Obsessive-Compulsive and Related Disorders in Older Adults

Abstract

Abstract While the population ages, the obsessive-compulsive and related disorders (OCRDs) remain understudied in older adults. Several OCRDs occur regularly in late life and are highly debilitating for older people. Other OCRDs have not been studied in older adults. This chapter summarizes the important emotional changes that are now known to characterize late life as a context for understanding older adults’ mental health. The chapter reviews estimates of late-life OCRD prevalence and whether the symptoms experienced by older people differ from symptoms in other age groups. The chapter examines age at onset and life course as important factors for understanding how the conditions come to affect older people. Studies on the life course of hoarding disorder (HD) suggest that while the condition begins early in life, the disorder is both chronic and progressive. Older adults often experience HD in severe form. Emerging information on the developmental course of HD and its prevalence in older adults has precipitated increased research and refinements in treatment. In contrast, late-life obsessive-compulsive disorder (OCD) remains neglected, and controlled treatment outcome studies have not occurred with older people. While most patients’ OCD begins early in life, evidence suggests that there is a subgroup who experience the disorder for the first time in late life. To better understand late-life OCRDs, new models test whether the important changes occurring in late life might interact with disorder risk factors to precipitate late-life obsessional disorders. The results of initial tests of these models are encouraging.