Evaluating Cognitive Impairment and Its Relation to Function in a Population of Individuals Who Are Homeless

Synovec, Caitlin

doi:10.1080/0164212x.2020.1838400

Cited by 6 publications

(14 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Occupational Therapy in Mental Health , 36 (4), 330–352. [ 11 ] 172 56 73.0% adults Health service for homeless people USA Assessment of Motor and Process Skills (AMPS) Allen Cognitive Level Screen (ACLS-5) Executive Function Performance Test (EFPT) Montreal Cognitive Assessment (MoCA) Synovec, C. E., & Berry, S. (2020). Addressing brain injury in health care for the homeless settings: A pilot model for provider training.…”

Section: Table A1mentioning

confidence: 99%

“…High rates of cognitive impairment [ 5 , 9 , 10 , 11 ], brain injury [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ], or both [ 7 , 28 , 29 ] have been found in homeless populations. Failure to identify these issues amongst people experiencing homelessness affects other social determinants at the individual level, including poor housing, health, social, vocational, and justice outcomes for people in this cohort, places undue pressure on the homelessness service delivery system, and increases demand on emergency and other public service responses.…”

Section: Introductionmentioning

confidence: 99%

“…Despite this opportunity for improved health outcomes and resource allocation, routine screening for cognitive impairment and brain injury does not feature in homelessness service delivery practice [ 11 , 22 , 49 ]. Research in this area has asserted the importance of identifying cognitive impairment and TBI [ 7 , 8 , 9 , 14 , 50 , 51 , 52 , 53 ], and provided helpful recommendations for clinicians in identifying cognitive impairment utilising abbreviated batteries more suited to a homeless client population [ 54 , 55 ], as well as guidelines for working with homeless people with an identified cognitive impairment or brain injury [ 11 , 51 , 56 ]. However, given that a great number of homelessness programs are operated by non-government organisations [ 57 , 58 , 59 , 60 ], a gap exists for people in this population who are being supported exclusively in non-clinical homelessness services by non-clinical staff.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Exploring and Mapping Screening Tools for Cognitive Impairment and Traumatic Brain Injury in the Homelessness Context: A Scoping Review

Fearn-Smith

Scanlan

Hancock

2023

IJERPH

View full text Add to dashboard Cite

Cognitive impairment is common amongst people experiencing homelessness, yet cognitive screening and the collection of history of brain injury rarely features in homelessness service delivery practice. The purpose of this research was to scope and map strategies for screening for the potential presence of cognitive impairment or brain injury amongst people experiencing homelessness and identify instruments that could be administered by homelessness service staff to facilitate referral for formal diagnosis and appropriate support. A search was conducted across five databases, followed by a hand search from relevant systematic reviews. A total of 108 publications were included for analysis. Described in the literature were 151 instruments for measuring cognitive function and 8 instruments screening for history of brain injury. Tools that were described in more than two publications, screening for the potential presence of cognitive impairment or history of brain injury, were included for analysis. Of those regularly described, only three instruments measuring cognitive function and three measuring history of brain injury (all of which focused on traumatic brain injury (TBI)) may be administered by non-specialist assessors. The Trail Making Test (TMT) and the Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID) are both potentially viable tools for supporting the identification of a likely cognitive impairment or TBI history in the homelessness service context. Further population-specific research and implementation science research is required to maximise the potential for practice application success.

show abstract

Section: Table A1mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Exploring and Mapping Screening Tools for Cognitive Impairment and Traumatic Brain Injury in the Homelessness Context: A Scoping Review

Fearn-Smith

Scanlan

Hancock

2023

IJERPH

View full text Add to dashboard Cite

show abstract

“…The Executive Function Performance Test (EFPT) (Baum et al, 2008) measures functional cognition through performance-based assessment of four daily living activities in a naturalistic setting. The EFPT was used in the Raphael-Greenfield (2012) paper, as well as in the studies by Synovec and Merryman (2016) and Synovec (2020), in conjunction with the Allen Cognitive Level Screen, Version 5 (ACLS-5) (Allen et al, 2007).…”

Section: Gabrielian Et Al (2015)mentioning

confidence: 99%

Evaluation of Functional Cognition in People Experiencing Homelessness: A Scoping Review

