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Geriatric Syndromes in Older Homeless Adults
Open accessAbstract
Background The average age of the US homeless population is increasing. Little is known about the prevalence of geriatric syndromes in older homeless adults.Objective To determine the prevalence of common geriatric syndromes in a sample of older homeless adults, and to compare these prevalences to those reported in the general older population.Design Cross-sectional.Participants Two hundred and forty-seven homeless adults aged 50-69 recruited from eight homeless shelters in Boston, MA.Main measures Interviews and examinations for geriatric syndromes, including functional impairment, cognitive impairment, frailty, depression, hearing impairment, visual impairment, and urinary incontinence. The prevalences of these syndromes in the homeless cohort were compared to those reported in three population-based cohorts.Key results The mean age of the homeless cohort was 56.0 years, and 19.8% were women. Thirty percent of subjects reported difficulty performing at least one activity of daily living, and 53.2% fell in the prior year. Cognitive impairment, defined as a Mini-Mental State Examination score <24, was present in 24.3% of participants; impaired executive function, defined as a Trail Making Test Part B duration >1.5 standard deviations above population-based norms, was present in 28.3% of participants. Sixteen percent of subjects met criteria for frailty, and 39.8% had major depression, defined as a score ≥10 on the Patient Health Questionnaire 9. Self-reported hearing and visual impairment was present among 29.7% and 30.0% of subjects, respectively. Urinary incontinence was reported by 49.8% of subjects. After multivariate adjustment for demographic characteristics, homeless adults were more likely to have functional impairment, frailty, depression, visual impairment and urinary incontinence compared to three population-based cohorts of older persons.Conclusions Geriatric syndromes that are potentially amenable to treatment are common in older homeless adults, and are experienced at higher rates than in the general older population.
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“Crisis or transitional homelessness is often caused by a discrete event: either an act of nature or political crisis that displaces individuals, an economic disruption (severe recession, foreclosure crisis), or a personal crisis (job loss, illness).28”
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Fazel, S., Geddes, J. R., & Kushel, M. (2014) · The Lancet · doi:10.1016/s0140-6736(14)61132-6 · Cited by 1,568
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Metadata
- Authors
- Brown, R. T., Kiely, D. K., Bharel, M., & Mitchell, S. L.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- Hebrew SeniorLife (US)
- Boston Medical Center (US)
- Corresponding author
- Brown, Rebecca T.
- ORCID
- Brown, Rebecca T.
- Venue
- Journal of General Internal Medicine
- Published
- 2011-08-31
- Volume
- 27
- Issue
- 1
- Pages
- 16-22
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC3250555
- OpenAlex
- W2021599942
- Cited by
- 256
- References
- 39
- Citations by year
- 2026: 7 · 2025: 20 · 2024: 19 · 2023: 26 · 2022: 19 · 2021: 27 · 2020: 25 · 2019: 24 · 2018: 15 · 2017: 15 · 2016: 18 · 2015: 16 · 2014: 12 · 2013: 12
- FWCI
- 14.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Hartford Foundation for Public Giving
- National Institutes of Health
- National Institute on Aging (AG-004390, P01AG004390, T32AG023480, K24AG033640)
- Topics
- Social Sciences › Sociology and Political Science › Homelessness and Social Issues
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- geriatric syndromes, homelessness, functional disability, cognitive impairment, frailty, depression, hearing loss, visual impairment, urinary incontinence, falls, executive function, prevalence, older adults
- MeSH terms
- Activities of Daily Living, Age Factors, Aged, Aged, 80 and over, Cross-Sectional Studies, Depression, Female, Ill-Housed Persons, Humans, Male, Middle Aged, Risk Factors, Urinary Incontinence, Cohort Studies, Geriatric Assessment, Frail Elderly
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