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Corner Clinic: Our Experts Answer Your Health Questions

This month we talk about adult ADHD, elderly drivers and post-workout recovery drinks

By UC San Diego Health Experts   |   February 24, 2016
  1. People think of Attention Deficit/Hyperactivity Disorder (ADHD) as a childhood disease. Can it also occur in adults?
  2. When is it time to take away the car keys from my elderly parents?
  3. What should I drink to recover from an intense workout?
David Feifel

People think of Attention Deficit/Hyperactivity Disorder (ADHD) as a childhood disease. Can it also occur in adults?

David Feifel, MD, PhD, director of the adult ADHD program

Yes. ADHD is a brain condition that is more than 80 percent genetic and occurs in both adults and children. Research indicates that about 4.5 percent of the U.S. adult population meets the criteria for ADHD, yet it often goes unrecognized in this group. This is likely because adults manifest the disorder a little differently than many children. Like children, adults tend to exhibit the deficit in sustaining attention but not the overt excessive movement common with kids. Consequently, many adults with ADHD may go undiagnosed for years. Some clues to watch for include trouble staying focused, difficulty finishing tasks and being easily sidetracked. Adults with ADHD may also be impatient, careless and easily lose things like keys or glasses. They may also have trouble listening and often fail to follow through on instructions, chores or duties in the workplace.

If you suspect that you or a family member have this condition, it’s best to see a physician specialized in treating adult ADHD. The specialist can provide a full assessment and prescribe treatment. Most adults experience a significant improvement in their ADHD symptoms and quality of life when they receive appropriate treatment.

Linda Hill

When is it time to take the keys away from my elderly parents?

Linda Hill, MD, MPH, director of Training, Research and Education Driving Safety (TREDS)

Currently in California, there are more than 82,000 drivers in their 90s and more than 540 licensed drivers over the age of 100. By 2030, one in five drivers will be over 65 years old. According to the National Highway Transportation Safety Administration, older drivers in general are excellent behind the wheel and are not involved in as many crashes as younger drivers. However, seniors are more likely to be killed or seriously injured in comparison to other age groups because they are more fragile and susceptible to injuries. Early identification of age-related medical impairments that can affect driving is key to protecting the health of older adults on our roadways.

As people age, they begin to experience health and functional challenges that interfere with their ability to drive safely, such as impaired vision, physical limitations and declining cognitive function. The American Medical Association recommends that seniors be screened for age-related driving impairments as part of routine physical examinations. Initial screening can be conducted between the ages of 65 and 70 and repeated every two years thereafter or as medically indicated. 

Family members are often the first to notice when the driving skills of a parent begin to diminish and it is important to communicate any concerns to a patient’s clinician.

It might be time to address a senior’s driving if he or she is:

  • Using bad judgment or having near-crashes
  • Forgetting basic rules of the road
  • Driving too fast or well below the speed limit
  • Forgetting where they are going or getting lost
  • Having difficulty making turns, parking or backing up
  • Having trouble moving their foot from the gas to brake or confusing the two pedals
  • Unable to explain damage to their vehicle

Many older adults will begin to self-regulate their driving by avoiding rush hour, freeways or night driving. This is a positive behavior on their part but may also suggest that they have their own concerns about their driving ability. Consider riding as a passenger with the family member you are concerned about or have a certified driving specialist take them on the road.

Before you ask a family member to significantly restrict or stop driving, be prepared to present transportation options. Ongoing conversations to reinforce driver safety with an elderly loved one can help ease the transition from the driver’s seat to the passenger’s seat when the time comes.

Kenneth Vitale

What should I drink to recover from an intense workout?

Kenneth Vitale, MD, physical medicine and rehabilitation specialist 

Periodically, we hear of the latest sports drinks claiming to provide optimal nutrition and recovery after exercise. Recently, tart cherry juice has received a lot of attention in the news. Tart cherry juice is simply the juice from tart cherries (as opposed to the sweet cherries we typically eat). It is very similar to sweet cherries, however it contains a much higher amount of antioxidants. Antioxidants can help us recover if we have done very exhaustive, high-intensity exercise to the point that we start to break down our own bodies. Therefore, if you are currently in a very high-level training regimen (such as a marathon or ultra-endurance race), you may benefit from the additional antioxidants found in tart cherries if your current diet does not contain enough antioxidants.

On a related note, milk has experienced somewhat of a revival in terms of health and exercise — specifically, chocolate milk. There isn’t a clear agreement, but many people in the strength and exercise field often recommend consuming a 4:1 carbohydrate-to-protein ratio after exercise, which is suggested to be the best ratio that your body can use to shuttle these nutrients into muscles. Chocolate milk (or any other milk with carbohydrates/sugars added) comes close to this ratio and is often much cheaper than other sports drinks. It also contains calcium, vitamin D and B vitamins. Some people don’t drink milk for a variety of reasons, but if you already are a milk drinker, you may find this an option for you.

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