Childhood ADHD and subthreshold symptoms are associated with cognitive functioning at age 40-a cohort study on perinatal birth risks

Nella Schiavone; Maarit Virta; Sami Leppämäki; Jyrki Launes; Ritva Vanninen; Annamari Tuulio-Henriksson; Ilkka Järvinen; Eliisa Lehto; Laura Hokkanen

doi:10.3389/fpsyg.2024.1393642

Childhood ADHD and subthreshold symptoms are associated with cognitive functioning at age 40-a cohort study on perinatal birth risks

Front Psychol. 2024 Aug 29:15:1393642. doi: 10.3389/fpsyg.2024.1393642. eCollection 2024.

Authors

Nella Schiavone¹, Maarit Virta¹, Sami Leppämäki², Jyrki Launes¹, Ritva Vanninen^{3

4}, Annamari Tuulio-Henriksson¹, Ilkka Järvinen¹, Eliisa Lehto¹, Laura Hokkanen¹

Affiliations

¹ Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.
² Terveystalo Healthcare, Helsinki, Finland.
³ Department of Clinical Radiology, Kuopio University hospital, Kuopio, Finland.
⁴ Clinical Radiology, School of Medicine, University of Eastern Finland, Kuopio, Finland.

Abstract

Introduction: In this prospective cohort study over 40 years we investigated the effect of childhood attention-deficit/hyperactivity disorder (ADHD) and subthreshold ADHD on cognitive performance in adulthood.

Methods: The cohort comprised individuals with mild perinatal risks. Childhood ADHD group (cADHD, n = 39) was compared to a group with subthreshold childhood attention or hyperactivity symptoms (cAP; n = 79), a group with similar perinatal risks but no ADHD symptoms (n = 255), and to controls without ADHD symptoms or perinatal risks (n = 69). The groups were assessed with multiple neuropsychological measures in domains of verbal reasoning, perceptual skills, memory, working memory, attention, executive functions, and speed. Group-level differences and frequencies of deficient functioning were analyzed.

Results: Overall, the groups' performance differed in all cognitive domains at age 40. Verbal reasoning, perceptual skills, memory, and speed had the largest effect sizes (0.51-0.62). The cADHD group's performance was lower than the other groups' on 13 out of 21 measures. The cAP group performed poorer than controls on five measures. In the cADHD group, 23% had three or more deficient cognitive domains, compared to 4-6% in the other groups.

Discussion: Childhood ADHD is associated with impaired cognitive functioning in adulthood on several cognitive domains whereas childhood subthreshold ADHD is linked to fewer cognitive deficits. Task complexity was linked to poorer performance within the ADHD group. Our results add to the scarce longitudinal evidence of cognitive outcomes related to childhood ADHD and subthreshold symptoms.

Keywords: ADHD; adult; cognition; cohort study; deficit; neuropsychological assessment.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. The first 30 years of the project were supported by the Academy of Finland, the Signe and Ane Gyllenberg Foundation, the Foundation of Pediatric Research, the Association for Life Insurance Companies, the Traffic Insurer’s Centre Finland, and the Rinnekoti Foundation. The most recent phase has been supported by the Social Insurance Institution of Finland (Kela), the Diabetes Research Foundation, the Juho Vainio Foundation, the Jalmari Ahokas foundation, the Yrjö Jahnsson foundation, and the Signe and Ane Gyllenberg foundation. NS acquired personal grants from the Finnish Cultural Foundation, Alfred Kordelin Foundation, and Signe and Ane Gyllenberg Foundation.