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ADHD Linked to Higher Brain Iron and Dementia Markers

3D illustration of neurons with amyloid plaques, representing the neurodegenerative effects of Alzheimer's disease.
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A study conducted by the Geneva University Hospitals (HUG) and the University of Geneva (UNIGE) has identified biological markers in adults with attention deficit hyperactivity disorder (ADHD) that resemble those seen in individuals with dementia. The research, published in Psychiatry and Clinical Neurosciences, reports that adults with ADHD have increased iron accumulation in specific brain regions and higher levels of neurofilament light chain protein (NfL) in their blood. These markers are known indicators of neurodegenerative diseases such as Alzheimer’s disease.


Neurofilament light chain protein (NfL)

A structural protein found in neurons, NfL is released into the bloodstream when neuronal damage occurs. Elevated NfL levels serve as a biomarker for neurodegenerative diseases, including Alzheimer’s and Parkinson’s disease.


The findings support the hypothesis that ADHD may be associated with an increased risk of developing dementia later in life, offering the first evidence of a possible neurological mechanism behind this link.

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ADHD and dementia: A potential connection

ADHD is a common neurodevelopmental disorder affecting approximately 3.5% of adults, according to a 2008 World Health Organization (WHO) study. It is characterized by difficulties in sustaining attention, impulsivity and hyperactivity. While ADHD is often diagnosed in childhood, symptoms can persist into adulthood, affecting daily life and cognitive function.


Dementias associated with aging, including Alzheimer’s disease, impact about 55 million people worldwide, with nearly 10 million new cases annually, according to WHO data from 2023. Alzheimer’s accounts for 60% to 70% of all dementia cases.

“Recent epidemiological studies show that adults suffering from ADHD have an increased risk of dementia at an advanced age, but the mechanism through which ADHD constitutes a risk is not known.” 



Professor Paul G. Unschuld.

Investigating brain iron levels and neuronal damage

To explore the link between ADHD and dementia risk, the research team analyzed brain iron levels and NfL concentrations in 32 adults aged 25–45 diagnosed with ADHD and compared them to 29 healthy individuals of the same age range. They employed a specialized magnetic resonance imaging (MRI) technique known as quantitative susceptibility mapping (QSM) to assess iron accumulation in different brain regions. In parallel, they measured NfL levels in blood samples.


Quantitative susceptibility mapping (QSM)

An advanced MRI technique used to measure magnetic properties in brain tissue. QSM provides insights into iron accumulation, which is associated with oxidative stress and neurodegeneration.


The study revealed that individuals with ADHD exhibited altered iron distribution in several brain regions, with a significant correlation between iron levels in the precentral cortex and NfL concentrations in the blood.


Iron is essential for normal brain function, but excessive accumulation can contribute to oxidative stress, leading to neuronal damage and neurodegenerative conditions such as Alzheimer’s disease. Similarly, elevated NfL levels in the blood indicate damage to neuronal axons, which are critical for nerve signal transmission. Together, these findings suggest that increased brain iron and NfL levels may signal an underlying neurodegenerative process, potentially raising the risk of dementia in individuals with ADHD.

Implications for early intervention and future research

The results underscore the need for further research to understand why individuals with ADHD might be more susceptible to dementia. 

"There is a well-known correlation between lifestyle and altered iron levels in brain. Additional longitudinal studies are required in order to determine if a reduction of iron levels in the brain is a potential treatment pathway for preventing dementia at an advanced age in persons with ADHD,” said Unschuld.

Additionally, the research highlights the importance of early detection and management of ADHD, not only to improve quality of life in adulthood but also to mitigate potential long-term cognitive effects. Proactive intervention could play a role in preserving brain health and reducing the risk of neurodegenerative diseases later in life.


Reference: Berberat J, Kagerer SM, Späni C, et al. Brain iron load and neuroaxonal vulnerability in adult attention‐deficit hyperactivity disorder. Psychiatry Clin Neurosci. 2025:pcn.13806. doi: 10.1111/pcn.13806


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