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February 25, 2025
Noting that “the association between adult ADHD and dementia risk remains a topic of interest because of inconsistent results,” an Israeli study team tracked 109,218 members of a nonprofit Israeli health maintenance organization born between 1933 and 1952 who entered the cohort on January 1, 2003, without an ADHD or dementia diagnosis and were followed up to February 28, 2020.
Israeli law forbids nonprofit HMOs from turning anyone away based on demographic factors, health conditions, or medication needs, thereby limiting sample selection bias.
The estimated prevalence of dementia in this HMO, as diagnosed by geriatricians, neurologists, or psychiatrists, is 6.6%. This closely matches estimates in Western Europe (6.9%) and the United States (6.5%).
The team considered, and adjusted for, numerous covariates: age, sex, socioeconomic status, smoking, depression, obesity, chronic obstructive pulmonary disease, hypertension, atrial fibrillation, heart failure, ischemic heart disease, cerebrovascular disease, diabetes, Parkinson’s disease, traumatic brain injury, migraine, mild cognitive impairment, psychostimulants.
With these adjustments, individuals diagnosed with ADHD were almost three times as likely to be subsequently diagnosed with dementia as those without ADHD. Men with ADHD were two and a half times more likely to be diagnosed with dementia, whereas women with ADHD were over three times more likely, than non-ADHD peers.
More concerning still, persons with ADHD were 5.5 times more likely to be subsequently diagnosed with early onset dementia, as opposed to 2.4 times more likely to be diagnosed with late onset dementia.
On the other hand, the team found no significant difference in rates of dementia between individuals with ADHD who were being treated with stimulant medications and individuals without ADHD. Those with untreated ADHD had three times the rate of dementia. The team nevertheless cautioned, “Due to the underdiagnosis of dementia as well as bidirectional misdiagnosis, this association requires further study before causal inference is plausible.”
Conclusions and Relevance:
This study reinforces existing evidence that adult ADHD is associated with an increased risk of dementia. Notably, the increased risk was not observed in individuals receiving psychostimulant medication, however the mechanism behind this association is not clear.
These findings underscore the importance of reliable ADHD assessment and management in adulthood. They also highlight the need for further study into the link between stimulant medications and the decreased risk of dementia.
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Stephen Z. Levine, Anat Rotstein, Arad Kodesh, Sven Sandin, Brian K. Lee, Galit Weinstein, Michal Schnaider Beeri, and Abraham Reichenberg, “Adult Attention-Deficit/Hyperactivity Disorder and the Risk of Dementia,” JAMA Network Open (2023) 6(10), e2338088, https://doi.org/10.1001/jamanetworkopen.2023.38088.
The focus on children and adolescents with ADHD often revolves around behavioral issues and academic difficulties, but the social struggles are real. Around 60% of youth with ADHD experience meaningful difficulties in social skills, reading social cues, and forming reciprocal relationships with peers. Over time, these struggles can raise the risk of anxiety and depression.
Medication remains the primary treatment for ADHD, with stimulants like methylphenidate (Ritalin) being the most commonly prescribed. While effective at reducing core symptoms such as inattention and impulsivity, medication has not been shown to improve social behavior or peer relationships.
The Background:
Exercise has recently emerged as a promising adjunctive therapy. A newly published meta-analysis examined whether structured physical activity can specifically improve social functioning in young people with ADHD. It builds on a previous review from 2015, addressing gaps that earlier work left open: social outcomes were rarely treated as a primary focus, and no prior analysis had systematically compared exercise types or asked how much exercise is actually needed to see benefits.
The Study:
The analysis included 13 randomized controlled trials involving 703 participants aged 6 to 18, all clinically diagnosed with ADHD. Only exercise programs lasting at least four weeks were considered. Studies that combined exercise with other therapies, such as psychotherapy, were excluded to isolate exercise's specific effects.
