-

Hoarding disorder is described as persistent difficulty discarding or parting with personal possessions irrespective of their objective use or value, resulting in accumulation of possessions filling up active living areas. It is a newly classified mental disorder in DSM-V next to the category of ObsessiveCompulsive Disorders. Evidence suggests a genetic contribution to hoarding behavior and early onset hoarding behaviors can be associated with craniofacial syndromes. We report a case of a woman with a history of craniofacial syndrome who was admitted to our geriatric psychiatry inpatient unit with late-onset hoarding behavior that preceded the progressive cognitive decline. In the setting of a craniofacial syndrome, late-onset hoarding behavior that preceded clinical dementia by at least a decade seems important to note, which may indicate, as opposed to common knowledge, late-onset hoarding behavior can also be seen in craniofacial syndrome, and/or craniofacial syndromes may expedite the onset of hoarding behavior in dementia.