Yaşlılarda Dikkat Eksikliği ve Hiperaktivite Bozukluğu

Abstract

Dikkat eksikliği hiperaktivite bozukluğu (DEHB), kalıtsal olarak geçebilen, çevresel faktörlerden etkilenen, çocukluk çağının en yaygın görülen nöropsikiyatrik sendromu olup, yetişkin çağda da devam edebilen ve hatta geriatrik popülasyonda görülebilen bir bozukluktur. Geriatrik popülasyonda kendini farklı semptomlarla gösterebilen, tanısı genelde göz ardı edilen DEHB, kimi zaman kendini demans ya da depresyon belirtileri ile de gösterebilmektedir. Yaşlı popülasyonda prevalansın %3-4 oranında olduğu düşünülmektedir. Henüz yaşlılara özgül DEHB tanı ölçütleri mevcut olmamakla birlikte DSM-5’de bulunan ölçütlerdenyararlanılarak tanı konulmaktadır. Görüntüleme ve nörofizyolojik yöntemlerden yararlanılsa da DEHB’ye yönelik özgül bir bulgu ya da görüntü yoktur. Frontal ve prefrontal alanlarda, gri cevher lezyonlarında bozukluklar manyetik rezonans görüntüleme (MRI) ile gösterilebilmektedir. DEHB patofizyolojisi tam olarak aydınlatılamamış olsa da geriatrik popülasyonda uyku bozukluklarından demansa kadar uzanan geniş bir spektrumda klinik özellikler gözlenmektedir. Dolayısıyla yaşlı bireylerde DEHB ayrıntılı bir şekilde incelenmeli ve yeni çalışmalarla hastalığa özgül tanı ölçütleri geliştirilmelidir çünkü mevcut literatürde belirtilen DEHB sıklığının gerçek yaşamdakinden çok daha az olduğu düşünülmektedir.

Keywords

• Dikkat eksikliği hiperaktivite bozukluğu,Yaşlılık

Attention Deficit Hyperactivity Disorder in the Elderly

Abstract

Attention deficit hyperactivity disorder (ADHD) is a neuropsychiatric syndrome which is hereditarily inherited, affected by environmental factors, and most commonly seen in childhood. It is a disorder that can continue in adulthood and is seen even in the geriatric population. ADHD, which may manifest itself with different symptoms in the geriatric population and the diagnosis of which is often overlooked, may sometimes present itself with dementia or depressive symptoms. Its prevalence is thought to be 3-4% in the elderly population. However, the diagnostic criteria of the ADHD in the elderly population are not yet available and the diagnosis is made based on the criteria found in the DSM-5 (Diagnostic and Statistical Manual of Mental Health Disorders, 5th edition). Although some imaging and neurophysiological methods are utilized, there is no specific finding or image for ADHD. Defects in gray matter lesions in frontal and prefrontal areas can be demonstrated by magnetic resonance imaging (MRI). Some researchers think that functional MRI will provide more promising results in the future. Although the pathophysiology of ADHD has not yet been fully elucidated, clinical features are observed in a wide spectrum ranging from sleep disorders to dementia in the geriatric population. Therefore, ADHD should be examined in detail in the elderly population and new diagnostic criteria should be developed for the disorder by new studies. Because it is thought that the frequency of ADHD in the current literature is much less than that in real life.

