Table 1.
Publications Included in Systematic Review.
| First Author (Year) | Purpose/Aim | Outcome/Assessment | N/ Age | Notable Findings |
|---|---|---|---|---|
| Keigher and Green blatt (1992) | To examine factors that lead to homelessness and shelter placement of seniors | Dementia/SPMSQ (Short Portable Mental Status Questionnaire) | 1 15/NA | Statistically significant difference found in mean dementia score between “Ever homeless” and “never homeless” groups. Black elderly are overrepresented in housing emergencies |
| Uryu et al. (2010) | To describe the neuropathology of subjects that often include homeless patients | AD/FTLD tauopathies/post-mortem brain dissection | 100/50.5 | Significant burden of AD pathology in cohort examined by medical examiner in the >65 yo group, consistent with diagnoses of AD or FTLD |
| Sajatovic et al. (2006) | To examine the prevalence of comorbidities such as PTSD, SUD, and dementia in a Veterans Health Administration database | Dementia, PTSD, SUD/diagnosis found in VA database | 16330/70.0 | Homelessness was more common in individuals with comorbid BPD and substance abuse (13.2% vs. 2%). No relationship seen between comorbid BPD and dementia with homelessness |
| Piña-Escudero et al. (2020) | Examining the relationship between homelessness and neurodegenerative diseases of the brain | Neurodegenerative diseases of the brain (AD, FTLD, etc.)/prior diagnosis in VA records | 13/59 (median) | Risk of homelessness is elevated in areas with poor social support when combined with early neurodegenerative diseases that lead to dementia. New propensity towards being homeless after a NDDB diagnosis |
| Bennett et al. (2009) | Determining characteristics of HIV-positive patients treated at a psychiatric emergency department | Dementia/diagnosed in claims data | (HIV+) 1 178/38.97 (HIV-) 57,123/38.78 | HIV-positive patients treated at psych ED were more likely to have dementia (2% vs. 1.1%) and more likely to be homeless (OR = 1.33, Cl= 1.08–1.64) and have SUD (OR = 1.4). HIV-positive odds risk of dementia was 3.0 (95% Cl = 1.8–5.1), most robust statistical finding in the study with high study n of 28,817 individual patients or 58,301 visits |
| Gonzalez et al. (2001) | Determining neuropsychological functioning of homeless patients via multiple screenings methods | Neuropsychological impairment/MMSE and Abbreviated Halston-Reitan Test Battery | 60/39.8 | Average Impairment Index (All) was above the impairment threshold of 1.55 at 2.0 across the entire group from ages 19–61 −80% of the cohort was considered neurologically impaired. Impairment was extremely common and not attributed to a specific medical history. |
| Jutkowitz et al. (2019) | To understand the use of nursing homes among veterans with comorbidities and at-risk for homelessness | Dementia/diagnosis in VA records | Homeless 3355/62.5 At-Risk 16264/75.8 Housed 64884/75.3 | Cross Cross sectional study. Homeless veterans were younger upon admission and were more likely to be diagnosed with dementia (ARR 1.14; 95% Cl = 1.04–1.25) as well as alcohol use disorder (ARR 2.18; 95% Cl = 2.05–2.31). Homeless veterans were more likely to be African American |
| Jutkowitz et al. (2021a) | Determining incidence of homelessness amongst American Veterans diagnosed with ADRDs | ADRD/diagnosis in VA records | 383,478/78.55 | Homeless veterans with an ADRD diagnosis were significantly younger (63.70 vs. 78.67, p < .001), more likely to be Black (Hazard rate = 1.67, Cl = 1.52–1.82 vs. White counterparts), and more likely to be single. They were also more likely to be comorbid with SUD, depression, hypertension, and other comorbidities than stably housed veterans |
| Jutkowitz et al. (2021b) | To determine ADRD prevalence in aging veterans with housing insecurity (homelessness or at-risk) | ADRD/diagnosis in VA records | 6,580,126 Homeless ADRD: 7363/64.05 At-risk ADRD: 13,667/76.96 Stably housed ADRD: 190,733/76.73 | Retrospective chart review using claims data from VA-treated homeless, at-risk, and stably housed veterans. Homeless prevalence of ADRDs was 3.66%, at-risk prevalence was 13.48%, and stably housed prevalence was 3.06%. ARR, respectively, was 1.58 (95% Cl 1.51–1.66), and 2.98 (95% Cl 2.81–3.16). Homeless and at-risk veterans with ADRD diagnoses were less likely to be White, more likely to be unmarried, and less likely to be in a rural area than their stably housed counterparts |