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Open Access Publications from the University of California

Novel treatment for geriatric hoarding disorder: an open trial of cognitive rehabilitation paired with behavior therapy.

  • Author(s): Ayers, Catherine R
  • Saxena, Sanjaya
  • Espejo, Emmanuel
  • Twamley, Elizabeth W
  • Granholm, Eric
  • Wetherell, Julie Loebach
  • et al.


To investigate the feasibility of an age-adapted, manualized behavioral treatment for geriatric hoarding.


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 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.


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.

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