Hoarding disorder in older adults: cognition, etiology and functional impact

囤积症（HD）是一种常见的慢性和使人衰弱的精神疾病， 不成比例地影响老年人，并对个人产生深远的公共卫生影响， 家庭和社会。虽然与HD中杂乱相关的安全风险一直存在， 记录（即高达25%的房屋火灾死亡是由于囤积）， 该患者人群的残疾情况尚不清楚。此外，导致老年人残疾的因素 成人HD，包括认知因素，尚未得到充分阐明。新兴数据， 包括我们小组的工作，表明特定认知领域的缺陷是常见的， 在HD的整个生命周期中。本项目将研究HD对老年人的功能影响 - 具体而言，认知功能，囤积症状严重程度， 残疾。此外，我们将评估HD的遗传风险特征，以及HD与 也影响残疾的内科和精神科合并症。为了实现我们的目标，我们将 联合收割机结合了临床、神经心理学和医学虚弱评估， 流行病学资源，在线脑健康登记处（BHR; www.brainhealthregistry.org）。 BHR旨在加速参与衰老和衰老的临床试验- 相关疾病，在三年内，招募了超过54，000名明确 有兴趣参与正在进行的研究，每月有1000名新参与者注册。 近一半（47%）的参与者年龄在60岁及以上。参与者的特点是 关于精神病，神经，家族和病史，并纵向跟踪 每六个月重新评估一次确定与老年人残疾相关的因素， HD将为制定更有效的治疗干预措施提供信息， 人口，并提供了改善生活质量的重大承诺。

Hoarding Disorder (HD) is a common, chronic and debilitating psychiatric disorder that disproportionately affects older adults, and has a profound public health impact on individuals, families and society. While safety risks associated with clutter in HD has been consistently documented (i.e. up to 25% of deaths by house fire are due to hoarding), the true extent of disability in this patient population is not known. Further, factors contributing to disability in older adults with HD, including cognitive factors, have not been adequately clarified. Emerging data, including work from our group, suggest that deficits in specific cognitive domains are common across the lifespan in HD. This project will examine the functional impact of HD in older adults – specifically, the relationships among cognitive functioning, hoarding symptom severity, and disability. Further, we will assess the genetic risk profile of HD, and the association of HD with medical and psychiatric comorbidities that also impact disability. To achieve our aims, we will combine in-person clinical, neuropsychological, and medical frailty assessments with a unique epidemiologic resource, the online Brain Health Registry (BHR; www.brainhealthregistry.org). The BHR, which was designed to accelerate participation in clinical trials of aging and aging- related disorders, has, in three years, enrolled over 54,000 subjects who are expressly interested in participating in ongoing research with 1000 new participants enrolling every month. Nearly half (47%) of participants are ages 60 and older. Participants are well characterized in regard to psychiatric, neurological, family and medical history, and are followed longitudinally with re-assessments every six months. Identifying factors related to disability in older adults with HD will inform the development of more effective treatment interventions in this vulnerable population and offers significant promise for improving quality of life.