A recent New York Times article grabbed attention with its provocative headline: “A.D.H.D. Diagnoses Are Surging Among Older Americans.”At first glance, this seems like an important story about mental health and aging. But if you dig deeper, you’ll see the headline doesn’t align with the data—and misses a critical opportunity to address the real mental health challenges facing older adults.
Let’s start with a clarification. In the field of mental health and aging, “older adults” generally refers to people aged 65 and older. The article, however, focuses on ADHD diagnoses in adults between 30 and 64. While that’s an interesting and worthwhile topic, it’s not a story about older adults. Instead, it distracts from a much bigger issue: the widespread underdiagnosis and undertreatment of mental health conditions in people aged 65 and older.
The Real Story: Mental Health Needs in Older Adulthood
Research consistently shows that mental health conditions, including ADHD, often go unnoticed and untreated in older adults. This isn’t because older adults don’t experience these conditions—quite the opposite. Many live with untreated mental health challenges that significantly impact their quality of life. The question is: Why aren’t we identifying and addressing these needs?
The answers are complex, but here are some key factors:
1. Ageism Perpetuates Overlooking Mental Health Needs
Ageism influences how we perceive and respond to older adults. Many mental health symptoms are dismissed as “just part of getting older,” which leads to serious conditions being ignored or minimized.
2. Misattribution to Cognitive or Physical Decline
When older adults present with symptoms like inattention, memory problems, or fatigue, these are often attributed to cognitive decline, dementia, or physical health issues, rather than exploring potential mental health conditions like depression, anxiety, or ADHD.
3. Communication Barriers in Healthcare
Older adults are more likely to report physical complaints than emotional or psychological ones. Unfortunately, most healthcare providers don’t adequately screen for mental health conditions in this population.
4. Coping and Resilience Mask Symptoms
Many older adults have spent decades developing coping strategies to manage untreated mental health challenges. While this resilience is admirable, it can also make symptoms less obvious to healthcare providers.
5. Lack of Provider Training
Most medical and mental health professionals receive little to no training in recognizing and treating mental health conditions in older adults. This knowledge gap leaves many older adults without the support they need.
6. Stigma and Silence
Many older adults grew up during a time when mental health issues were heavily stigmatized. Seeking help was seen as a sign of weakness, leading some to avoid discussing their struggles even with trusted providers.
7. Exclusion From Research
Older adults are routinely excluded from clinical trials, including those focused on mental health. This means fewer evidence-based treatments are tailored to their unique needs.
A Missed Opportunity
Instead of only exploring why ADHD diagnoses are “surging” in middle-aged adults, the article could have expanded the conversation to the glaring absence of data on adults aged 65 and older. For example, why don’t we see a similar surge in ADHD diagnoses among older adults? Is it because they aren’t experiencing symptoms—or because we aren’t looking for them?
The underreporting and undertreatment of mental health conditions in later life is a critical issue with far-reaching consequences. Left untreated, these conditions can lead to poor physical health, increased mortality, and diminished quality of life for older adults.
Moving the Conversation Forward
As a clinical psychologist specializing in mental health and aging, I see these challenges firsthand every day. The mental health needs of older adults are real, urgent, and worthy of our attention. It’s time we take ageism and misinformation out of the equation and prioritize equitable, accurate conversations about mental health across the lifespan.
So, to the journalists, researchers, and policymakers out there: Let’s not conflate middle age with older adulthood. Instead, let’s expand the conversation to include those aged 65 and older, who are too often left out. When we do, we’ll uncover new opportunities to improve care for one of our fastest-growing populations.
If you’re ready to take that step, I’m here to help lead the way. Let’s tell the full story—and make it count.
