From: unk...@googlegroups.com   
      
   ADHD and Dementia: What's the Connection?   
   Can ADHD Lead to Dementia Later in Life?   
   Published on November 29, 2014 by Larry Maucieri, Ph.D.,   
   ABPP-CN in The Distracted Couple   
      
   ADHD and Dementia with Lewy Bodies (DLB)   
      
   I recently attended the annual CHADD Convention in Chicago, a large national   
   meeting about ADHD. A speaker I heard there mentioned that there is a link   
   between ADHD and Dementia with Lewy Bodies (DLB), a kind of dementia. I knew   
   of an article several    
   years back that suggested a possible link between the two conditions, but had   
   not heard anything else on it since then. As a clinical neuropsychologist, I   
   work with clients impacted by ADHD as well as dementias such as DLB, and so   
   the speaker's comments    
   intrigued me. I wondered if more research had linked the two disorders since I   
   last read about it.   
      
   What is Dementia with Lewy Body (DLB)?   
      
   Before talking about ADHD and DLB, it would help to describe what DLB is.   
   Although many people have not have heard of it before, DLB is not a rare form   
   of dementia. It is not anywhere close to Alzheimer's disease in terms of   
   frequency or public    
   familiarity, but some experts have ranked it as possibly the second most   
   common form of dementia after Alzheimer's. DLB can look a bit like Parkinson's   
   disease, and it can sometimes be difficult to tell them apart. A few recent   
   media reports for instance    
   have debated whether Robin Williams showed signs of Parkinson's disease or DLB   
   before his death.   
      
   Related Links   
   What to do when your Child is Scatterbrained   
   What Can I Do About My Adult ADHD?   
   ADHD Adults: "What It Feels Like to Have ADHD"   
   What Role, Obligation?   
   ADHD Adults: "What It Feels Like to Have ADHD"   
      
       
   Microscopic abnormalities inside of nerve cells called Lewy bodies (hence the   
   name) occur in both DLB and Parkinson's disease. The movement problems that   
   occur in Parkinson's disease also tend to appear in DLB. Like all common   
   dementias, DLB is slow but    
   progressive, leads to multiple cognitive problems, and eventually costs the   
   individual his/her ability to independently handle tasks of daily life. Memory   
   can be impacted in DLB but not nearly to the level that it is diminished in   
   Alzheimer's disease.    
   Other cognitive problems occur, and the person eventually has difficulty doing   
   tasks that were not too challenging before, like driving a car, managing   
   his/her finances, and making appointments.   
      
   Although DLB is difficult to spot, there are sometimes signs that point to DLB   
   in the course of the illness. Some of these involve REM-related sleep   
   problems, fluctuations of on and off weeks in terms of cognition early on, and   
   perhaps most distinctively    
   of all, very detailed and convincing visual hallucinations, often of animals   
   and people, that emerge early in the disease process. The hallucinations are   
   sometimes among the first symptoms of DLB. Frequent falls, dizziness, and   
   incontinence are also    
   sometimes seen in DLB. Hallucinations can also occur in Parkinson's disease,   
   but these are usually considered a side-effect of medication. Clinicians   
   sometimes distinguish the two conditions by considering tremors and motor   
   problems coming before    
   cognitive symptoms as more suggestive of Parkinson's disease, and the opposite   
   pattern (cognitive problems before motor symptoms) as more suggestive of DLB.   
   The age of onset for DLB tends to be after age 50.   
      
   So Are DLB and ADHD Linked?   
      
   So we know what ADHD is, and we know a little bit about DLB. Are they related?   
   Well ... possibly.   
      
   The study I read before was published in 2011 by Dr. Angel Golimstok and   
   colleagues in Argentina. They thought that ADHD and DLB might be linked   
   because of similar levels of brain chemicals in the two disorders (dopamine   
   and norepinephrine). In the study,   
    people who had probable DLB were more likely to endorse prior ADHD symptoms   
   (the authors stopped short of calling it a prior ADHD diagnosis) than those   
   who had probable Alzheimer's disease or who had no dementia. I say "probable"   
   here because a    
   definitive diagnosis for either dementia can only be made by autopsy. In   
   individuals who were too impaired to recall the past, their earlier life   
   symptom recollections were obtained from someone close to them who knew their   
   histories. The differences in    
   endorsed past ADHD symptoms were big - almost 48% in the DLB group versus   
   about 15% in the other two groups - but the study was not perfect.   
      
   The study had some weaknesses. For instance, reports of past behaviors are   
   susceptible to error; definitive diagnoses of ADHD, DLB, or Alzheimer's   
   disease were not be made in this type design; and it was unclear how   
   characteristic this sample was to the    
   general population. There is also a difference between saying someone has ADHD   
   and someone has some of the symptoms of ADHD, or even symptoms that look like   
   ADHD. Still, it did raise some interesting questions about a link between the   
   two disorders.   
      
   In science though, to establish a relationship, multiple studies saying the   
   same thing are needed, rather than just the results of one study. It is a   
   point often lost by the media, but no single study is perfect, so rarely can   
   it be trusted by itself as    
   the last word on a topic. Consider how some of the weaknesses mentioned above   
   might lead to inaccurate results.   
      
   The interesting thing about the ADHD-DLB link was that the 2011 study got a   
   lot of publicity, but additional studies confirming these results (or even   
   looking at the same topic) were just not found when I searched for them for   
   some time on Google, and on    
   the research publication databases Medline and Psych-Info. Perhaps there are   
   other studies out there that confirm the suspicions of these researchers, but   
   if so, they are pretty hard to find and there are not many of them!   
      
   What this suggests to me is that there might be a link between ADHD and later   
   life DLB, but it is just too soon to make the leap that there is a link   
   between them. This single study just can't establish that link so   
   conclusively. What it does do is set    
   up a good working hypothesis for other studies to see if a trend of research   
   all suggest an ADHD-DLB link. Right now though, it is just too soon to   
   consider it a closed case.   
      
   http://www.psychologytoday.com/blog/the-distracted-couple/201411   
   adhd-and-dementia-what-s-the-connection   
      
   --- SoupGate-Win32 v1.05   
    * Origin: you cannot sedate... all the things you hate (1:229/2)