The researchers used a technique called network meta-analysis, which allows different interventions to be compared against one another even when they haven't been tested head-to-head, alongside dose-response modeling to identify how much exercise produces the greatest benefit.
Results:
The most striking results came from closed-skill exercise: across four studies involving 92 participants, it was associated with a very large reduction in social dysfunction. Open-skill exercise, by contrast, showed no measurable improvement across four studies with 91 participants. Multicomponent exercise (the group combining elements of both open- and closed-skill) reported large gains in two smaller studies with 33 participants.
Mind-body exercise showed a moderate benefit across three studies involving 44 participants.
The dose-response analysis offered a practically useful finding: 30 to 60 minutes of moderate-intensity exercise per day appeared to produce the best outcomes, with a minimum of roughly 15 to 30 minutes daily needed to achieve any meaningful benefit.
The Take-Away:
The results are encouraging but should be interpreted carefully. The number of studies in each category was small (two to three studies each), and sample sizes were modest, meaning the findings may not hold up as more evidence accumulates. The absence of publication bias is reassuring, as is the use of rigorous methodology, but this remains an early-stage evidence base. Larger, well-designed trials are needed before firm clinical recommendations can be made.
For now, the findings position structured physical activity (particularly closed-skill and multicomponent exercise) as a plausible complement to existing ADHD treatment, specifically targeting the social difficulties that medication tends not to address. The practical dose guidance is a useful starting point: around half an hour of moderate daily exercise as a minimum, with an hour as the apparent sweet spot. As low-risk additions to a treatment plan go, that’s a relatively accessible bar for most families to consider alongside professional guidance.
Exercise has attracted growing attention as an intervention for ADHD. As a potential treatment option for ADHD, it is, of course, highly appealing because it can be low- to no-cost, widely accessible, and free of the side effects that can accompany medication. From previous studies, we know that certain types of exercise may be more effective than others, but do we actually know enough for clinicians to prescribe physical activity as a treatment for ADHD?
The First Study: Effects on Core ADHD Symptoms
Despite encouraging findings in individual studies, researchers have lacked clear guidance on which types of exercise work best, at what intensity, and for how long. A meta-analysis by Chen et al. set out to address this by pooling data from 20 randomized controlled trials (RCTs) involving 841 children and adolescents aged 4–18, all of which compared exercise interventions against non-exercising control groups.
The results were cautiously optimistic. Across standardized symptom scales, exercise produced a small improvement in ADHD symptoms overall. Objective cognitive tests showed a moderate improvement. Emotional and behavioral outcomes, however, showed no significant change.
To understand what was driving differences between studies, the researchers broke results down by exercise type. Therapeutic and alternative exercises (targeted movements and specific techniques such as those prescribed by physical therapists) were associated with moderate symptom improvements. Mind-body practices (such as yoga or tai chi) showed small-to-moderate gains. Conventional aerobic exercise yielded smaller effects, while skill-based competitive sports showed no measurable benefit. Notably, the variability between individual studies remained high throughout, meaning these categories should be interpreted with some caution.
Results:
The authors recommend that clinicians and parents consider incorporating therapeutic or alternative exercise sessions twice a week, each lasting 60–90 minutes, as a supplemental strategy alongside existing ADHD treatment. They stop short of calling this definitive, noting that future research should clarify how exercise produces its effects and how it might best be combined with medication or behavioral therapy.
The Second Study: Effects on Inhibitory Control
A second meta-analysis, by Zhang et al., zoomed in on a specific and particularly relevant cognitive challenge in ADHD: inhibitory control. Inhibitory control refers to the ability to suppress impulsive responses and tune out irrelevant distractions. This capacity underlies much of the restlessness, interrupting, and difficulty staying on task that characterize the condition.
This analysis drew on 34 studies with over 1,300 participants spanning all age groups, making it broader in scope than the Chen et al. review. Overall, exercise was associated with a moderate improvement in inhibitory control. When the analysis was restricted to RCTs alone, this finding held up. When studies with a high risk of bias were excluded, however, the effect size dropped to small-to-moderate.
