Simple Screening Tool Detects Hoarding Behaviors in Those with Memory Loss

Researchers at the University of Colorado Anschutz Medical Campus have developed a one-question screening tool to aid quickly identify hoarding behaviors in patients experiencing memory loss and other brain disorders. Early detection of these behaviors could lead to timely interventions, reducing safety risks, alleviating caregiver stress, and improving quality of life for both patients and their families.

The Need for Early Detection

Hoarding disorder, characterized by persistent difficulty discarding possessions regardless of their value, can create unsafe living conditions, cause significant stress, and diminish quality of life. Although often associated with psychiatric conditions like obsessive-compulsive disorder, hoarding is also increasingly recognized in individuals with neurodegenerative diseases such as Alzheimer’s disease and other forms of dementia.

Introducing the Single-Item Hoarding Screen (SIHS)

Traditional assessments for hoarding behavior involve lengthy interviews and detailed questionnaires, which aren’t always practical in busy clinical settings. To address this, researchers developed the Single-Item Hoarding Screen (SIHS). This tool asks caregivers a single question: “Is there any concern regarding clutter in the home or possible hoarding behavior?” Caregivers can respond with “no,” “maybe,” or “yes.”

Study Findings

A study involving 135 patients in a behavioral neurology clinic, with conditions including Alzheimer’s disease, Lewy body dementia, primary progressive aphasia, and behavioral variant frontotemporal dementia, revealed the following:

• 23% of caregivers expressed some level of concern about hoarding (10% answered “yes,” and 13% answered “maybe”).
• Caregivers who answered “yes” reported significantly higher scores on a well-established hoarding assessment.
• Hoarding concerns were linked to more severe depression symptoms, greater neuropsychiatric symptoms, and higher caregiver stress.

Hoarding behaviors were particularly common in patients with behavioral variant frontotemporal dementia, a condition affecting judgment and impulse control.

Implications and Future Research

The study, published in The Journal of Neuropsychiatry and Clinical Neurosciences, suggests that even a single screening question can effectively flag potentially serious hoarding behavior. Researchers emphasize that this tool is a first step and requires further validation through larger studies to confirm its reliability and applicability across diverse populations.

“This will benefit patients and those who care for them, since there is a clear relationship between caregiver stress and hoarding,” said Peter Pressman, MD, associate professor of neurology at Oregon Health & Science University, who conducted the research while at CU Anschutz. “If physicians don’t ask questions about this, we can’t assume people will tell them.”