Keywords

• Attention Deficit Hyperactivity Disorder,Elderly

References

1. APA (1968) Diagnostic and Statistical Manual of Mental Health Disorders, 2th edition (DSM-II). Washington DC, American Psychiatric Association.
2. APA (1978) Diagnostic and Statistical Manual of Mental Health Disorders, 3th edition (DSM-III). Washington DC, American Psychiatric Association.
3. APA (1987) Diagnostic and Statistical Manual of Mental Health Disorders, 3th edition (DSM-III-R). Washington DC, American Psychiatric Association.
4. APA (2000) Diagnostic and statistical manual of mental disorders, 4th edition (DSM-IV-TR). Washington DC, American Psychiatric Association.
5. APA (2013) Diagnostic and statistical Manual of Mental disorders, 5th edition (DSM-5). Washington DC, American Psychiatric Association.
6. Brod M, Schmitt E, Goodwin M, Hodgkins P, Niebler G. (2012) ADHD burden of illness in older adults: a life course perspective. Quality of Life Research, 21:795-799.
7. Butterfield ME, Saal J, Young B, Young JL. (2016) Supplementary guanfacine hydrochloride as a treatment of attention deficit hyperactivity disorder in adults: a double blind, placebo-controlled study. Psychiatry research, 236:136-141.
8. Casey B, Epstein JN, Buhle J, C. Liston, M.C. Davidson, S.T. Tonev et al. (2007) Frontostriatal connectivity and its role in cognitive control in parent-child dyads with ADHD. American Journal of psychiatry, 164:1729-1736.

