Characteristics of Hoarding in Older Adults

Abstract

Objective This study determined the clinical characteristics of late-life hoarding disorder (HD). Methods Older adults (age ≥ 60) with HD (n = 55) and without psychiatric diagnoses (n = 39) were compared on psychiatric, functional, cognitive, and health-related measures. Associations between age and clinical characteristics in a large sample of mixed age (n = 210, age range 20–78) participants with HD were also determined. Results Individuals with late-life HD were characterized by substantial impairments in psychiatric, functional, cognitive, and medical status. Health risks (e.g., risks of falls, fire) were also common. However, older age was generally not associated with increased severity of hoarding or other clinical correlates (with the exception of one global clinician-rated measure of severity). Conclusions Late-life HD is characterized by considerable morbidity and health risks, and these characteristics may be consistent across the lifespan in cross-sectional mixed-age samples of individuals with HD.

Cognitive Behavioral Therapy for Hoarding Disorder: A Meta-Analysis

“…Older adults with HD may be at particular risk for chronic medical illness and executive dysfunction . Research in middle‐to‐later adulthood HD patients suggests that older age is not significantly associated with greater hoarding severity, depression, or functional impairment, although therapists rated older HD patients as more severely psychiatrically ill in general than younger patients . Further research on the impact of age on CBT response in HD, including potential remediation for cognitive dysfunction, is needed.…”

Psychometric Evaluation of the Saving Inventory-Revised in Older Adults

“…Hoarding may be more prevalent in later life (Marx & Cohens-Mansfield, 2003; Samuels et al, 2008) and older adults with HD report that their hoarding symptoms increased steadily across their lifespans (Dozier, Porter, & Ayers, 2015). The consequences of hoarding may be magnified in older adults, including social dysfunction, increased medical problems, interference with activities of daily living, and functional impairment (Ayers & Dozier, 2015; Ayers, Scheisher, Liu, & Wetherell, 2012; Diefenbach, DiMauro, Frost, Steketee, & Tolin, 2013; Turner, Steketee, & Nauth, 2010). …”

Novel Treatment for Geriatric Hoarding Disorder: An Open Trial of Cognitive Rehabilitation Paired with Behavior Therapy

“…1 Clinically significant hoarding is defined as: 1) the acquisition of and failure to discard a large number of possessions that appear (to others) to be useless or of limited value; 2) living or work spaces sufficiently cluttered that they preclude activities for which those spaces were designed; and 3) significant distress or impairment in functioning caused by the hoarding behavior or clutter. 2 HD is common, with prevalence estimates at approximately 5.3%.…”

“…8 Given age-related physical and cognitive changes, hoarding is particularly dangerous in late life due to increased risk of falls, fire hazards, poor nutrition, and health/medication mismanagement. 1 To date, standard cognitive behavioral treatments for late-life hoarding have not proven to be effective. 9,10 The current report presents the results of an open trial of a novel treatment approach targeting the neurocognitive deficits and geriatric-specific aspects of late-life HD, as well as its core symptoms.…”