Differences in associations between attention‐deficit hyperactivity disorder symptoms and physical activity across childhood and adolescence and among males and females in a representative UK birth cohort

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Abstract Background Children and adolescents with attention‐deficit hyperactivity disorder (ADHD) exhibit higher physical activity (PA) levels than peers without ADHD. It remains unclear how this association evolves across developmental stages and differs between sexes. This study explores associations between ADHD symptoms and PA levels in childhood and adolescence, focusing on sex differences. Methods Data from the Millennium Cohort Study at ages 7 ( n = 14,043), 11 ( n = 13,469), 14 ( n = 11,872) and 17 ( n = 10,757) were included. Moderate‐to‐vigorous PA (MVPA) was objectively measured using accelerometers at ages 7 and 14, and PA by parent‐ and self‐reporting at ages 7, 11 and 14. ADHD symptoms were assessed by the ADHD subscale of the Strengths and Difficulties Questionnaire (SDQ) at all ages. Multiple linear regressions and mixed‐effects regression models estimated associations between PA and SDQ ADHD scores adjusting for confounders. Results MVPA was associated with higher SDQ ADHD scores at age 7 ( b = 0.009, p < 0.001) and, to a lesser extent, age 14 ( b = 0.004, p = 0.004). MVPA and SDQ ADHD scores were associated among males at ages 7 ( b = 0.008, p = 0.001) and 14 ( b = 0.004, p = 0.007), but among girls at age 7 only ( b = 0.011, p < 0.001). Age 7 MVPA was associated with higher ADHD symptoms at ages 11 ( b = 0.004, p = 0.003) and 17 ( b = 0.004, p = 0.031), however age 14 MVPA was not associated with ADHD symptoms at age 17. Higher reported PA levels at ages 7, 11 and 14 were associated with lower SDQ ADHD scores. Conclusion Young people with higher objectively‐measured PA levels exhibited higher ADHD symptoms, although this association was stronger in males. By adolescence, PA and SDQ ADHD scores were less strongly associated, and no longer significantly associated among adolescent females. Subjectively‐measured PA showed the inverse association with ADHD symptoms, emphasising the importance of mode of PA measurement.

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