Although adult attention-deficit/hyperactivity disorder has recently gained increased attention, few reports on attention-deficit/hyperactivity disorder in the pre-elderly or elderly have been published. Here, we present the case of a patient with attention-deficit/hyperactivity disorder who gradually developed dementia-like symptoms as she aged, which initially made her condition difficult to distinguish from early onset Alzheimer’s disease. This report illustrates that some types of attention-deficit/hyperactivity disorder may be misdiagnosed as dementia. The patient was a 58-year-old woman. Although she presented with a tendency for inattentiveness and forgetfulness since childhood, she did not have a history of psychiatric disorders prior to consultation. Around the age of 52 years, her inattentiveness and forgetfulness gradually progressed, and at 57 years of age, she became inattentive and forgetful that it interfered with her work and daily life. For example, she forgot meetings with important clients and transferred money to the wrong bank account; these failures resulted in poor management of her company. At home, she experienced increasing difficulties with remembering prior commitments with her family and misplacing items, which her family members noticed. With the encouragement of her family and employees, who worried that she was suffering from dementia, she visited our memory clinic, whereby she was suspected of having early onset Alzheimer’s disease. However, neuropsychological tests and brain imaging evaluations did not reveal any significant abnormalities. After dismissing various possible diagnoses, including dementia, other organic diseases, mood disorders, and delirium, we diagnosed her with attention-deficit/hyperactivity disorder. Treatment with 18 mg of methylphenidate was initiated, and significant improvements in her symptoms were observed within a few days; for example, she stopped losing her things, was able to concentrate for long durations, and could complete more tasks than she could before treatment. Since initiating treatment, she has returned to work and has been able to perform her daily activities without difficulty. This case supports that some patients with late-onset attention-deficit/hyperactivity disorder may gradually develop dementia-like symptoms during the pre-elderly and elderly stages of life. Therefore, clinicians should consider late-onset attention-deficit/hyperactivity disorder as a differential diagnosis of some types of dementias.

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迟发性注意力不足/多动障碍作为痴呆的鉴别诊断：病例报告

尽管近来成人注意力缺陷/多动障碍已引起越来越多的关注，但是关于老年人或老年人的注意力缺陷/多动障碍的报道很少。在此，我们介绍了一个患有注意力缺陷/多动障碍的患者，该患者随着年龄的增长逐渐出现痴呆样症状，这最初使她的病情难以与早期阿尔茨海默氏病区分开。该报告表明，某些类型的注意力不足/多动障碍可能被误诊为痴呆症。该患者是一名58岁的女性。尽管她从小就表现出注意力不集中和健忘的趋势，但在咨询之前没有精神病史。在52岁左右，她的注意力不集中和健忘逐渐发展，57岁那年，她变得专心和健忘，因为这会干扰她的工作和日常生活。例如，她忘记了与重要客户的会面，并将资金转入了错误的银行帐户；这些失败导致她公司的管理不善。在家里，她在回忆起与家人的先前约定和错放物品方面遇到了越来越多的困难，这是她的家人注意到的。在担心自己患有痴呆症的家人和员工的鼓励下，她参观了我们的记忆诊所，据信她被怀疑患有早老性早老性痴呆症。但是，神经心理学测试和脑成像评估未发现任何明显的异常。排除各种可能的诊断，包括痴呆，其他器质性疾病，情绪障碍，和del妄，我们诊断出她患有注意力不足/多动症。开始用18 mg哌醋甲酯治疗，几天后她的症状有了明显改善。例如，她不再失去自己的东西，能够长期专注，并且可以完成比治疗前更多的任务。自开始治疗以来，她重返工作岗位并能够轻松进行日常活动。该病例支持某些晚期发作的注意力不足/多动障碍患者可能在老年前和老年阶段逐渐发展为痴呆样症状。因此，临床医生应将迟发性注意力不足/多动障碍视为某些类型痴呆的鉴别诊断。我们诊断出她患有注意力不足/多动症。开始用18 mg哌醋甲酯治疗，几天后她的症状有了明显改善。例如，她不再失去自己的东西，能够长期专注，并且可以完成比治疗前更多的任务。自开始治疗以来，她重返工作岗位并能够轻松进行日常活动。该病例支持某些晚期发作的注意力不足/多动障碍患者可能在老年前和老年阶段逐渐发展为痴呆样症状。因此，临床医生应将迟发性注意力不足/多动障碍视为某些类型痴呆的鉴别诊断。我们诊断出她患有注意力不足/多动症。开始用18 mg哌醋甲酯治疗，几天后她的症状有了明显改善。例如，她不再失去自己的东西，能够长期专注，并且可以完成比治疗前更多的任务。自开始治疗以来，她重返工作岗位并能够轻松进行日常活动。该病例支持某些晚期发作的注意力不足/多动障碍患者可能在老年前和老年阶段逐渐发展为痴呆样症状。因此，临床医生应将迟发性注意力不足/多动障碍视为某些类型痴呆的鉴别诊断。开始用18 mg哌醋甲酯治疗，几天后她的症状有了明显改善。例如，她不再失去自己的东西，能够长期专注，并且可以完成比治疗前更多的任务。自开始治疗以来，她重返工作岗位并能够轻松进行日常活动。该病例支持某些晚期发作的注意力不足/多动障碍患者可能在老年前和老年阶段逐渐发展为痴呆样症状。因此，临床医生应将迟发性注意力不足/多动障碍视为某些类型痴呆的鉴别诊断。开始用18 mg哌醋甲酯治疗，几天后她的症状有了明显改善。例如，她不再失去自己的东西，能够长期专注，并且可以完成比治疗前更多的任务。自开始治疗以来，她重返工作岗位并能够轻松进行日常活动。该病例支持某些晚期发作的注意力不足/多动障碍患者可能在老年前和老年阶段逐渐出现痴呆样症状。因此，临床医生应将迟发性注意力不足/多动障碍视为某些类型痴呆的鉴别诊断。例如，她不再失去自己的东西，能够长期专注，并且可以完成比治疗前更多的任务。自开始治疗以来，她重返工作岗位并能够轻松进行日常活动。该病例支持某些晚期发作的注意力不足/多动障碍患者可能在老年前和老年阶段逐渐发展为痴呆样症状。因此，临床医生应将迟发性注意力不足/多动障碍视为某些类型痴呆的鉴别诊断。例如，她不再失去自己的东西，能够长期专注，并且可以完成比治疗前更多的任务。自开始治疗以来，她重返工作岗位并能够轻松进行日常活动。该病例支持某些晚期发作的注意力不足/多动障碍患者可能在老年前和老年阶段逐渐出现痴呆样症状。因此，临床医生应将迟发性注意力不足/多动障碍视为某些类型痴呆的鉴别诊断。她重返工作岗位，并能够轻松地进行日常活动。该病例支持某些晚期发作的注意力不足/多动障碍患者可能在老年前和老年阶段逐渐出现痴呆样症状。因此，临床医生应将迟发性注意力不足/多动障碍视为某些类型痴呆的鉴别诊断。她重返工作岗位，并能够轻松地进行日常活动。该病例支持某些晚期发作的注意力不足/多动障碍患者可能在老年前和老年阶段逐渐发展为痴呆样症状。因此，临床医生应将迟发性注意力不足/多动障碍视为某些类型痴呆的鉴别诊断。