Hoarding disorder (HD) in late life is associated with increased risk for fire, falling, poor sanitary conditions, disability, and health risks. However, research on the health status of individuals with HD is limited. Hoarding symptoms and the resulting clutter may exacerbate health conditions and lead to improper management of medical illnesses.Objective-The purpose of this study is to characterize the health status of older adults with hoarding. The rates of medical conditions will be compared to a non-psychiatric peer group.Method-72 older adults with HD and 25 age matched normal controls, completed a medical conditions checklist, symptom severity measures (i.e., UCLA Hoarding Severity Scale, UHSS; Saving Inventory-Revised, SI-R) and a measure capturing activities of daily living (activities of daily living-hoarding, ADL-H).Results-Older adults with HD (n = 72) reported significantly more health conditions compared to their non-psychiatric peers (n = 25). Hoarding severity significantly predicted the total number of medical conditions. Further, the vast majority of HD patients reported at least one medical condition.Conclusion-This is alarming given that hoarding patients utilized health services less than typical for older adults. Given the health status of older adults with HD, interventions should target the prevention and management of medical conditions.

This study describes the initial contact of 255 potential participants, recruitment of 63 participants, and retention of 57 participants from three geriatric Hoarding Disorder (HD) studies. Patients with HD were easily recruited from the community, primarily through the use of clinician referrals and posted flyers, as evidenced by steady patient flow despite lack of compensation for participation. Contrary to treatment outcomes of late life mood and anxiety disorders, geriatric HD patients are largely retained in clinical research treatment studies. Results demonstrate that older adults with HD can be engaged in treatment. Participants often needed the study staff to provide substantial support, including informal motivational interviewing and problem solving, in scheduling and attending the initial visit.Keywords hoarding disorder; older adults; recruitment and retention Address correspondence to Catherine R. Ayers, PhD, ABPP, Anxiety Disorders Clinic, VA San Diego Healthcare System, 3350 La Jolla Village Drive 116B, San Diego, CA 92161, USA. cayers@ucsd.edu. U.S. Department of Veterans AffairsPublic Access Author manuscript Clin Gerontol. Author manuscript; available in PMC 2018 January 29. VA Author ManuscriptVA Author Manuscript VA Author ManuscriptHoarding Disorder (HD) is characterized by an inability to discard possessions regardless of the objects' value due to a desire to keep the items as well as to avoid the distress accompanying the act of discarding. This prevents the use of active living spaces due to excessive clutter and causes clinically significant distress or functional impairment (American Psychiatric Association, 2013). Hoarding has been associated with an increased risk for fire or falling in the home as well as increased medical problems in older adults (Ayers, Iqbal, & Strickland, 2014;Dong, Simon, Mosqueda, & Evans, 2011;Kim, Steketee, & Frost, 2001). Further, geriatric HD patients exhibit lower global functioning and increased impairment in activities of daily living than non-HD peers (Ayers, Schiehser, Liu, & Wetherell, 2012). Epidemiological research has suggested that the prevalence of DSM-5 hoarding disorder is approximately 1.5% of the general population (Nordsletten et al., 2013), and there is some evidence to suggest that clinically significant compulsive hoarding may increase with age (Samuels et al., 2008). However, there has been no large-scale investigation of the prevalence of HD in older adults. The course of HD appears chronic for 73.0% of adult with compulsive hoarding symptoms and increasing for another 21.2% (Tolin, Meunier, Frost, & Steketee, 2010). When left untreated older adults with HD can experience moderate to severe symptomatology (Ayers, Saxena, Golshan, & Wetherell, 2010).Individuals with HD often resist treatment or seek intervention only as a result of family or community pressure (Frost, Steketee, & Williams, 2000). In a clinical case series examining mid-life and older adults with clinically significant hoarding symptoms, Christensen & Greist (200...

Generalized anxiety disorder (GAD) is characterized by persistent and hard-to-control worry that is often excessive in comparison to the stressor or situation. Individuals with GAD typically worry about routine daily matters, such as health, finances, social situations, and occupational situations. This worry is usually unfounded and interferes with the everyday functioning of the individual, as they are in a constant state of disaster anticipation. Physical symptoms often appear in conjunction with GAD, including fatigue, headache, nausea, sweating, and insomnia, among others (Diagnostic and Statistical Manual of Mental Disorders, 5th ed.; American Psychiatric Association, 2013).GAD is not uncommon in the geriatric population, with rates ranging from 2.8% to 11.2% (