Geriatric Syndromes in Older Homeless Adults
Geriatric Syndromes in Older Homeless Adults
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DOI：
10.1007/s11606-011-1848-9
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发表时间：
2012-01-01
影响因子：
5.7
通讯作者：
Mitchell, Susan L.
中科院分区：
文献类型：
--
作者：
Brown, Rebecca T.;Kiely, Dan K.;Mitchell, Susan L.
美国无家可归者的平均年龄正在增加。人们对无家可归的老年人中老年综合症的患病率知之甚少。确定无家可归的老年成年人样本中常见老年综合征的患病率，并将这些患病率与一般老年人群的患病率进行比较。247名年龄在50-69岁之间的无家可归的成年人从马萨诸塞州波士顿的8个无家可归者收容所招募。访谈和检查老年综合征，包括功能障碍、认知障碍、虚弱、抑郁、听力障碍、视力障碍和尿失禁。这些综合征在无家可归者队列中的患病率与在三个基于人群的队列中报告的患病率进行了比较。无家可归者的平均年龄为56.0岁，其中19.8%为女性。30%的研究对象报告在进行至少一项日常生活活动方面有困难，53.2%的人在前一年有所下降。24.3%的参与者存在认知障碍，定义为迷你精神状态检查得分< 24；28.3%的参与者存在执行功能受损，定义为轨迹测试B部分持续时间>高于基于人群的标准1.5个标准差。16%的受试者符合虚弱的标准，39.8%的人患有重度抑郁症，抑郁症的定义是患者健康问卷上的分数为千分之一。自我报告的听力和视力障碍分别占29.7%和30.0%。49.8%的受试者报告尿失禁。在对人口统计学特征进行多变量调整后，与三个基于人群的老年人队列相比，无家可归的成年人更有可能出现功能障碍、虚弱、抑郁、视力障碍和尿失禁。可能需要治疗的老年综合症在无家可归的老年人中很常见，其发病率高于一般老年人。
The average age of the US homeless population is increasing. Little is known about the prevalence of geriatric syndromes in older homeless adults.To determine the prevalence of common geriatric syndromes in a sample of older homeless adults, and to compare these prevalences to those reported in the general older population.Cross-sectional.Two hundred and forty-seven homeless adults aged 50-69 recruited from eight homeless shelters in Boston, MA.Interviews and examinations for geriatric syndromes, including functional impairment, cognitive impairment, frailty, depression, hearing impairment, visual impairment, and urinary incontinence. The prevalences of these syndromes in the homeless cohort were compared to those reported in three population-based cohorts.The mean age of the homeless cohort was 56.0 years, and 19.8% were women. Thirty percent of subjects reported difficulty performing at least one activity of daily living, and 53.2% fell in the prior year. Cognitive impairment, defined as a Mini-Mental State Examination score < 24, was present in 24.3% of participants; impaired executive function, defined as a Trail Making Test Part B duration > 1.5 standard deviations above population-based norms, was present in 28.3% of participants. Sixteen percent of subjects met criteria for frailty, and 39.8% had major depression, defined as a score a parts per thousand yen10 on the Patient Health Questionnaire 9. Self-reported hearing and visual impairment was present among 29.7% and 30.0% of subjects, respectively. Urinary incontinence was reported by 49.8% of subjects. After multivariate adjustment for demographic characteristics, homeless adults were more likely to have functional impairment, frailty, depression, visual impairment and urinary incontinence compared to three population-based cohorts of older persons.Geriatric syndromes that are potentially amenable to treatment are common in older homeless adults, and are experienced at higher rates than in the general older population.