ADHD may still be under-recognised and under-diagnosed in England, according to a study led by researchers at University College London, the University of Liverpool, and King's College London published on July 9.
The research found that only 1.19% of people in England had an ADHD diagnosis recorded in their primary care records. This rate is lower than international estimates of actual ADHD prevalence, which typically range between 3% and 5%. The gap was especially pronounced among older adults; just 0.05% of men and women over the age of 65 were diagnosed with ADHD.
The study reported that diagnosis rates for ADHD have increased substantially over the past decade for both children and adults. However, recorded diagnoses remain below international prevalence estimates across all age groups. Rates of new diagnoses rose markedly after 2020, particularly among boys under 18 years old and adult women. Diagnosis rates among those aged 65 and over remained consistently low throughout the period studied.
Lead author Dr. Amber John said, "The low rates observed in older adults don't necessarily mean that ADHD is uncommon in older age. Instead, they may reflect historical differences in recognition and access to diagnosis, particularly among generations who grew up before ADHD was widely recognised." Senior author Professor Joshua Stott said, "It is important that people are guided by the data. For nearly all age groups, while prevalence is still lower than expected in 2025, there was an increase in diagnoses of ADHD after 2020. This has relevance because health providers should take these changing diagnostic prevalences into account when planning services in support of people living with ADHD." Joint first author Dr. Gavin Stewart said, "When we compared recorded ADHD diagnoses with published estimates of how common ADHD is in the population, we found a substantial gap across every age group. This gap was especially large in older adults, suggesting that many people may have gone unrecognised."
A previous UCL-led study found that adults with diagnosed ADHD have reduced life expectancies compared to those without such a diagnosis. Professor Stott said, "When it comes to mid-life and late-life health outcomes in people with high ADHD traits, they tend to have increased rates of physical and mental health difficulties. Consequently, it is useful for services and clinicians to be aware that while many in this group probably don't have diagnoses, they may well have extra needs." Study co-author Dr. Georgia Pavlopoulou added, "Our findings suggest that ADHD is being under-recognised, challenging increasingly common narratives about overdiagnosis... some groups who do not fit traditional stereotypes about ADHD... may be particularly affected... We want to see services better resourced to provide culturally responsive, gender-informed and equitable support."
The authors noted limitations including potential misclassification from routine healthcare records as well as variation between studies used for international benchmarks.
