Diogenes syndrome in a 10-year retrospective observational study: An elderly case series in Tokyo.

Objectives: Supporting people suffering from Diogenes Syndrome (DS) is a challenge for geriatric psychiatry. However, there is a lack of knowledge about DS in Japan. Therefore, a systematic longitudinal study to clarify the factors associated with DS and its prognosis was conducted.

Methods/design: A retrospective study using data from case records of a municipal psychogeriatric service was conducted. The study population was socially isolated older adults with complex mental health and social care needs who had been referred to the service over 10 years. The participants were stratified into DS and non-DS groups, multivariate analysis was performed to identify factors associated with DS, and survival analysis was performed.

Results: Of the 270 participants, 61 with Environmental Cleanliness and Clutter Scale (ECCS) scores >12 were assigned to the DS group, and 209 with ECCS scores ≤12 were assigned to the non-DS group. On multiple logistic regression analysis, significantly more people in the DS group were living alone, had advanced dementia, and had reduced basic activities of daily living (BADL) compared to the non-DS group. Furthermore, survival analysis showed that the DS group had a higher risk of early death than the non-DS group.

Conclusions: In the present study, social isolation, living alone, advanced dementia, and reduced BADL were found to be associated with DS. In addition, DS had a high risk of early death. Support for DS must take into account not only mental and social health, but also physical health from an early stage.