ADHD Tied to Higher Mortality Risk

People with attention-deficit hyperactivity disorder (ADHD) had a higher mortality risk compared with others, a study of 16 million people showed.

In a systematic review and meta-analysis, ADHD was tied to a 71% increased risk of all-cause mortality (HR 1.71, 95% CI 1.31-2.24, P<0.001), reported Joshua Stott, PhD, of University College London, and colleagues.

Risks of suicide (HR 1.89, 95% CI 1.21-2.95, P=0.005), unintentional or intentional injury (HR 1.55, 95% CI 1.22-2.00, P<0.001), and natural-cause mortality (HR 1.27, 95% CI 1.16-1.38, P<0.001) also were higher, Stott and colleagues wrote in JAMA Network Open.

ADHD medication use was linked with a lower risk of all-cause mortality (HR 0.75, 95% CI 0.64-0.87, P<0.001), the researchers said.

“Importantly, these findings do not suggest that everyone with ADHD will die young, nor do they suggest that increased mortality is impossible to change or inherent to ADHD,” Stott told MedPage Today.

“Our findings underscore the importance of ensuring that everyone who may have ADHD has access to accurate diagnosis and treatment,” he said. “While ADHD diagnosis rates have risen in recent years, they may still lag behind actual prevalence, particularly for older age groups where mortality risk may be most pertinent.”

Adult ADHD is often unrecognized and undiagnosed, but there’s been a recent increase in adults seeking evaluation and treatment, noted Jeffrey Newcorn, MD, of Icahn School of Medicine at Mount Sinai in New York City, who wasn’t involved with the study.

“Even when ADHD is diagnosed, the diagnosis is often made late,” Newcorn told MedPage Today. “According to recent data from the CDC, a large number of adults with ADHD are diagnosed for the first time in adulthood, perhaps as many as half, even though the disorder almost always begins in childhood. Also, a large number of adults who are diagnosed with ADHD do not receive treatment.”

The CDC estimates that 15 million adults (6%) in the U.S. have ADHD and nearly one in three of them take ADHD stimulant medication. The agency also reports that 7 million children (11.7%) ages 3 to 17 years have an ADHD diagnosis, according to a national survey of parents.

Increased mortality in people with ADHD may result from several pathways, Stott and colleagues observed. Core traits like impulsivity, emotional dysregulation, and risk-taking may contribute to injury, they said. Co-existing mental health conditions like depression may raise the risk of suicide. Natural-cause mortality may be elevated through behaviors like smoking and alcohol use, barriers to healthcare services, and higher rates of cardiovascular disease and metabolic disorders.

Earlier research reported increased mortality risks for people with ADHD, with some studies pointing to a 6- to 7-year life expectancy gap between people with ADHD and those without. In their study, Stott and colleagues expanded previous reports and included peer-reviewed research until July 2025.

The researchers assessed quantitative studies that reported all-cause or cause-specific mortality outcomes in people with ADHD across all age groups. ADHD was defined through diagnostic criteria, self-identification, trait measures, or ADHD polygenic risk scores.

The work included 19 studies with 15,920,970 participants; most (63.9%) were male. Twelve studies reported outcomes that could be used in meta-analyses.

Five meta-analyses were conducted in total:

• All-cause mortality (nine studies)

• Unintentional or intentional injury (four studies)

• Natural-cause mortality (three studies)

• All-cause mortality in people with ADHD using ADHD medication (three studies)

Significant levels of heterogeneity emerged in the first four analyses but not in the natural-cause model. The analysis that tested associations between ADHD medication and all-cause mortality had a moderate level of heterogeneity (I² = 55%), but the Q statistic was not significant (Q=4.38, P=0.11).

This association “should be interpreted cautiously because the medication analysis was based on only three studies and may be subject to residual confounding and confounding by indication, given potential differences between treated and untreated individuals in health care access, socioeconomic status, illness severity, treatment adherence, and psychiatric comorbidity,” Stott and co-authors pointed out.

Despite substantial heterogeneity, all studies consistently showed higher mortality in the ADHD groups, the researchers emphasized. “This finding suggests that heterogeneity is likely due to differences in the magnitude of the effect rather than disagreement about the direction of the association,” the team wrote.

The studies included in the meta-analysis were cross-cultural, which may reflect differences in diagnostic criteria and access to care, Stott and colleagues noted. Many studies also had gender imbalances, they acknowledged.