This post reviews the open access article: Life expectancy and years of life lost for adults with diagnosed ADHD in the UK: Matched cohort study published in the British Journal of Psychiatry.
The Impact of Diagnosed ADHD on Life Expectancy
O’Nions et al. (2025) investigated the impact of diagnosed attention-deficit hyperactivity disorder (ADHD) on life expectancy in the UK. Using a matched cohort design, researchers analyzed primary care data from 792 general practices, including 30,039 adults diagnosed with ADHD and a matched control group of 300,390 individuals. Mortality rates were assessed using Poisson regression, and life expectancy was estimated using the life-table method, which allows for a statistical projection of expected lifespan. The primary aim was to quantify years of life lost (YLL) in adults diagnosed with ADHD, an analysis that had not previously been performed using direct mortality data.
Findings
The study found a significant reduction in life expectancy for adults with ADHD. Males diagnosed with ADHD had a life expectancy 6.78 years shorter than their non-ADHD counterparts, with a confidence interval ranging from 4.50 to 9.11 years. Females with ADHD experienced an even greater reduction, losing an estimated 8.64 years (CI: 6.55–10.91). The study confirmed previous research indicating that ADHD is linked to increased mortality risk, but this was the first to use actual mortality data rather than extrapolated risk factors. Adults with ADHD were found to have higher rates of physical and mental health conditions, including cardiovascular disease, substance use disorders, and psychiatric comorbidities such as depression and anxiety.
Limitations
While the study offers a compelling argument for ADHD’s impact on lifespan, several limitations warrant consideration. First, the sample was drawn from individuals formally diagnosed with ADHD, which may exclude a substantial portion of undiagnosed cases. ADHD is frequently underdiagnosed, particularly in females and older adults, potentially leading to an overrepresentation of individuals with more severe or treatment-resistant symptoms. Second, the study lacked information on cause-specific mortality, meaning it was unable to determine whether deaths were due to suicide, cardiovascular disease, or other factors disproportionately affecting ADHD populations. Third, treatment effects were not analyzed; it remains unclear whether stimulant medication, behavioral therapy, or other interventions mitigate the observed life expectancy gap. Lastly, socioeconomic status and other environmental variables were not adjusted for, despite their potential role in shaping health outcomes for individuals with ADHD.
How ADHD Can Shorten Life Expectancy
ADHD itself is not a direct cause of death, but its symptoms—such as impulsivity, emotional dysregulation, and inattention—can contribute to behaviors that increase health risks. Individuals with ADHD have higher rates of substance use, smoking, and obesity, all of which contribute to chronic conditions such as heart disease and diabetes. Impulsivity may lead to dangerous behaviors, including reckless driving and increased accident risk. Difficulties with executive functioning—such as forgetfulness and disorganization—can result in missed medical appointments, inconsistent medication adherence, and overall poor healthcare engagement. Social consequences, including higher unemployment rates and financial instability, further exacerbate stress-related health risks, compounding the likelihood of premature mortality.
How Early Detection Can Extend Lifespans
Early diagnosis and intervention offer a crucial pathway to mitigating the risks associated with ADHD. Much like chronic conditions such as diabetes, ADHD requires long-term management to prevent secondary complications. Evidence suggests that stimulant medications, such as methylphenidate (Ritalin) and amphetamines (Adderall), improve impulse control and executive functioning, potentially reducing risk-taking behaviors. Behavioral therapy and executive function training can further help individuals manage lifestyle factors, improve adherence to medical care, and develop healthier routines. Public health efforts should focus on increasing ADHD screening in adults, particularly among populations historically underdiagnosed, to ensure earlier access to treatment and support services.
Can Neurofeedback Save Lives?
Based on six RCTs, Stefanie Enriquez-Geppert and colleagues rated NFB for ADHD level 5 - efficacious and specific in Evidence-Based Practice in Biofeedback and Neurofeedback (4th ed.). NFB interventions included training to decrease the theta/beta ratio and increase sensorimotor rhythm (SMR) activity or slow cortical potential (SCP) activity. NFB training resulted in post-treatment gains in ADHD symptoms, including the Attention Deficit Disorders Evaluation Scale (ADDES). Participants also improved on intelligence, TOVA measures of attentiveness, impulse control, and response variability, and Wide Range Achievement Test scores.
Due to the O'Nions and colleagues study limitations, we don't know whether the association of ADHD with shortened life expectancy is valid. Further, researchers have not established that early ADHD diagnosis and treatment can prevent early deaths. If the answers to these questions are yes, then neurofeedback to enhance executive functions and impulse control may indeed save lives.
Conclusion
This study provides the first direct evidence that adults with ADHD face a reduced lifespan, emphasizing the need for improved diagnosis, early intervention, and long-term management. The findings reinforce that ADHD is not merely a challenge of attention and impulsivity but a condition with profound health implications. Given that many of the risk factors associated with ADHD-related premature mortality are modifiable, targeted healthcare strategies and policy changes could significantly improve life expectancy for this population. Neurofeedback, an evidence-based ADHD treatment, should be one of these targeted interventions.
