Hoarding in the elderly: a critical review of the recent literature

Abstract

ABSTRACTBackground:Hoarding is now a stand-alone diagnosis in DSM-5. The objective of this review is to critically evaluate the most recent literature on hoarding disorder (HD) in ageing patients.Methods:A literature search was conducted using PubMed and PsychINFO to identify papers from 2000 to 2015 that examined HD and hoarding symptoms in late-life participants.Results:Thirteen studies met inclusion criteria. Selected studies had significant methodological limitations with regard to participant sampling, diagnostic criteria, and methods for identifying co-morbid conditions. Hoarding in the elderly generally had onset before age 40 years, increased in severity after middle age, and was linked with social isolation. Depression was associated with hoarding in 14–54% of geriatric cases. Co-morbid anxiety and PTSD were also found. A variety of medical conditions were more common in seniors with hoarding including arthritis and sleep apnea. Late-life hoarding was associated with deficits in memory, attention, and executive function.Conclusions:HD in the elderly has distinct features. A combination of self-neglect, psychiatric and medical co-morbidities, and executive dysfunction may contribute to the progression of hoarding symptoms in the elderly.