Cognitive functioning in individuals with severe compulsive hoarding behaviors and late life depression

The cognitive characteristics of individuals with severe compulsive hoarding behaviors (SCH) are not well understood and existing studies have largely focused on individuals with SCH and concurrent anxiety disorders. The present study was conducted to evaluate the frequency with which SCH co-occurs with LLD and to compare the cognitive characteristics of individuals with late life depression and concurrent SCH (LLD+SCH) to that of LLD individuals without SCH (LLD).

Participants included 52 LLD individuals who received psychiatric and neuropsychological evaluations as part of a larger study. Cognitive performance on measures of memory, attention, language, information processing speed, and categorization/problem solving ability was evaluated for each participant using standard neuropsychological measures. Measures of depression and anxiety symptom severity were also obtained.

Seven (13%) of the 52 LLD participants reported significant SCH behaviors. The two groups (LLD+SCH; LLD) did not differ with respect to demographic characteristics or severity of depression or anxiety. Individuals with LLD+SCH demonstrated significantly poorer performance on two measures of categorization/problem solving ability relative to individuals with isolated LLD. Clinically significant impairments on measures of categorization ability, information processing speed, and verbal memory were more common for SCH+LLD than LLD participants.

Our preliminary results suggest that SCH behaviors in LLD are associated with specific aspects of executive dysfunction characterized by categorization deficits and to a lesser extent information processing speed and verbal memory deficits. Further study of cognitive functioning in older adults with LLD and SCH may clarify the underlying cognitive characteristics of the SCH syndrome.