Synovec,

Boland,

Westover

2023

IJOH

View full text Add to dashboard Cite

The identified prevalence of cognitive impairment in people experiencing homelessness has placed a focus on the use of measures of cognition to predict functioning and ability to move successfully into housing. Functional cognition is the cognitive ability to perform daily life tasks, incorporating cognitive functioning, performance skills, and patterns. Given the increased research on cognitive status and functional skills within people experiencing homelessness, a scoping review was conducted to synthesize the existing literature and identify how functional cognition is evaluated in this population, and identify implications for homeless and housing services. This scoping review was conducted using the Joanna Briggs Institute protocol. Included studies assessed functional cognition, or assessed a component of cognition and related it to functional performance. Of 8,848 articles retrieved from the initial search, thirty-seven articles were determined to meet the inclusion criteria for data extraction. Categories for data extraction included functional domain addressed, tools used for assessment of cognition and/or function, and how reported outcomes were interpreted. Narrative analysis identified domains of cognition and function assessed, and relationships between cognition and function domains. Only the functional domain of Activities of Daily Living/Instrumental Activities of Daily Living (ADL/IADL) were found to have a consistent relationship between cognition and performance and primarily when performance-based assessments were used. Challenges with generalizing study findings broadly include: study populations do not reflect demographics of those experiencing homelessness; a variety of assessment tools for cognition and function are utilized; and the broad use of the term function encompasses several different areas of independent living in the community. Several studies identified that even with the presence of decreased cognition, those with the experience of homelessness are able to maintain housing when given individualized and appropriate supports. This scoping review indicates inconsistent methods to assess cognition and functional cognition within people experiencing homelessness. Performance-based assessments of ADL/IADL are more likely to identify the impact of cognition on function, while neurocognitive assessments are more beneficial to assess social/community integration. Findings indicate that to support the transition from homelessness to housing and increase the likelihood of housing stability; assessments should focus on identifying strengths and necessary/individualized ongoing supports.

show abstract

“…Studies reporting prevalence of dementia and MCI in older adults experiencing homelessness have relied on prior formal diagnosis, lower sensitivity tools (e.g., Modified Mini‐Mental State [3MS]), post mortem examination, clinical study enrollment, or non‐shelter clinical sites. 4 , 5 , 6 , 7 Observational studies found 25% to 80% of homeless participants exhibiting some type of impairment. 5 , 8 Population studies of veterans experiencing homelessness found absolute risk ratio (ARR) 1.58 for dementia compared to veterans with stable housing.…”

Section: Introductionmentioning

confidence: 99%

Dementia and mild cognitive impairment screening in an emergency homeless shelter

Ross,

Dzenga,

Myers

et al. 2024

Alzheimer's & Dementia

View full text Add to dashboard Cite

INTRODUCTIONOlder adults represent the fastest growing segment of the homeless community. Little is known about the prevalence of dementia and mild cognitive impairment (MCI) in this population.METHODSDementia and MCI screening using the Montreal Cognitive Assessment (MoCA) was incorporated into the standard senior evaluation for adult clients aged ≥ 55 in a large emergency homeless shelter.RESULTSIn a 6‐week period, 104 of 112 (92.9%) assessments were positive for dementia or MCI using a standard cutoff of 26, and 81 (72.3%) were positive using a conservative cutoff of 23. There was no significant difference in MoCA scores based on sex or education level, and no significant correlation between age and MoCA score.DISCUSSIONOlder adults experiencing homelessness may have a high likelihood of dementia or MCI. Routine MoCA screening in older adults experiencing homelessness is feasible and can help to identify services needed to successfully exit homelessness.

show abstract

Evaluating Cognitive Impairment and Its Relation to Function in a Population of Individuals Who Are Homeless

Cited by 6 publications

References 49 publications

Exploring and Mapping Screening Tools for Cognitive Impairment and Traumatic Brain Injury in the Homelessness Context: A Scoping Review

Exploring and Mapping Screening Tools for Cognitive Impairment and Traumatic Brain Injury in the Homelessness Context: A Scoping Review

Evaluation of Functional Cognition in People Experiencing Homelessness: A Scoping Review

Dementia and mild cognitive impairment screening in an emergency homeless shelter

Contact Info

Product

Resources

About