One notable null result: three studies that used EEG to measure brain activity during inhibitory tasks found no significant effects on the neural signatures most closely tied to this process. This suggests exercise may influence behavior without necessarily changing the underlying brain mechanisms researchers expected, or that current methods aren't yet sensitive enough to detect such changes.
The dosing question produced some of the more practically useful findings. Single exercise sessions yielded only borderline small improvements. Sustained exercise programs, by contrast, showed moderate improvements, and programs with sessions three times per week produced large gains and had the strongest effect between the two meta-analyses. Exercise intensity and total program duration, perhaps interestingly, were not significant factors.
Results:
The authors are measured in their conclusions: exercise shows a real but modest benefit for inhibitory control, and frequency appears to matter more than intensity. They caution against overstating the case for exercise as treatment for ADHD overall, as it did not significantly affect hyperactivity or impulsivity as standalone outcomes, and its neural effects remain unclear.
The Broader Picture :
Ultimately, these two meta-analyses support exercise as a meaningful supplemental intervention for ADHD, particularly for attention and cognitive control, while urging realistic expectations. Neither suggests exercise should replace established treatments. Both are limited by high variability across the underlying studies, and both call for better-designed research to sharpen the guidance available to clinicians and families.
Boredom is more than just feeling restless or under-stimulated. It’s a negative emotional state that arises when activities feel meaningless or dull and, for those with ADHD, this negative emotional state might be markedly more intense. Researchers increasingly view boredom as functional: an internal signal pushing people to seek more rewarding and meaningful experiences. But for some, that signal becomes chronic and overwhelming.
People who are highly prone to boredom face a range of psychological and behavioral consequences, including anxiety, depression, difficulty identifying their own emotions (alexithymia), impulsivity, and physical complaints. These struggles often surface in harmful behaviors: overeating, substance use, compulsive internet use, and gambling.
For people with ADHD, boredom can cross into genuine distress. Many describe it as “torture” or “an itchy coat you can’t scratch”, language that conveys not mild discomfort but an urgent, almost unbearable need to escape. This makes sense given that ADHD involves core difficulties with attention, arousal regulation, and motivation, all of which make sustained engagement harder and boredom far more likely.
The Study:
A recent meta-analysis of 18 studies involving more than 22,000 participants confirmed a moderately strong and consistent positive association (an overall effect size of r = 0.40) between ADHD and self-reported boredom. All but one study found significant results, and there was no evidence of publication bias.
“While the relationship between ADHD and boredom may seem obvious,” the authors state, “this has paradoxically led to the phenomenon being understudied.”
Despite how significant this connection appears to be, the researchers noted it has attracted surprisingly little scientific attention; a gap they attribute to a widespread assumption that boredom in ADHD is simply a byproduct of inattention or impulsivity, and therefore not worth studying on its own terms. They push back on that view, arguing that boredom may be a more fundamental part of the ADHD experience: a bridge between atypical brain function and the behavioral, emotional, and cognitive difficulties that shape long-term outcomes.
The Take-Away:
Ultimately, addressing the profound boredom experienced by individuals with ADHD requires a multifaceted approach that goes beyond simply treating inattention. Researchers emphasize the need for rigorous studies to determine if stimulant medications actively reduce this intense boredom by repairing underlying brain mechanisms, rather than just as a side effect of improved focus. Beyond medication, tailored psychological therapies may offer promise; psychoeducation can help individuals reframe boredom as a biological signal rather than a personal failure or character flaw.
Additionally, another approach suggests that rather than solely focusing on treating the individual, systemic issues must be addressed, such as the effects of low-stimulation environments. For example, prioritizing a better "person-environment fit" through smaller class sizes, flexible academic pacing, and/or offering highly stimulating, novel tasks, schools and workplaces can offer meaningful relief from the chronic distress of ADHD-related boredom.
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