Factors associated with cognitive impairment in a cohort of older homeless adults: Results from the HOPE HOME study.
Drug Alcohol Depend
; 178: 562-570, 2017 09 01.
Article
en En
| MEDLINE
| ID: mdl-28738314
ABSTRACT
BACKGROUND:
We evaluated cognitive function and factors associated with cognitive impairment in a cohort of older homeless adults. We hypothesized that substance use and a history of traumatic brain injury would be associated with cognitive impairment.METHODS:
We recruited 350 homeless individuals aged ≥50 years using population-based sampling and conducted structured interviews and neuropsychological testing. We evaluated alcohol use with the Alcohol Use Disorder Identification Test, defining high-severity alcohol use as a total score ≥16 or ≥4 on the alcohol dependency sub-scale. We assessed global cognition with the Modified Mini-Mental State Test (3MS) and processing speed and executive function with the Trail Making Test (TMTB), defining impairment as performing 1.5 standard deviations below the standardized mean. We used multivariable logistic regression to examine the association between alcohol use and cognition.RESULTS:
Participants had a median age of 58 years [IQR 54-61], 76.7% were men, and 79.9% were African American. A quarter (25.1%) of participants met criteria for impairment on the 3MS; 32.9% met criteria for impairment on TMTB. In models adjusted for sociodemographic variables and health conditions, high-severity alcohol use was associated with global cognitive impairment (AOR 2.39, CI 1.19-4.79) and executive dysfunction (AOR 3.09, CI 1.61-5.92).CONCLUSIONS:
Older homeless adults displayed a prevalence of cognitive impairment 3-4 times higher than has been observed in general population adults aged 70 and older. Impaired cognition in older homeless adults could impact access to housing programs and the treatment of health conditions, including the treatment of alcohol use disorders.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
/
8_ODS3_consumo_sustancias_psicoactivas
Problema de salud:
2_sustancias_psicoativas
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8_alcohol
Asunto principal:
Personas con Mala Vivienda
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Trastornos del Conocimiento
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Trastornos Relacionados con Sustancias
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Alcoholismo
/
Pruebas Neuropsicológicas
Tipo de estudio:
Etiology_studies
/
Incidence_studies
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Observational_studies
/
Prevalence_studies
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Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Límite:
Humans
Idioma:
En
Revista:
Drug Alcohol Depend
Año:
2017
Tipo del documento:
Article