Contributions Of Attention Deficit/Hyperactivity Disorder In Adults/older Adults To Physical Health Conditions: A Systematic Review And Meta-analysis Protocol - Info and Reading Options

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Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by inattention, hyperactivity and/or impulsivity (American Psychiatric Association, 2013). The global prevalence of ADHD in adults is 2.58% (Simon, Czobor, Bálint, Mészáros, & Bitter, 2009; Song et al., 2021), with a lower prevalence of 2.18% reported among older adults (Dobrosavljevic, Solares, Cortese, Andershed, & Larsson, 2020). The prevalence of ADHD in psychiatric outpatient clinics may be as high as 14.61% (Adamis, Flynn, Wrigley, Gavin, & McNicholas, 2022). In most cases, ADHD onset is in early childhood, and studies have shown that ADHD symptoms may persist into adulthood (Soler-Gutiérrez, Pérez-González, & Mayas, 2023; Wender, Wolf, & Wasserstein, 2001). Although overt symptoms of ADHD such as hyperactivity and impulsivity may be lower in older adults (Callahan & Plamondon, 2019), these may be expressed as other difficulties in later life such as excessive talking, fidgeting, and feelings of inner restlessness (Zalsman & Shilton, 2016). These difficulties often have significant impacts on lifestyle (Adamou et al., 2013; Michielsen et al., 2015), this could impact physical health conditions. Several previous reviews have summarized the relationship between ADHD and physical diseases. Some have focused narrowly on specific physical health conditions such as diabetes (Cortese et al., 2016), cardiovascular disease (Li et al., 2023), and obesity (Cortese et al., 2016), but recent publications suggest that ADHD is associated with a broad range of somatic health conditions (e.g., rheumatoid arthritis, asthma, and celiac disease). As such, a comprehensive summary of these findings is warranted. Two recent review articles have discussed the connection between adult ADHD and a broad range of comorbid diseases, uncovering strongest associations between ADHD and obesity, sleep disorders, and asthma (Instanes et al., 2018) as well as cardiovascular disease (Fischer & Nilsen, 2024). However, both these reviews synthesized evidence qualitatively, whereas conducting a meta-analysis or meta-regression could lead to a precise effect size estimation of the association between ADHD and physical health conditions (O’Connor & Sargeant, 2014). In addition, over the last five years, there has been a significant increase in the number of large population-based studies exploring the association between adult ADHD and various health conditions (Dobrosavljevic et al., 2023; Du Rietz et al., 2021; Garcia-Argibay et al., 2022; Li et al., 2022; Libutzki, Neukirch, Reif, & Hartman, 2024), warranting the need for an updated synthesis of this evidence to provide a clear understanding of the state of knowledge in this regard. Therefore, this present systematic review aims to synthesize all available evidence on the association between adult ADHD and health conditions into a single comprehensive review. Therefore, this current systematic review and meta-analysis aims to quantitatively synthesize the evidence on the association between ADHD and different physical health conditions in adults.

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