Impulsive-Compulsive Behaviors in Older Adults: Rethinking our Approach to Clinical Assessment Considering the Related Harm

Impulsive compulsive behaviours (ICBs) such as hypersexuality, pathological gambling, compulsive eating and compulsive shopping are commonly associated with younger age groups. However, they also present in older adults where they go under recognised and as such can be the source of financial problems and relationships breakdown. The purpose of this study is to explore the nature, extent and impact of ICBs in ‘healthy’ adults aged 55 years and over, considering the utility of the Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviour to identify predisposing interacting variables that might underly the development of this type of behaviour. The recruited participants (n=81) were asked to fill in an online survey composed of adaptations of 15 validated scales and questionnaires that assess impulsivity and compulsivity (e.g., Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease–Rating Scale, (QUIP-rs)), as well as the harm related to ICBs, and operationalize the constructs of affect, cognition and execution that we are interested in. Participants were be assigned to an ICB control group with QUIP-rs scores of 5 or less and an ICB index group with scores of 6 or more. Categorical and continuous predictor variables were examined using independent student t-tests and multiple linear regression. Unsupervised machine learning using K-cluster analysis modeled the predictor variables. The best fitting model was identified from the BIC score (closer to the upper boundary of 1 the better the model).