9. Castellanos FX, Lee PP, Sharp W, Jeffrie N O, Greenstein D K, Clasen et al. (2002) Developmental trajectories of brain volume abnormalities in children and adolescents with attention-deficit/hyperactivity disorder. Jama, 288:1740-1748.
10. Chang Z, D’Onofrio BM, Quinn PD, Lichtenstein P, Larsson H. (2016) Medication for attention-deficit/hyperactivity disorder and risk for depression: a nationwide longitudinal cohort study. Biological psychiatry, 80:916-922.
11. Chang Z, Lichtenstein P, D’onofrio BM, Sjölander A, Larsson H. (2014) Serious transport accidents in adults with attention-deficit/hyperactivity disorder and the effect of medication: a population-based study. JAMA psychiatry, 71:319-325.
12. Chen Q, Sjölander A, Runeson B, D’onofrio BM, Lichtenstein P, Larsson H. (2014) Drug treatment for attention-deficit/hyperactivity disorder and suicidal behaviour: register based study. Bmj 348: g3769.
13. Cubillo A, Halari R, Smith A, Giampietro V, Taylor E, Rubia K. (2012) Fronto-cortical and fronto-subcortical brain abnormalities in children and adults with ADHD: a review and evidence for fronto-striatal dysfunctions in adults with ADHD followed up from childhood during motivation and attention. Cortex, 48:194-215.
14. Cubillo A, Rubia K. (2010) Structural and functional brain imaging in adult attention-deficit/hyperactivity disorder. Expert review of neurotherapeutics, 10:603-620.
15. Ellison-Wright I, Ellison-Wright Z, Bullmore E. (2008) Structural brain change in attention deficit hyperactivity disorder identified by meta-analysis. BMC psychiatry, 8:51.
16. Faraone SV, Biederman J, Mick E. (2006) The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychological medicine, 36:159-165.
17. Faraone SV, Glatt SJ. (2010) A comparison of the efficacy of medications for adult attention-deficit/hyperactivity disorder using meta-analysis of effect sizes. Journal of Clinical Psychiatry, 71:754
18. Faraone SV. (2000) Genetics of childhood disorders: XX. ADHD, part 4: is ADHD genetically heterogeneous? Journal of the American Academy of Child & Adolescent Psychiatry, 39:1455-1457.
19. Fassbender C, Zhang H, Buzy WM, Cortes RC, Mizuiri D, Beckett et al. (2009) A lack of default network suppression is linked to increased distractibility in ADHD. Brain research, 1273:114-128.
20. Fayyad J, Sampson NA, Hwang I, Adamowski T, Gaxiola S, Al-Hamzawi et al. (2017) The descriptive epidemiology of DSM-IV adult ADHD in the world health organization world mental health surveys. ADHD Attention Deficit and Hyperactivity Disorders, 9:47-65.
21. Fischer BL, Gunter-Hunt G, Steinhafel CH, Howell T. (2012) The identification and assessment of late-life ADHD in memory clinics. Journal of attention disorders, 16:333-338.
22. Frank M et al. (2012) Cutting Edge Psychiatry in Practice 2012. http://www.cepip.org/sites/default/files/CEPiP.2012.1.pdf ( 07/12/2018 Accessed date)
23. Fusar-Poli P, Rubia K, Rossi G, Sartori G, Balottin U. (2012) Striatal dopamine transporter alterations in ADHD: pathophysiology or adaptation to psychostimulants? A meta-analysis. American Journal of Psychiatry, 169:264-272.
24. Ghanizadeh A. (2015) A systematic review of reboxetine for treating patients with attention deficit hyperactivity disorder. Nordic journal of psychiatry, 69:241-248.
25. Gizer IR, Ficks C, Waldman ID. (2009) Candidate gene studies of ADHD: a meta-analytic review. Human genetics, 126:51-90.
26. Golimstok A, Rojas J, Romano M, Zurru M, Doctorovich D, Cristiano E. (2011) Previous adult attention‐deficit and hyperactivity disorder symptoms and risk of dementia with Lewy bodies: a case–control study. European Journal of Neurology, 18:78-84.
27. Guldberg-Kjär T, Johansson B. (2009) Old people reporting childhood AD/HD symptoms: Retrospectively self-rated AD/HD symptoms in a population-based Swedish sample aged 65–80. Nordic journal of psychiatry, 63:375-382.
28. Henry E, Hill Jones S. (2011) Experiences of older adult women diagnosed with attention deficit hyperactivity disorder. Journal of women & aging, 23:246-262.
29. Jain R, Segal S, Kollins SH, Khayrallah M. (2011) Clonidine extended-release tablets for pediatric patients with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 50:171-179.
30. Kollins SH, Jain R, Brams M, Segal S, Findling RL, Wigal et al. (2011) Clonidine extended-release tablets as add-on therapy to psychostimulants in children and adolescents with ADHD. Pediatrics, 127:1406-1413.
31. Kooij J, Bijlenga D, Salerno L, Jaeschke R, Bitter I, Balázs et al. (2019) Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European psychiatry, 56:14-34.
32. Kooij JS, Michielsen M, Kruithof H, Bijlenga D. (2016) ADHD in old age: a review of the literature and proposal for assessment and treatment. Expert review of neurotherapeutics, 16:1371-1381.
33. Krause J. (2008) SPECT and PET of the dopamine transporter in attention-deficit/hyperactivity disorder. Expert Review of Neurotherapeutics, 8:611-625.
