SEARCHSYSTEMATIC_REVIEWgeriatrics, epidemiology

systematic_review·geriatrics, epidemiology, public health, systematic review, family medicine·PMC10061143

Accelerated aging in people experiencing homelessness: A rapid review of frailty prevalence and determinants

Frontiers in Public Health · 6 authors, 6 centres

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TL;DR

This rapid review synthesized 14 primary research papers on frailty in adults experiencing homelessness.

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This rapid review synthesized 14 primary research papers on frailty in adults experiencing homelessness. The methods involved a streamlined search and screening process for primary studies on frailty prevalence and determinants. The central results indicate that frailty, including cognitive impairment and geriatric conditions, occurs at higher rates and decades earlier in people experiencing homelessness than in community-dwelling cohorts. Limitations include the predominance of cross-sectional studies, which precludes causal inferences, and potential confounding from mental health and educational factors in cognitive assessments. The implications suggest a need for cohort studies to investigate causal effects and for targeted, multidimensional interventions addressing the interplay of physical, cognitive, and psychosocial health in this population.

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systematic_review

SPECIALTY

geriatrics

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AI pipeline

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100% · A

ORIGINAL PAPER

PMC10061143

Accelerated aging in people experiencing homelessness: A rapid review of frailty prevalence and determinants

Frontiers in Public Health

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ABSTRACT

Introduction Older people experiencing homelessness (PEH) are a rapidly growing population at risk of accelerated aging and the early onset of geriatric conditions. One construct that shows promise in predicting age-related decline is frailty. Better understanding the rates and causes of frailty in PEH may improve understanding of its antecedents, thereby facilitating more targeted health and aged care service interventions. The aim of this study was to conduct a rapid review on the prevalence and determinants of frailty in adult PEH. Methods We conducted a rapid review of primary research papers studying PEH and frailty or frailty-related concepts. Results Fourteen studies were included, which indicate that frailty presents earlier and at higher rates in PEH than community-dwelling cohorts. A notable difficulty for many aging PEH was early-onset cognitive impairment which was associated with a range of negative functional outcomes. Another recurrent theme was the negative impact that drug and alcohol use and dependence can have on the health of PEH. Further, psychosocial and structural determinants such as loneliness, living in an impoverished neighborhood and being female had statistically significant associations with frailty and functional decline in PEH. Discussion and implications PEH in their 40s and 50s can be frail and experience geriatric conditions, including cognitive impairment. Factors that have important relationships to frailty and functional decline in PEH include cognitive deficits, drug and alcohol dependence and loneliness, as well as upstream determinants such as gender and ethnicity. More targeted data and research on these factors, including cohort studies to better investigate their potentially causal effects, is important for researchers and practitioners assessing and treating frailty in PEH, particularly those interested in early intervention and prevention. Prospero registration ID CRD42022292549.

CITATION EXPORT

Rhys Mantell, Ye In Jane Hwang, Kylie Radford et al.. Accelerated aging in people experiencing homelessness: A rapid review of frailty prevalence and determinants. Frontiers in Public Health. (2023). https://doi.org/10.3389/fpubh.2023.1086215

AUTHORS

6 · 6 CENTRES

Rhys Mantell, Ye In Jane Hwang, Kylie Radford, Silvija Perkovic, Patricia Cullen, Adrienne Withall

1School of Population Health, Faculty of Medicine and Health, University of New South Wales (UNSW), Sydney, NSW, Australia
2UNSW Ageing Futures Institute, University of New South Wales (UNSW), Sydney, NSW, Australia
3School of Psychology, Faculty of Science, University of New South Wales (UNSW), Sydney, NSW, Australia
4Neuroscience Research Australia (NeuRA), Sydney, NSW, Australia
5The George Institute for Global Health, University of New South Wales (UNSW), Sydney, NSW, Australia
6Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, NSW, Australia