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Age at onset and clinical features of late life compulsive hoarding
International Journal of Geriatric Psychiatry, 06/29/09

Ayers CR et al. - Compulsive hoarding is a progressive and chronic condition that begins early in life. Left untreated, its severity increases with age. Compulsive hoarding should be considered a distinct clinical syndrome, separate from OCD. Unfortunately, compulsive hoarding is largely unrecognized and untreated in older adults.

Methods

Participants were 18 older adults (60) with clinically significant compulsive hoarding.
They were assessed using structured interviews, including the Mini International Neuropsychiatric Interview (MINI), Structured Clinical Interview for DSM-IV (SCID I), Yale-Brown Obsessive Compulsive Scale (YBOCS), and UCLA Hoarding Severity Scale (UHSS).
Self-report Measures Included the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Sheehan Disability Scale (SDS), and Savings Inventory-Revised (SI-R).
Psychosocial and medical histories were also obtained.
To determine age at onset, participants were asked to rate their hoarding symptoms and describe major life events that occurred during each decade of their lives.

Results

Results show that (1) onset of compulsive hoarding symptoms was initially reported as being in mid-life but actually found to be in childhood or adolescence. No subjects reported late onset compulsive hoarding.
(2) Compulsive hoarding severity increased with each decade of life.
(3) Comorbid mood and anxiety disorders were common, but only 16% of patients met criteria for OCD if hoarding symptoms were not counted toward the diagnosis.
(4) The vast majority of patients had never received treatment for hoarding.
(5) Older adults with compulsive hoarding were usually socially impaired and living alone.

Exclusive Author Commentary
Catherine Ayers, Ph.D., 06/29/09

Compulsive hoarding (CH) severity increases with age and causes great distress and impairment for many older adults with CH. Often, CH is not detected by health care professionals. Providers treating older adults should assess for possible CH.

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