Acceso usuarios
Sophie Bayard, Clarisse Madiouni, François Radiguer, Maëva Roulin, Sébastien Henrard
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
