Hoarding in Late Life and Aging Parents

At Hoarding Help Central, we understand the importance of identifying the reasons that hoarding behavior ever starts in the first place. With compulsive hoarding affecting 1.5 percent of the population, we feel it is vital to understand the origins of hoarding disorder as well as its prevalence among affected demographics.

One demographic that is less talked about in terms of hoarding behavior is those over the age of 40. With hoarding generally appearing before the age of 20, there is a smaller demographic of people that experience the onset of hoarding symptoms at the age of 40 and over. Regardless, knowing more about the prevalence of hoarding in late life is essential to treating the issue.

Today, Hoarding Help Central will be discussing the prevalence, onset, effects, and treatment options available for older adults suffering from hoarding disorder. As both a chronic and progressive disease, hoarding disorder can be a challenge to treat, and knowing as much as possible about the way it affects older adults can tell us much about the disorder overall. Let’s get started!

Prevalence of Hoarding Disorder in Late Life

Although older adults are not the primary demographic of focus when discussing hoarding disorder, there is much known about the prevalence of the disease in this demographic. Current estimates of the prevalence in the nongeriatric community range from somewhere between 2 percent and 5.3 percent. Currently, it is difficult to pinpoint the exact prevalence of hoarding disorder in nongeriatric adults due to a lack of consistency in hoarding symptom severity measurements.

In efforts to pinpoint the rate of prevalence of hoarding disorder in older adults, it can be helpful to look at the characteristic traits of older adults suffering from the disease. These findings can be measured thanks to affected individuals who present for treatment. Those who meet the criteria for hoarding disorder, as defined by the DSM-5, are mostly women at 69 percent. Further, most of those affected are white and unmarried, living alone at 85 percent.

Older adults living alone show higher levels of clutter, but there are no reported differences in either their urges to save or difficulty in getting rid of items. It is important to note that clinical assessments that rely on clutter levels may prove misleading if individuals live with either a partner or a roommate. This is because the physical manifestation of hoarding symptoms may be artificially deflated. To get the most accurate view of hoarding symptoms, it is best practice to inquire about areas of the home controlled solely by the individual as well as communal areas.

The Onset of Hoarding Disorder in Older Adults

It is essential to understand the onset of hoarding disorder in older adults as it can assist clinicians struggling with a definite diagnosis. There is a consistent pattern concerning age in those that either self-report symptoms of hoarding disorder or have met the diagnostic criteria for hoarding disorder. Most often, these symptoms can be observed before the age of 20, but a smaller demographic will experience onset at age 40 or later.

The progression of hoarding disorder throughout a lifetime is still up for some debate. Those that self-report as having hoarding problems most commonly report that symptoms seem to stabilize upon reaching middle age, remaining relatively sustained into old age. Those that meet the criteria for compulsive hoarding, however, say that their symptoms get increasingly worse with age, extending well into old age.

Hoarding Disorder’s Impact on the Well-Being of Older Adults

Although the effects of hoarding disorder seem to be prevalent across the life span, the symptoms of hoarding disorder may have a particularly harmful impact on the well-being of the geriatric population. This is mainly because they experience an increased risk of falling, poor hygiene and nutrition, and a variety of medical problems that can be made worse by hoarding behaviors. These risks increase with the level of symptom severity.

Other problems reported by the older population of people suffering from hoarding disorder include social isolation due to the shame of their environment, food contamination, and even medication mismanagement. Since most of the current medical research surrounding hoarding disorder in the older population is mostly self-reported, the risks associated with hoarding disorder are likely underreported.

Treatment Options For Older Adults

So what can be done for older adults suffering from hoarding disorder? The two most commonly used methods of treatment for older adults suffering from the symptoms of compulsive hoarding include psychotherapy and medication. The medication shown to produce the most promising results is an extended-release antidepressant known as venlafaxine.

Venlafaxine has proven beneficial in addressing the symptoms of hoarding disorder, decreasing symptoms by up to 36 percent after 12 weeks. Unfortunately, these means of treating compulsive hoarding symptoms proved most beneficial in younger people, showing less promise in those of an older age.

Currently, cognitive behavioral therapy is the only manualized treatment for hoarding disorder. This treatment is usually implemented in the form of several therapy sessions. These sessions consist of motivational interviewing and cognitive restructuring. This practice is focused on addressing the distorted thinking patterns that result in hoarding behaviors. Discussing the way that patients associate items with comfort and alleviation of anxiety is another main focus of cognitive-behavioral therapy.

These strategies have been shown to produce the most dramatically positive results in those suffering from hoarding disorder in late life. While there is still much research to be done, these results are promising and may lead to better treatment options overall for older adults suffering from hoarding disorder.