Relationship of Hoarding and Depression Symptoms in Older Adults

• Published in: The American journal of geriatric psychiatry 2024-04, Vol.32 (4), p.497-508
• Main Authors: Nutley, Sara, Nguyen, Binh K., Mackin, Robert Scott, Insel, Philip S., Tosun, Duygu, Butters, Meryl, Aisen, Paul, Raman, Rema, Saykin, Andrew J., Toga, Arthur W., Jack, Clifford, Weiner, Michael W., Nelson, Craig, Kassel, Michelle, Kryza-Lacombe, Maria, Eichenbaum, Joseph, Nosheny, Rachel L., Mathews, Carol A.
• Format: Article
• Language: English
• Subjects: Brain Health Registry; hoarding disorder; Late-life depression; major depressive disorder; reliable change; stability analysis; trajectory analysis
• ISSN: 1064-7481; 1545-7214; 1545-7214
• DOI: 10.1016/j.jagp.2023.11.006

•What is the primary question addressed by this study? The question addressed by the study must limited to only one sentence.This study assesses the rates, stability, and trajectories of clinically significant hoarding symptoms in older adults with depression (late-life depression).•What is the main finding of this study? The finding must be limited to two sentences.Hoarding symptoms were present in up to 33% of older adults with active depression in two independent cohorts. Hoarding severity was stable over time and did not co-vary with depression severity.•What is the meaning of the finding? The meaning of the finding must be limited to one sentence.Hoarding is a more common comorbidity in late life depression than previously suggested and should be considered in screening and management in this population, and the interaction of these conditions should be further characterized with attention to determining factors which may improve hoarding outcomes. Hoarding disorder (HD) is a debilitating neuropsychiatric condition that affects 2%–6% of the population and increases in incidence with age. Major depressive disorder (MDD) co-occurs with HD in approximately 50% of cases and leads to increased functional impairment and disability. However, only one study to date has examined the rate and trajectory of hoarding symptoms in older individuals with a lifetime history of MDD, including those with current active depression (late-life depression; LLD). We therefore sought to characterize this potentially distinct phenotype. We determined the incidence of HD in two separate cohorts of participants with LLD (n = 73) or lifetime history of MDD (n = 580) and examined the reliability and stability of hoarding symptoms using the Saving Inventory-Revised (SI-R) and Hoarding Rating Scale-Self Report (HRS), as well as the co-variance of hoarding and depression scores over time. HD was present in 12% to 33% of participants with MDD, with higher rates found in those with active depressive symptoms. Hoarding severity was stable across timepoints in both samples (all correlations >0.75), and fewer than 30% of participants in each sample experienced significant changes in severity between any two timepoints. Change in depression symptoms over time did not co-vary with change in hoarding symptoms. These findings indicate that hoarding is a more common comorbidity in LLD than previously suggested, and should be considered in screening and management of LLD. Future studies should