Columbia Study Highlights Driving Risks in Adults with ADHD

Guohua Li, MD, DrPHFinster Professor of Epidemiology and Anesthesiology Columbia University Irving Medical Center

Prof. Guohua Li Interview with:
Guohua Li, MD, DrPH
Finster Professor of Epidemiology and Anesthesiology
Columbia University Irving Medical Center What is the background for this study? How was the ADHD diagnosis determined?

Response: The reported prevalence of ADHD in children and young adults in the United States has more than doubled since the 1990s because of improved diagnosis.  Currently, ADHD affects about 13 percent of children under 18 years of age and eight percent of adults under 45 years of age.  Little is known about the prevalence of ADHD in older adults although it is estimated that ADHD symptoms may persist throughout the lifespan in about one-third of children diagnosed with the disorder.  Diagnostic criteria for adulthood ADHD include having five or more relevant symptoms, adverse impact on social, academic, and occupational activities,  and onset of symptoms before age 12.

In this study, ADHD status is determined based on an affirmative response to the question of whether the participant had ever had ADHD or had ever been told by a doctor or other health professional that he or she had ADHD. What are the main findings?

Response:  This study involved following 2832 drivers aged 65 to 79 years for up to 44 months.  Of the older adult drivers studied, 75 (2.6%) had ADHD.  During the follow-up, those with ADHD had significantly higher incidence rates per mile driven of hard braking events (i.e., maneuvers with linear acceleration rates ≥ 0.4 g), self-reported traffic ticket events, and self-reported vehicular crashes than their counterparts without ADHD. After adjusting for demographic and other characteristics,

ADHD was associated with a seven percent increased risk of hard braking events, a 102 percent increased risk of self-reported traffic ticket events, and a 74 percent increased risk of self-reported vehicular crashes. What should readers take away from your report?

Response: ADHD symptoms may decrease as age increases.  But not every child with ADHD will grow out of the symptoms.  Our study shows that about three percent of older adult drivers have ADHD and that those with this medical condition are more prone to crashes than their counterparts without. What recommendations do you have for future research as a results of this study?

Response: Evidence-based programs are warranted to improve screening, diagnosing, and treating ADHD among older adults.  Future research needs to evaluate interventions to ensure safe mobility for older adults being afflicted with this medical condition.

No disclosures


Yuxin Liu et al, Motor Vehicle Crash Risk in Older Adult Drivers With Attention-Deficit/Hyperactivity Disorder, JAMA Network Open (2023). DOI: 10.1001/jamanetworkopen.2023.36960

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Last Updated on October 4, 2023 by Marie Benz