Dementia More Prevalent Among Homeless vs Housed Individuals in Canada

Compared with housed populations in Ontario, Canada, people experiencing homelessness experience a higher burden of dementia, according to study results published in The Lancet Public Health.

Researchers conducted a population-based, cross-sectional, comparative analysis to assess the prevalence of dementia among people experiencing homelessness vs housed individuals in the general population and those living in low-income neighborhoods. Patients aged 45 and older on January 1 2019 who visited hospital-based ambulatory care, were hospitalized, or visited a community health center in 2019 were eligible for inclusion. People experiencing homeless ness who had at least 1 healthcare record with an indication of unstable housing were also identified for inclusion. Estimates of prevalence were generated using Poisson models. 

A total of 12,863 individuals comprised the homelessness group (median age, 57; men, 61.2%; rural resident, 7.0%), 475,544 individuals comprised the low-income comparator group (median age, 64; women, 55.3%; rural resident, 15.9%), and 2,273,068 individuals comprised the general population comparator group (median age, 63; women, 53.5%; rural resident, 15.3%).

Among the homelessness, low-income, and general population groups, the overall prevalence of dementia in 2019 was 68.7 per 1000, 62.6 per 1000, and 51.0 per 1000 people, respectively.

The prevalence of dementia increased with age in all groups and in both sexes. Aside from those aged 85 and older, the prevalence of dementia was greatest among people experiencing homelessness, followed by the low-income group and the general population group. Among women, prevalence ratios were highest in the age groups of 55 to 64 and 65 to 74. Among men, prevalence ratios were significantly elevated in the age groups of 45 to 54, 55 to 64, and 65 to 74 years.

After adjusting for age, sex, geographical location of residence, and health complications associated with dementia, the prevalence ratios of dementia among individuals experiencing homelessness were 1.71 (95% CI, 1.60-1.82) vs the low-income group and 1.90 (95% CI, 1.79-2.03) vs the general population.

“Access to permanent, supportive housing structures for people experiencing homelessness would also offer protective factors against the range of morbidities experienced in this population, which we found to be associated with higher odds of dementia,” the researchers concluded.

This article originally appeared on Neurology Advisor