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Hoarding severity predicts functional disability in late-life hoarding disorder patients
- Authors:
- AYERS Catherine R., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 29(7), 2014, pp.741-746.
- Publisher:
- Wiley
Objective: Late-life hoarding is a serious psychiatric condition with significant implications in health and functioning. Geriatric hoarding patients show greater impairment in activities of daily living and have a greater number of medical conditions compared with same-aged nonhoarders. This study examined the relationship between geriatric hoarding severity and functional disability severity. Methods: Sixty-five subjects age 60 or older with hoarding disorder (HD) participated in the current study. Participants were assessed with measures of hoarding severity, psychiatric symptoms, and general disability. Hierarchical regression was used to test the unique association of hoarding symptoms with functional disability beyond the effects of demographic factors, anxiety, and depression. Results: When controlling for demographics (age and gender) and psychiatric symptoms (anxiety and depression), hoarding severity predicts functional disability severity. Analyses also show that clinician-administered measures of hoarding are stronger predictors of disability than patient self-report measures. Conclusions: When treating older adults with HD, clinicians must consider symptom impact on daily life. A multidisciplinary team must be utilized to address the wide-ranging consequences of hoarding symptoms. Future work should examine how psychiatric treatment of HD affects functional disability (Publisher abstract)
Age of onset and progression of hoarding symptoms in older adults with hoarding disorder
- Authors:
- DOZIER Mary E., PORTER Ben, AYERS Catherine R.
- Journal article citation:
- Aging and Mental Health, 20(7), 2016, pp.736-742.
- Publisher:
- Taylor and Francis
Objectives:The authors investigated (1) age of onset of hoarding disorder (HD) symptoms and diagnosis, (2) late-onset HD, (3) progression of HD symptoms, and (4) association between demographics and hoarding progression. Method: Eighty-two older adults with HD provided retrospective ratings of their hoarding symptoms for each decade of life. Age of onset of symptoms (saving, difficulty discarding, and clutter) was operationalised as the first decade in which the participant reported at least minor symptom severity, and age of onset for possible HD diagnosis was operationalised as the first decade in which the participant reported all three symptoms. The authors used mixed effects modeling to examine the progression of HD symptoms. Results: The median age of onset for symptoms was between 10 and 20 years, and the median age of onset for possible HD diagnosis was between 20 and 30 years. Twenty-three percent of participants reported onset of possible HD diagnosis after the age of 40. All HD symptoms increased in severity over time. Men reported higher initial clutter and a slower increase in hoarding severity for all symptoms. Increased education was associated with slower increase in saving. Having at least one parent with hoarding tendencies was associated with higher initial hoarding symptoms. Conclusion: Generally, symptoms of HD begin relatively early and worsen across the lifespan. However, approximately one fourth of older adults with HD reported a possible onset after the age of 40. (Edited publisher abstract)
Age at onset and clinical features of late life compulsive hoarding
- Authors:
- AYERS Catherine R., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(2), February 2010, pp.142-149.
- Publisher:
- Wiley
Compulsive hoarding is a debilitating disorder, yet little is known about its onset or clinical features. Hoarding symptoms often come to clinical attention with older patients. However, no prior study has examined whether elderly compulsive hoarders have early or late onset of hoarding symptoms, whether their hoarding symptoms are idiopathic or secondary to other conditions, or whether their symptoms are similar to compulsive hoarding symptoms seen in younger and middle-aged populations. This study determines the onset and clinical features of late life compulsive hoarding, including psychiatric and medical relationships. A group of 18 participants over 60 with clinically significant compulsive hoarding were assessed using structured interviews, including the Mini International Neuropsychiatric Interview, Structured Clinical Interview for DSM-IV, Yale-Brown Obsessive Compulsive Scale, and UCLA Hoarding Severity Scale. Self-report Measures Included the Beck Anxiety Inventory, Beck Depression Inventory, Sheehan Disability Scale, and Savings Inventory-Revised. Psychosocial and medical histories were also obtained. Participants were asked to rate their hoarding symptoms and describe major life events that occurred during each decade of their lives. Results show that 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. Compulsive hoarding severity seemed to increase with each decade of life. Comorbid mood and anxiety disorders were common, but only 16% of patients met criteria for OCD. The vast majority of patients had never received treatment for hoarding behaviour. Older adults with compulsive hoarding were usually socially impaired and lived alone. In conclusion compulsive hoarding appears to be 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.