Our Research

Researchers evaluated cognitive function and factors associated with cognitive impairment in a cohort of older homeless adults. They conducted structured interviews and neuropsychological testing with participants. 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. Future research will be helpful in clarifying whether treatment of alcohol misuse leads to improvements in cognitive function and whether specific treatment strategies are more effective in this population.

Little is known about chronic pain in older adults experiencing homelessness. In this cross-section, population-based study, researchers interviewed 350 homeless individuals aged 50 years and older to assess factors associated with chronic moderate to severe pain. Overall, 46.8% reported chronic moderate to severe pain. Researchers suggest clinicians should consider the management of associated mental health conditions and the sequelae of experiencing abuse in the treatment of chronic pain in older adults experiencing homelessness.

The prevalence of substance use decreases as individuals age, but older adults now have a higher prevalence of substance use than older adults did 10 years ago. People experiencing homelessness have a higher prevalence of substance use disorders compared to the general population. In this cohort study, researchers examined the prevalence of and factors associated with substance use in a population of homeless individuals aged 50 and older. They found a high prevalence of substance use and an association between psychiatric hospitalization and depression with substance use. Researchers also recommend targeted treatment programs and geriatric substance use workforce development.

Researchers examined whether childhood adversity is associated with depressive symptoms, suicide attempts, or psychiatric hospitalization among older homeless adults. Using population-based sampling methods, the study enrolled 350 homeless adults aged 50 and older in Oakland, California. They found that childhood adversities are associated with poor mental health outcomes among older homeless adults. Researchers recommend screening for childhood adversities should be undertaken by all providers who care for older homeless adults.

The median age of single homeless adults is over 50. Individuals who are homeless visit emergency departments (EDs) at higher rates than the general population. Researchers described the use of and factors associated with ED use in a sample of homeless adults 50 and older. They found that a sample of adults aged 50 and older who were experiencing homelessness at study entry had higher rates of ED use in the prior 6 months than the general US age-matched population. Within the sample, ED use rates varied based on individuals’ residential histories, suggesting that individuals’ ED use is related to exposure to homelessness.

Little is known about pathways to homelessness among older adults. In this study, researchers interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported current health and functional status, including recent mental health and substance use problems. Researchers found that the life course experiences and current health and functional status of individuals with first homelessness before age 50 differed in key ways from those whose first homelessness occurred later.

Adults aged 50 and older make up half of individuals experiencing homelessness and have high rates of morbidity and mortality. Researchers administered structured interviews including assessments of health, history of homelessness, social support, and life course. They found that compared to those who were unsheltered, having social support when last stably housed was significantly associated with cohabiting and institution use. Further research on the newly homeless individuals and cohabiters in this cohort may elucidate more clearly the trajectories of these different phenotypes of homelessness.

Tobacco-attributable deaths contribute significantly to the increased mortality observed among homeless adults aged 50 years or more. In this longitudinal cohort study, researchers examine smoking behaviors and factors associated with smoking cessation among homeless individuals aged 50 years or more. Researchers found tobacco use in older homeless adults and rates of quit attempts were similar to that observed in the general population, but successful quitting was lower.