Deaths Among Individuals Exhibiting Hoarding Behavior - A 15-year retrospective forensic study

This study characterizes the demographic features, medical history, autopsy findings, toxicological results, and causes of death of decedents with evidence of hoarding behavior. The results were compared with three methodologically comparable studies. Inclusion criteria comprised adult decedents examined at the Institute for Legal Medicine in Frankfurt/Main,Germany whose case records mentioned hoarding or domestic squalor. In a 15-year period, 161 cases met the inclusion criteria. Of the decedents, 24.2% were female, 75.8% were male. The mean age at death was 57.8 years. Physical comorbidities were documented in 58% of cases, with cardiovascular disease being the most prevalent condition in 16% of cases. Alcohol abuse was reported in 40% of the cases based on witness statements or medical records. Toxicological analyses were performed in 43% of cases, with opioids being the most common detected substance class. The cause of death remained unclear in 25% of cases, while cardiovascular disease accounted for 22% of deaths. Life expectancy within the study population was significantly lower than the German-population average. Consistent with the comparison studies, inadequate medical care for pre-existing conditions was frequently observed. Overall, the study population represents a socioeconomically diverse group in bad general health and a high rate of cardiovascular disease. As this study is based on forensic postmortem cases, the findings of this study may not be directly applicable to the living population.