I’m haunted by the possibility of developing dementia one day

[u/NoteFabulous3175]

According to the scientific literature, those with ADHD are nearly three times more likely to develop dementia than the general population. I’m only 21 years old, yet I think about that statistic almost everyday. The thought of loosing my mind scares me so much more than the thought of dying. I’m not exactly sure why, but it probably has something to do with witnessing my grandmother slowly die from Alzheimer’s disease, seeing how much my aunt suffers from her schizophrenia, and the time I spent working in nursing home and being physically, sexually, and verbally assaulted by elders with dementia as a teenager, as well as seeing the suffering of those elders. I’ve made peace with the fact that I will die one day, but my only hope is that day will come before the day I loose my mind. I want to spend my last few years of life conscious of my reality and in control of my mind, not slowly wasting away while my neuron’s degenerate and my mind deteriorates until I can no longer recognize myself in the mirror. Until I’m betrayed by my own mind and forced to spit in the face of my own morals by harming a loved one or caretaker. As if my ADHD hasn’t caused and will continue to cause me enough suffering in this life. Such a significant increase in risk of developing dementia just feels like rubbing salt in the wound. I’m not suicidal, but I think I would seriously consider ending things at some point during the early stages of dementia if I develop it one day. It wouldn’t be a choice made out of despair or fear. It would be a choice made out of love for myself and the life I lived, and perhaps what’s even more significant, it would be a choice I would get to make.

Anyone else a bit paranoid about developing dementia? Or how do you reconcile with the possibility of developing it one day?

[u/elianrae]

According to the scientific literature, those with ADHD are nearly three times more likely to develop dementia than the general population.

Okay, what's the base likelihood though?

because like

30% is 3 times more likely than 10% - that's alarming

but also 0.3% is 3 times more likely than 0.1% - and honestly that's not alarming or particularly worth worrying about

[u/NoteFabulous3175 → u/elianrae]

“Among individuals with a diagnosis of ADHD, 42.9% (6 of 14) received a diagnosis of dementia at 85 years of age compared with 15.2% of individuals without ADHD (1223 of 8032).” Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC10582792/#:~:text=Among%20individuals%20with%20a%20diagnosis,ADHD%20(1223%20of%208032).

[u/elianrae → u/NoteFabulous3175]

Ah.

Okay I would not be particularly concerned by this study, but for an entirely different reason --

This prospective national cohort study consisted of 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. Participants were aged 51 to 70 years in 2003.

(...)

Participants with a diagnosis of or medication for dementia or diagnosis of ADHD by December 31, 2002, were not eligible for inclusion

Nobody in this cohort had an ADHD diagnosis at the start of this study. Everybody in this cohort was over 51 at the start of the study. They're all very late life diagnoses. Among people who are first diagnosed with ADHD in their 50s-70s, there's a strong association with dementia. Well. Yeah. No shit, some of them probably just had dementia.

...

this is also a really interesting finding

There was no clear association between adult ADHD and dementia among individuals with ADHD who received psychostimulant medications. Due to the underdiagnosis of dementia as well as bidirectional misdiagnosis, this association requires further study before causal inference is plausible.

like

if you're under 50, already diagnosed, and on stimulants? I would not stress very much about this study.

[u/CrimsonSuede → u/elianrae]

Thanks for pulling out this study.

As someone who also has bipolar II (which also has a higher rate of dementia compared to those without), my understanding is that the cumulative brain damage from manic episodes is the most likely factor for that increase. So being diagnosed early and getting properly medicated decreases the odds of dementia.

If at least based on that, it makes sense that ADHD meds bringing an unbalanced brain to a more balanced state would help mitigate increased risk of developing dementia later.

Tbh, at this point, I think microplastics will play a bigger role as a dementia risk factor lol. But that’s still a relatively new area of study.