Cognitive impairment and homelessness: A scoping review

Abstract

This paper reports the findings of a scoping review designed to identify research which has explored the relationship between cognitive impairment and homelessness. A systematic search of databases for articles published between 2007 and 2017 was conducted using keywords relating to cognitive impairments and homelessness. Sources were expanded using manual searches of citations and grey literature. Forty studies represented in 45 papers were selected for review using predefined inclusion criteria. Sources were subject to quality appraisal and data were extracted in line with review questions. Prevalence studies were over‐represented in the review, while qualitative data were lacking. Aetiology of impairments was delineated by acquired and developmental causes. A variety of measures were employed by studies which were not validated in homeless populations. Studies did not give sufficient consideration to co‐occurring disorders and overlapping symptoms between aetiologies. Because of these factors, it was difficult to conclude that all studies had accurately measured what they set out to; however, the evidence suggested that cognitive impairment was disproportionately over‐represented in homeless populations. Cognitive impairment was found to be both a risk factor to and perpetuator of homelessness. Risk factors for homelessness were similar to those of the general population, though exaggerated by sequelae of certain cognitive impairments. The results of this review suggest that more attention needs to be paid to the underlying socioeconomic disadvantages, persons with cognitive impairments face which may lead to homelessness. Further research should prioritise the voice of homeless persons with cognitive impairments, to better understand both causes of homelessness and effective methods of rehabilitation.

Ecological Momentary Assessment of Alcohol Consumption and Its Concordance with Transdermal Alcohol Detection and Timeline Follow‐Back Self‐report Among Adults Experiencing Homelessness

“…For instance, as the time interval increases, people tend to smooth out the variation in alcohol consumed on each day and report less drinking overall (Hoeppner et al, 2010; Searles et al, 2002). Moreover, the TLFB’s accuracy can be influenced by a person’s impaired ability to recall alcohol consumption from memory, which may be more prevalent among people experiencing homelessness due to the high prevalence of comorbid mental and substance use disorders (Hurstak et al, 2017; Stasiewicz et al, 2008; Stone et al, 2019).…”

“It Wasn't Just One Thing”: A Qualitative Study of Newly Homeless Emergency Department Patients

“…This speculation is supported by the fact that only a minority of people who enter shelters in NYC have previously accessed available homelessness prevention services . Prior research has suggested high rates of traumatic brain injury and cognitive impairment among people who are homeless, which may have also been somewhat contributory to our findings, although we did exclude patients who were not able to understand the study informed consent process.…”

The Unmet Rehabilitation Needs in an Inclusion Health Integrated Care Programme for Homeless Adults in Dublin, Ireland

“…According to the World Health Organization, disability is the umbrella term for impairments, activity limitations, and participation restrictions, referring to the negative aspects of the interaction between an individual (with a health condition) and that individual's contextual factors (environmental and personal factors) [8]. Many studies have reported that the prevalence of mental illness and physical and cognitive disability is higher among homeless individuals compared to the general population [9][10][11][12]. According to article 26 of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), which has been ratified and signed by the Irish government, all persons with a disability should have access to habilitation and rehabilitation [13].…”