34. Lange KW, Reichl S, Lange KM, Tucha L, Tucha O. (2010) The history of attention deficit hyperactivity disorder. Attention deficit and hyperactivity disorders, 2:241-255.
35. Luna B, Padmanabhan A, O’Hearn K. (2010) What has fMRI told us about the development of cognitive control through adolescence? Brain and cognition 72:101-113.
36. Maneeton N, Maneeton B, Srisurapanont M, Martin SD. (2011) Bupropion for adults with attention‐deficit hyperactivity disorder: Meta‐analysis of randomized, placebo‐controlled trials. Psychiatry and clinical neurosciences, 65:611-617.
37. Michielsen M, Comijs HC, Semeijn EJ, Beekman AT, Deeg DJ, Kooij JS. (2013) The comorbidity of anxiety and depressive symptoms in older adults with attention-deficit/hyperactivity disorder: a longitudinal study. Journal of affective disorders, 148:220-227.
38. Michielsen M, Semeijn E, Comijs HC, Van de Ven P, Beekman AT, Deeg et al. (2012) Prevalence of attention-deficit hyperactivity disorder in older adults in The Netherlands. The British Journal of Psychiatry, 201:298-305.
39. Nakao T, Radua J, Rubia K, Mataix-Cols D. (2011) Gray matter volume abnormalities in ADHD: voxel-based meta-analysis exploring the effects of age and stimulant medication. American Journal of Psychiatry, 168:1154-1163.
40. Ormhøj SS, Pottegård A, Gasse C, Rasmussen L. (2018) Use of attention‐deficit/hyperactivity disorder medication among older adults in Denmark. British journal of clinical pharmacology, 84:1505-1513.
41. Riahi F, Tehrani‐Doost M, Shahrivar Z, Alaghband‐Rad J. (2010) Efficacy of reboxetine in adults with attention‐deficit/hyperactivity disorder: A randomized, placebo‐controlled clinical trial. Human Psychopharmacology: Clinical and Experimental, 25:570-576.
42. Rosazza C, Minati L. (2011) Resting-state brain networks: literature review and clinical applications. Neurological sciences, 32:773-785.
43. Schneider M, Retz W, Coogan A, Thome J, Rösler M. (2006) Anatomical and functional brain imaging in adult attention-deficit/hyperactivity disorder (ADHD) a neurological view. European Archives of Psychiatry and Clinical Neuroscience, 256:32-41.
44. Senol V, Unalan D, Akca RP, Basturk M. (2018) Prevalence of attention-deficit/hyperactivity and other disruptive behaviour disorder symptoms among primary school-age children in Kayseri, Turkey. Journal of International Medical Research, 46:122-134.
45. Shaw P, Eckstrand K, Sharp W, Blumenthal J, Lerch J, Greenstein et al. (2017) Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation. Proceedings of the National Academy of Sciences, 104:649-654.
46. Simon V, Czobor P, Bálint S, Mészáros A, Bitter I. (2009) Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. The British Journal of Psychiatry, 194:204-211.
47. Snyder SM, Hall JR. (2006) A meta-analysis of quantitative EEG power associated with attention-deficit hyperactivity disorder. Journal of Clinical Neurophysiology, 23:441-456.
48. Sokunbi MO, Fung W, Sawlani V, Choppin S, Linden DE, Thome J. (2013) Resting state fMRI entropy probes complexity of brain activity in adults with ADHD. Psychiatry Research: Neuroimaging, 214:341-348.
49. Sowell ER, Thompson PM, Toga AW. (2004) Mapping changes in the human cortex throughout the span of life. The Neuroscientist, 10:372-392.
50. Springer R, Springer RJ. (2018) ADHD: The Lifespan and Effects from Adolescence through Adulthood. https://digitalcommons.murraystate.edu/bis437/87 (20.02.2018 accessed date)
51. Stefanatos GA, Baron IS. (2017) Attention-deficit/hyperactivity disorder: A neuropsychological perspective towards DSM-V. Neuropsychology Review, 17:5-38.
52. Surman CB, Goodman DW. (2017) Is ADHD a valid diagnosis in older adults? ADHD Attention Deficit and Hyperactivity Disorders, 9:161-168.
53. Tannock R. (1998) Attention deficit hyperactivity disorder: advances in cognitive, neurobiological, and genetic research. The Journal of Child Psychology and Psychiatry and Allied Disciplines, 39:65-99.
54. Tatlow-Golden M, Prihodova L, Gavin B, Cullen W, McNicholas F. (2016) What do general practitioners know about ADHD? Attitudes and knowledge among first-contact gatekeepers: systematic narrative review. BMC family practice, 17:129.
55. Wetzel M, Burke W. (2008) Addressing attention-deficit/hyperactivity disorder in later adulthood. Clinical Geriatrics, 16:33-39.
56. Wolf RC, Plichta MM, Sambataro F, Fallgatter AJ, Jacob C, Lesch et al. (2009) Regional brain activation changes and abnormal functional connectivity of the ventrolateral prefrontal cortex during working memory processing in adults with attention‐deficit/hyperactivity disorder. Human brain mapping, 30:2252-2266.
57. Yener S. (2017) Dikkat eksikliği-hiperaktivite bozukluğu yaraticiliği tetikler mi? psikolojik iklimin araci rolü. Sinop Üniversitesi Sosyal Bilimler Dergisi, 1:115-148.