Trajectories of functional impairment in homeless older adults: Results from the HOPE HOME study

Autor: Lauren M. Kaplan, David Sanchez-Migallon Guzman, Margot Kushel, Claudia Ponath, Christopher T. Lee, Rebecca T. Brown
Přispěvatelé: Tan, Maw Pin
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Gerontology
Male
Aging
Functional impairment
Activities of daily living
Epidemiology
Social Sciences
Otology
Older homeless persons
Deafness
California
0302 clinical medicine
Elderly
7.1 Individual care needs
Risk Factors
Activities of Daily Living
Medicine and Health Sciences
Medicine
030212 general & internal medicine
Prospective Studies
Prospective cohort study
Hearing Disorders
Multinomial logistic regression
Cognitive Impairment
Visual Impairments
education.field_of_study
Multidisciplinary
Geography
Cognitive Neurology
Depression
Applied Mathematics
Simulation and Modeling
Rehabilitation
1. No poverty
Homelessness
Homeless Persons
Middle Aged
Infectious Diseases
Mental Health
Neurology
Physical Sciences
Ill-Housed Persons
Female
0305 other medical science
Algorithms
Cohort study
Research Article
General Science & Technology
Science
Cognitive Neuroscience
Population
Human Geography
Research and Analysis Methods
03 medical and health sciences
Clustering Algorithms
Clinical Research
Behavioral and Social Science
MD Multidisciplinary
Humans
education
Aged
030505 public health
business.industry
Prevention
Biology and Life Sciences
Brain Disorders
Health Care
Ophthalmology
Otorhinolaryngology
Age Groups
Medical Risk Factors
People and Places
Quality of Life
Earth Sciences
Housing
Cognitive Science
Population Groupings
Home study
Management of diseases and conditions
Self Report
business
Mathematics
Neuroscience
Follow-Up Studies
Zdroj: PLoS ONE
PloS one, vol 14, iss 8
PLoS ONE, Vol 14, Iss 8, p e0221020 (2019)
ISSN: 1932-6203
Popis: Difficulty performing activities of daily living ("functional impairment") is common in homeless adults aged 50 and older. However, little is known about the trajectory of these impairments, nor the extent to which these trajectories are similar to those of older adults in the general population. We identified trajectories of functional impairment in homeless adults aged 50 and older, and risk factors for differing trajectories. We conducted a prospective cohort study of 350 homeless adults, aged 50 and older, recruited via population-based sampling in Oakland, California and interviewed at 6-month intervals for up to 3 years. We assessed functional trajectories based on self-reported difficulty performing 5 activities of daily living. We used multivariable multinomial logistic regression to identify baseline risk factors for each trajectory. At baseline, participants' mean age was 58 years (SD, 5.3), 24.1% were women, 80.9% were African American, and 38.6% had difficulty performing 1 or more activities of daily living. We identified 4 distinct functional trajectories: minimal impairment in 136 participants (41.1%); persistent impairment in 81 (25.4%); partial improvement in 74 (23.5%); and decline in 28 (10.0%). Risk factors for persistent impairment included falls in the 6 months before baseline, depressive symptoms, and low physical performance. Although functional impairment improved in some homeless adults, it persisted or worsened in many others. These findings suggest that, similar to older adults in the general population, functional impairment among older homeless persons is not a transient phenomenon, but instead a chronic issue requiring long-term solutions.
Databáze: OpenAIRE
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