Late-Onset ADHD symptoms in the general population: A scoping review of longitudinal trajectories in population-based cohorts

• Sophie Bayard ^[2] ; Clarisse Madiouni ^[2] ; François Radiguer ^[1] ; Maëva Roulin ^[3] ; Sébastien Henrard ^[4]
  1. [1] University of Paris-Sorbonne

     University of Paris-Sorbonne

     París, Francia

     
  2. [2] Univ Paul Valéry Montpellier 3, Univ Montpellier, EPSYLON EA 4556, F34000, Montpellier, France
  3. [3] Centre Genepsy, Romans-sur-Isère, France
  4. [4] Payrac, France

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• Localización: European journal of psychiatry, ISSN 0213-6163, Vol. 40, Nº 1, 2026
• Idioma: inglés
• DOI: 10.1016/j.ejpsy.2025.100337
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  • Background and objectives: The developmental validity of late-onset ADHD remains debated. This scoping review aimed to synthesize evidence from longitudinal trajectory studies in the general population to (1) examine the existence and characteristics of late-onset ADHD symptom trajectories, and (2) identify associated factors.

    Methods: Following PRISMA-ScR guidelines, we systematically reviewed longitudinal studies published up to May 2025 that applied person-centered trajectory modeling to ADHD symptoms in population-based cohorts.

    Twelve eligible studies were included.

    Results: Among the twelve studies included in this scoping review, ten identified at least one symptom trajectory consistent with late-onset ADHD, with prevalence estimates ranging from 3 % to 17.5 %, and were analyzed to examine associated factors. These late-onset trajectories were predominantly inattentive and less disruptive than persistent profiles, but consistently observed across cohorts but were reported in the majority of cohorts (10/12), not all. The most robustly supported associated factors included higher childhood cognitive functioning, fewer early externalizing problems, emerging internalizing psychopathology during adolescence, lower family socio- economic status, female gender, and polygenic liability for ADHD. However, methodological variability, particularly in informant source, symptom measurement and model specification, significantly influenced identification. Notably, no study assessed sleep-wake disturbances, treatment history, contextual supports or neurological antecedents.

    Conclusion: Late-onset ADHD trajectories are commonly identified in general population cohorts (10/12 studies).

    Their interpretation calls for a dimensional, developmentally sensitive framework. Future studies should incorporate overlooked domains such as sleep-wake functioning, treatment exposure, and neurological risk factors to refine clinical characterization and diagnostic criteria