnosed and treated? Well, if you spent your whole life with a disorder for which people said you were lazy and stupid and incompetent, it would be very helpful to be able to sort out the difference between what you have, which is ADHD, versus who you are as a person.

NEIGHMOND: Goodman says people at any age find it liberating to realize their impairments are the result of a treatable disorder and not a character weakness or intellectual inadequacy. That was certainly the case for Kathy Fields, who is now on ADHD medication.

FIELDS: The dots started connecting.

NEIGHMOND: She can focus and get things done. Goodman does have a word of caution when it comes to medication for adults. He says it's important to consider other health problems, like high blood pressure or heart disease and any other medications patients might be on. Patti Neighmond, NPR News.