Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Psychology Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA.
Int J Geriatr Psychiatry. 2013 Nov;28(11):1175-81. doi: 10.1002/gps.3940. Epub 2013 Feb 26.
Hoarding disorder (HD) is a chronic and debilitating psychiatric condition. Midlife HD patients have been found to have neurocognitive impairment, particularly in areas of executive functioning, but the extent to which this is due to comorbid psychiatric disorders has not been clear.
AIMS/METHOD: The purpose of the present investigation was to examine executive functioning in geriatric HD patients without any comorbid Axis I disorders (n = 42) compared with a healthy older adult comparison group (n = 25). We hypothesized that older adults with HD would perform significantly worse on measures of executive functioning (Wisconsin Card Sort Task [Psychological Assessment Resources, Lutz, Florida, USA] ( Psychological Assessment Resources, 2003) and the Wechsler Adult Intelligence Scale-IV digit span and letter-number sequencing tests [Pearson, San Antonio, TX, USA]).
Older adults with HD showed significant differences from healthy older controls in multiple aspects of executive functioning. Compared with healthy controls, older adults with HD committed significantly more total, non-perseverative errors and conceptual level responses on the Wisconsin Card Sort Task and had significantly worse performance on the Wechsler Adult Intelligence Scale-IV digit span and letter-number sequencing tests. Hoarding symptom severity was strongly correlated with executive dysfunction in the HD group.
Compared with demographically-matched controls, older adults with HD have dysfunction in several domains of executive functioning including mental control, working memory, inhibition, and set shifting. Executive dysfunction is strongly correlated with hoarding severity and is not because of comorbid psychiatric disorders in HD patients. These results have broad clinical implications suggesting that executive functioning should be assessed and taken into consideration when developing intervention strategies for older adults with HD.
囤积症（HD）是一种慢性且使人虚弱的精神疾病。研究发现，中年 HD 患者存在神经认知障碍，尤其是在执行功能方面，但这种障碍在多大程度上是由于共病精神障碍引起的尚不清楚。
目的/方法：本研究旨在比较无共病轴 I 障碍的老年 HD 患者（n = 42）和健康老年对照组（n = 25）的执行功能。我们假设 HD 患者在执行功能测试（威斯康星卡片分类任务[心理评估资源，佛罗里达州卢茨]（ Psychological Assessment Resources, 2003）和韦氏成人智力量表-IV 数字跨度和字母数字排序测试[皮尔逊，德克萨斯州圣安东尼奥]）上的表现会明显更差。
HD 患者在执行功能的多个方面与健康老年对照组存在显著差异。与健康对照组相比，HD 患者在威斯康星卡片分类任务上的总错误、非持续错误和概念水平反应明显更多，并且在韦氏成人智力量表-IV 数字跨度和字母数字排序测试上的表现明显更差。囤积症状严重程度与 HD 组的执行功能障碍密切相关。
与人口统计学匹配的对照组相比，老年 HD 患者在执行功能的多个领域存在障碍，包括心理控制、工作记忆、抑制和转换。执行功能障碍与囤积严重程度密切相关，而不是由于 HD 患者的共病精神障碍引起的。这些结果具有广泛的临床意义，表明在为老年 HD 患者制定干预策略时，应评估并考虑执行功能。
