Our Research

The US homeless population is aging. Older adults and those living in poverty are at a high risk of food insecurity. Researchers conducted a cross-sectional analysis of baseline data from a population-based study of 350 homeless adults aged ≥50. They found older homeless adults experience a high prevalence of food insecurity. To alleviate food insecurity in this population, targeted interventions must address specific risk groups.

The median age of single homeless adults is approximately 50 years. Older homeless adults have poor social support and experience a high prevalence of chronic disease, depression, and substance use disorders. This study aimed to describe the access to and use of mobile phones, computers, and the Internet among a cohort of 350 homeless adults over the age of 50 years. Researchers found that participants with phones used them for social support and communication with healthcare providers; however, few had annual phone contracts.

People experiencing homelessness have inadequate resources for regular dental hygiene and a higher prevalence of risk for tooth loss, including smoking and substance use. This study aimed to describe the prevalence of and factors associated with oral health measures in a sample of older homeless adults in Oakland, CA. Researchers conducted a cross-sectional analysis of data from a population-based study of 350 homeless adults aged ≥50. They found that tooth loss and oral pain are highly prevalent in older homeless adults.

Older homeless adults experience premature development of age-related conditions and an elevated symptom burden. The study aimed to characterize the experience, understanding, and management of physical, psychological, social (e.g., loneliness), and existential (e.g., regret, loss of dignity) symptoms among older homeless adults. Researchers conducted semistructured interviews from June 2016 to March 2017 with a purposive sample of participants from the Health Outcomes of People Experiencing Homelessness in Older Middle Age cohort, a longitudinal study of homeless adults aged 50 and older. They found that homelessness causes and exacerbates physical and psychological distress. Interventions should address multiple interconnected dimensions of suffering.

Older homeless-experienced adults have low engagement in advance care planning (ACP) despite high morbidity and mortality. Researchers conducted a cross-sectional analysis of a cohort of 350 homeless-experienced adults aged 50 and older in Oakland, California. They assessed the prevalence of potential surrogate decision-makers, ACP contemplation, discussions, and ACP documentation (surrogate designation, advance directives). Researchers found a low prevalence of engagement in a full range of ACP behaviors, including contemplation, discussions, and formal ACP documentation.

Homeless adults in their 50s and 60s have a similar prevalence of geriatric conditions, including functional and cognitive impairment, as adults in their 70s and 80s in the general population. Researchers aimed to describe the prevalence of symptoms among older homeless-experienced adults, analyze factors associated with moderate–high physical symptom burden, and identify symptom clusters. They conducted a cross-sectional analysis within longitudinal cohort study. Researchers found a high prevalence of symptomatology across multiple domains. They found that symptom domains clustered together: those with higher physical symptomatology had a high prevalence of other symptom domains.

The prevalence of tobacco use among populations experiencing homelessness is between 60% and 80%. In this qualitative study, researchers examined attitudes toward tobacco control policies among older African American homeless-experienced smokers. Researchers identified seven major themes from their in-depth semistructured interviews. They found that older African American homeless-experienced smokers face significant barriers to smoking cessation.

Older homeless adults living in shelters have high rates of geriatric conditions, which may increase their risk for acute care use and nursing home placement. In this cohort study, researchers interviewed homeless adults aged 50 and older to determine the prevalence of common geriatric conditions and if the prevalence of these conditions differs across living environments. Researchers found geriatric conditions were common among older homeless adults living in diverse environments.

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.