Clinical Trial: Hoarding Older Adults

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Treatment of Late Life Compulsive Hoarding

Brief Summary: The purpose of this investigation is to examine treatment outcome of a new intervention for hoarding in older adults compared to standard case management for hoarding. The new intervention combines exposure therapy and cognitive remediation.

Detailed Summary: Research has shown that hoarding disorder (HD) is debilitating chronic and progressive condition that has significant public health implications. Older adults represent the largest group of HD suffers due to increasing severity with age. Often, Veterans with HD are seen in the VA system and the status of their hoarding is never assessed. Providers are treating patients for other health and social service issues yet missing an important source of disability and distress. This insidious, often undetected condition leads to greater medical and social disability and is costly to the VA system as patients continue to decompensate. When HD is even detected, patients in the VA receive indefinite case management and inadequate treatment. The cases the investigators know about have caused significant financial burden to the investigators' system. Most importantly, HD causes significant impairment and poor quality of life for the Veterans, particularly older Veterans. Unfortunately, the investigators know nothing about how to treat late life HD. Nor do the investigators know how neurocognitive features impact treatment response, which the investigators strongly suspect influence treatment outcome. HD is a potentially treatable source of disability in the VA system - one that the VA must research and treat. This study represents the first randomized controlled trial of a novel intervention for the treatment of HD in older Veterans. The main objective of this proposal is to further refine and test a new treatment for hoarding in older Veterans (age 60-85) which will be accomplished through a series of treatment development phases (case series, open labeled trial) and a randomized controlled trial. The new treatment (Cognitive Remediation and Exposure Therapy for hoarding; CogRET) is hypothesis driven and based on late life anxiety literature, consultation with mentors, results of the pilot study using a standard cognitive-behavioral intervention, and several case series that wi
Sponsor: VA Office of Research and Development

Current Primary Outcome: Hoarding Symptom Severity as Measured by the Saving Inventory-Revised (SI-R) at 6 Months [ Time Frame: 6 months ]

Hoarding symptom severity (primary outcome) will be measured using the Savings Inventory-Revised (SI-R), a 23-item self-report measure used to assess common hoarding symptoms. Subtests include excessive clutter, compulsive acquisition, and difficulty discarding. The SI-R has demonstrated good internal consistency, divergent validity, concurrent validity, divergent validity, test-retest reliability in clinical samples with hoarding. The total score will be used for analyses. The range of the total score is 0-92, with higher scores indicating worse hoarding severity.


Original Primary Outcome: Savings Inventory-Revised, UCLA Hoarding Severity Scale [ Time Frame: 5 years ]

Current Secondary Outcome:

  • Change in Functional Impairment as Measured by the Activities of Daily Living, Functional Disability Index, Clutter Image Rating Scale [ Time Frame: 5 years ]
  • Executive Functioning as Measured by the Delis Kaplan Executive Functioning System (D-KEFS) at 6 Months [ Time Frame: 6 months ]
    The D-KEFS Trail Making Test Condition 4: Number-Letter Switching Scaled Score was used to assess executive functioning. Scaled scores range from 1-19. Higher scores represent less impairment.


Original Secondary Outcome: Activities of Daily Living, Functional Disability Index, Clutter Image Rating Scale [ Time Frame: 5 years ]

Information By: VA Office of Research and Development

Dates:
Date Received: October 20, 2010
Date Started: November 2010
Date Completion:
Last Updated: July 20, 2016
Last Verified: July 2016