Risk of dementia among veterans experiencing homelessness and housing instability.
Risk of dementia among veterans experiencing homelessness and housing instability.
复制标题
无家可归和住房不稳定的退伍军人面临痴呆风险。
DOI：
10.1111/jgs.18680
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发表时间：
2024
影响因子：
6.3
通讯作者：
Jutkowitz,Eric
中科院分区：
文献类型：
--
作者：
Roncarati,JillS;DeVone,Frank;Halladay,Christopher;Tsai,Jack;Jutkowitz,Eric
背景在美国，2020 年有近 85,000 名退伍军人经历过无家可归，还有数千人经历过住房不稳定，占总人口的很大一部分。1许多无家可归的退伍军人正在老龄化，并患有复杂的并发医疗、精神和药物滥用疾病。无家可归和年龄较大使退伍军人面临更大的年龄相关疾病风险，包括阿尔茨海默病和相关痴呆 (ADRD)。方法我们使用 Cox 比例风险模型，与九年期间稳定居住的退伍军人的匹配队列相比，检查了经历无家可归和住房不稳定的退伍军人的 ADRD 诊断率。结果在匹配队列中，95% (n= 88,811) 的退伍军人是男性，67% 是男性。 (n= 59,443) 是白人，平均年龄 63 岁 (SD = 10.8)。与没有住房不稳定的退伍军人相比，住房不稳定的退伍军人患 ADRD 的风险更高，为 1.53（95% 置信区间 (CI) 1.50、1.59）。 结论 经历住房不稳定的退伍军人比匹配的住房稳定的退伍军人队列接受 ADRD 诊断的风险要高得多。卫生系统和提供者应考虑对经历住房不安全的人进行认知筛查。现有的永久支持性住房计划应考虑修改环绕式服务的方法，以支持经历 ADRD 的退伍军人。
BackgroundIn the United States, nearly 85,000 Veterans experienced homelessness during 2020, and thousands more are experiencing housing instability, representing a significant proportion of the population.1Many Veterans experiencing homelessness are aging and have complex co‐occurring medical, psychiatric, and substance use disorders. Homelessness and older age put Veterans at greater risk for age‐related disorders, including Alzheimer's disease and related dementias (ADRD).MethodsWe examined the rate of ADRD diagnosis for Veterans experiencing homelessness and housing instability compared to a matched cohort of stably housed Veterans over a nine‐year period using cox proportional hazard models.ResultsIn the matched cohort, 95% (n= 88,811) of Veterans were men, and 67% (n= 59,443) were White and were on average 63 years old (SD = 10.8). Veterans with housing instability had a higher hazard of 1.53 (95% confidence interval (CI) 1.50, 1.59) for ADRD compared to Veterans without housing instability.ConclusionsVeterans experiencing housing instability have a substantially higher risk of receiving an ADRD diagnosis than a matched cohort of stably housed Veterans. Health systems and providers should consider cognitive screening among people experiencing housing insecurity. Existing permanent supportive housing programs should consider approaches to modify wraparound services to support Veterans experiencing ADRD.