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

囤积障碍(HD)是一种常见的、慢性的、令人衰弱的精神障碍 对老年人的影响不成比例，并对个人的公共健康产生深远的影响， 家庭和社会。虽然与高清杂乱相关的安全风险一直是 有记录的(即高达25%的房屋火灾死亡是由于囤积)，真实的程度 这一患者群体中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，还没有得到充分的澄清。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 在高清模式下的使用寿命。该项目将研究HD对老年人的功能影响 -具体地说，认知功能、囤积症状严重程度和 残疾。此外，我们将评估先天性心脏病的遗传风险概况，以及先天性心脏病与 医疗和精神并存也会影响残疾。为了实现我们的目标，我们将 将面对面的临床、神经心理学和医疗脆弱性评估与独特的 流行病学资源，在线脑健康注册(BHR；www.brainHealth Registry.org)。 BHR旨在加快参与老龄化和老龄化的临床试验- 相关障碍，在三年内已经招募了超过54,000名受试者，他们明确地 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。参与者的特征很好地体现在 关于精神病史、神经史、家族史和病史，并进行纵向跟踪 每六个月重新评估一次。确定与老年人残疾相关的因素 房署将通知制定更有效的治疗干预措施，以治疗这一弱势群体 并为改善生活质量提供了巨大的希望。

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.