A large-scale study suggests many adults, especially those over 65, may be living with ADHD without a formal diagnosis or access to appropriate support.
A major new study has found that Attention Deficit Hyperactivity Disorder (ADHD) may still be significantly underdiagnosed among adults in England, despite a sharp rise in awareness and diagnoses in recent years.
Researchers from University College London (UCL), the University of Liverpool and King's College London analysed healthcare records from more than 42 million people in England and found that recorded ADHD diagnosis rates remain well below estimates of how common the condition is thought to be in the wider population.
The study found that around 1.19% of people in England had an ADHD diagnosis recorded in their primary care records. However, international research generally suggests that between 3% and 5% of adults may have ADHD, indicating that many people could still be living with the condition without a formal diagnosis.
The gap appeared particularly pronounced among older adults. Researchers found that only around 0.05% of people aged over 65 had an ADHD diagnosis on their medical records, despite evidence suggesting the condition can persist throughout life.
The researchers also examined trends over time and found that new ADHD diagnoses increased across most age groups after 2020. They believe growing public awareness, improved recognition by healthcare professionals and greater understanding of adult ADHD may have contributed to the rise.
However, the findings suggest that many adults, particularly those who grew up before ADHD was widely recognised, may never have been assessed or diagnosed. This could mean some people are not receiving support that could help them manage difficulties with attention, organisation, impulsivity or other symptoms associated with the condition.
The authors say healthcare services and clinicians should be aware that low diagnosis rates among older adults do not necessarily mean ADHD is rare in later life. Instead, many people may have gone unrecognised for decades.
Study co-author Dr Georgia Pavlopoulou, Associate Professor at UCL and Neurodiversity Programmes Lead at Anna Freud, said:
“Our findings suggest that ADHD is being under-recognised, challenging increasingly common narratives about overdiagnosis. The results also indicate that some groups who do not fit traditional stereotypes about ADHD, including older people, women and those from minoritised ethnic communities, may be particularly affected.
“To turn this evidence into action, we want to see services better resourced to provide culturally responsive, gender-informed and equitable support.”
The findings have been published in The Lancet Regional Health – Europe
More information: Original UCL article: UCL News – ADHD may be underdiagnosed in adults across England
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