title: Novel treatment for geriatric hoarding disorder: an open trial of cognitive rehabilitation paired with behavior therapy.
abstract: OBJECTIVE
  To investigate the feasibility of an age-adapted, manualized behavioral treatment for geriatric hoarding.
  
  
  METHODS
  Participants were 11 older adults (mean age: 66 years) with hoarding disorder. Treatment encompassed 24 individual sessions of psychotherapy that included both cognitive rehabilitation targeting executive functioning and exposure to discarding/not acquiring. Hoarding severity was assessed at baseline, mid-treatment, and posttreatment.
  
  
  RESULTS
  Results demonstrated clinically and statistically significant changes in hoarding severity at posttreatment. No participants dropped out of treatment. Eight participants were classified as treatment responders, and three as partial responders. Partial responders reported severe/extreme hoarding and psychiatric comorbidities at baseline.
  
  
  CONCLUSIONS
  The combination of cognitive rehabilitation and exposure therapy is a promising approach in the treatment of geriatric hoarding. Targeting neurocognitive deficits in behavioral therapy for these geriatric patients with hoarding disorder doubled response rates relative to our previous trial of cognitive behavior therapy alone.
authors.affiliation: Research Service, VA San Diego Healthcare System, San Diego, CA; Psychology Service, VA San Diego Healthcare System, San Diego, CA; Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA. Electronic address: cayers@ucsd.edu.
authors.forename: Catherine R
authors.initials: CR
authors.lastname: Ayers
authors.affiliation: Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA.
authors.forename: Sanjaya
authors.initials: S
authors.lastname: Saxena
authors.affiliation: Psychology Service, VA San Diego Healthcare System, San Diego, CA; Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Espejo
authors.affiliation: Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA.
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Twamley
authors.affiliation: Psychology Service, VA San Diego Healthcare System, San Diego, CA; Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA.
authors.forename: Eric
authors.initials: E
authors.lastname: Granholm
authors.affiliation: Psychology Service, VA San Diego Healthcare System, San Diego, CA; Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA.
authors.forename: Julie Loebach
authors.initials: JL
authors.lastname: Wetherell
mesh_terms: D000368:Aged; D000375:Aging / Q000523:psychology*; D015928:Cognitive Behavioral Therapy; D005260:Female; D000067836:Hoarding Disorder / Q000534:rehabilitation* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: CBT; OCD; cognitive remediation; hoarding; older adults