Key Takeaways
ADHD is associated with a significant reduction in life expectancy: On average, men lose 6.78 years and women 8.64 years, with a potential range of 4.50–10.91 years, making ADHD’s impact comparable to chronic smoking.
The primary drivers of premature mortality in ADHD are behavioral and systemic factors: These include higher rates of cardiovascular disease, substance use, and psychiatric comorbidities, rather than ADHD itself being a direct cause of death.
The study’s limitations highlight the need for further research: Unaccounted factors such as treatment history, socioeconomic background, and cause-specific mortality prevent a full understanding of ADHD’s impact on lifespan.
Early diagnosis and intervention can mitigate these risks: Stimulant medication, behavioral therapy, and healthcare engagement strategies may significantly reduce the life expectancy gap observed in ADHD populations.
ADHD must be recognized as a lifelong condition requiring ongoing support: Despite its classification as a neurodevelopmental disorder, ADHD is often dismissed as a childhood issue. This perception must change to ensure individuals receive adequate long-term care and risk-reduction strategies.
Glossary
ADHD (Attention-Deficit Hyperactivity Disorder): a neurodevelopmental disorder characterized by inattention, impulsivity, and hyperactivity that can affect social, academic, and occupational functioning. Attention Deficit Disorders Evaluation Scale (ADDES): a standardized rating scale designed to assess symptoms of attention-deficit/hyperactivity disorder (ADHD) based on observer reports from teachers and parents. all-cause mortality: a measure of death from any cause, rather than specific diseases, providing a broad estimate of overall health risks in a population.
comorbidity: the presence of one or more additional medical or psychiatric conditions alongside a primary diagnosis. continuous performance test (CPT): a neuropsychological assessment measuring sustained attention and response inhibition by requiring individuals to respond to specific stimuli while ignoring non-target stimuli over a prolonged period. executive functioning: a set of cognitive processes that regulate attention, impulse control, and working memory, often impaired in ADHD.
HRV biofeedback: a self-regulation technique that trains individuals to control heart rate variability (HRV) through paced breathing and cognitive strategies to enhance autonomic balance and stress resilience.
life-table method: a statistical technique for estimating life expectancy by analyzing mortality rates across different age groups within a population.
Poisson regression: a statistical method used to model count data and estimate rates, commonly applied in studies assessing mortality risk.
retrospective study: a research design analyzing past data from records, surveys, or recollections to examine relationships between variables, often used in epidemiology and clinical research.
sensorimotor rhythm (SMR): a brainwave frequency range (12–15 Hz) over the sensorimotor cortex associated with motor inhibition and focus, often targeted in neurofeedback to improve attention and impulse control.
slow cortical potential (SCP): gradual voltage shifts in the EEG lasting several hundred milliseconds to seconds, linked to cortical excitability regulation, often used in neurofeedback for attention and self-regulation training.
stimulant medication: a class of drugs, including methylphenidate and amphetamines, used to enhance dopamine activity in the brain to improve focus and impulse control in ADHD patients. Test of Variables of Attention (TOVA): a computerized continuous performance test assessing attention and impulsivity by measuring response times, errors of omission (inattention), and errors of commission (impulsivity). Wide Range Achievement Test (WRAT): a standardized test measuring fundamental academic skills, including reading, spelling, and arithmetic, commonly used to assess educational achievement and learning disabilities.
References
Berger, I., Slobodin, O., & Cassuto, H. (2017). Usefulness and validity of continuous performance tests in the diagnosis of Attention-Deficit Hyperactivity Disorder Children. Archives of Clinical Neuropsychology, 32, 81–93. https://doi.org/10.1093/arclin/acw101 Enriquez-Geppert, S., Brown, T., Henrich, H., Arns, M., & Pimenta, M. G. (2023). Attention Deficit Hyperactivity Disorder. In I. Khazan, F. Shaffer, D. Moss, R. Lyle, & S. Rosenthal (Eds). Evidence-based practice in biofeedback and neurofeedback (4th ed.). Association for Applied Psychophysiology and Biofeedback.
Groeneveld, K., Mennenga, A., Heidelberg, R., Martin, R., Tittle, R., Meeuwsen, K., Walker, L., & White, E. (2019). Z-Score neurofeedback and heart rate variability training for adults and children with symptoms of Attention-Deficit/Hyperactivity Disorder: A retrospective study. Applied Psychophysiology and Biofeedback, 44, 291 - 308. https://doi.org/10.1007/s10484-019-09439-x
Park, J., Kim, C., Ahn, J., Joo, Y., Shin, M., Lee, H., & Kim, H. (2019). Clinical use of continuous performance tests to diagnose children with ADHD. Journal of Attention Disorders, 23, 531 - 540. https://doi.org/10.1177/1087054716658125
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