The health impacts of hoarding disorder in older adults: A scoping review

Abstract

Background: Hoarding Disorder (HD) is a mental health condition characterised by persistent difficulty discarding or parting with possessions, regardless of their actual value. This behaviour leads to the accumulation of a large number of items, often to the extent that living spaces become cluttered and difficult to use, this has wider implication for the person who hoards, and people who live with and around them including public and environmental health risks such as fire, infestation , and structural damage to homes. Hoarding disorder can have significant effects on the individual's quality of life yet little is known about the health impacts of a person with hoarding disorder. The absence of a stand-alone diagnosis until 2013 for symptoms of hoarding means literature is limited and challenging to analyse and much remains unknown about the epidemiology Hoarding Disorder 

Methods: A scoping review of literature from 2013 – 2024 was undertaken in May 2024 using three databases to identify relevant studies, further searches were also conducted through grey literature. The screening process involved evaluating studies against inclusion criteria and data was subsequently extracted for thematic analysis. 

Results: Ten studies were included in the review , with three themes identified; Hoarding Disorder and Older Age, Hoarding Disorder and Medical Co-Morbidity and Hoarding Disorder and Depression and Anxiety. Results suggested that there is generally no substantial connection between severity of hoarding and older age but rather older adults appear to have increased severity due to age related function impairment. Results identified people with Hoarding Disorder generally have lower quality of life due to increased numbers of medical comorbidities including physical and mental health conditions and that there is a strong correlation between Hoarding Disorder and depression and anxiety .  

Conclusion: Hoarding Disorder has a complex impact on public health, influencing not just mental and physical health but considering the wider impacts socially and financially. Effective management is required to address the complex needs of people with Hoarding Disorder which requires a multidisciplinary approach comprising mental health specialists, social workers, public health officials, and legal authorities to mitigate its broader shared impacts.