Potentially modifiable risk factors for dementia in people experiencing homelessness: a scoping review

ABSTRACT

Protracted homelessness creates a biopsychosocial circumstance for poor health outcomes, including a worsening cognitive profile with an increased risk for dementia. Dementia is a global public health concern, and it is reported that up to 40% of all dementia may be attributed to potentially modifiable lifestyle risk factors. Whilst Alzheimer’s disease, vascular dementia, and frontotemporal dementia remain the most common types of dementia overall, the experience of homelessness may directly influence other dementias, including alcohol dementia and HIV-associated dementia to be more frequently seen. We searched five databases (CINAHL, PsycINFO, Informit, Web of Science, and PubMed) and followed scoping review methodology to identify studies exploring potentially modifiable risk factors for dementia in people experiencing homelessness. After excluding prevalence studies, reviews and articles that were not original research, we identified a total of seven studies. We included studies reporting on risk factors for cognitive impairment, itself being a risk factor for dementia. Our results show a paucity of literature examining how the experience of homelessness influences the risk for developing dementia. This contributes to a lack of understanding how potentially modifiable risk factors for dementia may, or may not, differ between people experiencing homelessness and the stably domiciled populations.

KEYWORDS:

• Homelessness
• homeless
• dementia
• cognitive impairment
• risk factors

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Clare Beard

Clare Beard is a PhD candidate, casual tutor and research assistant in the College of Public Health, Flinders University, Adelaide, South Australia. She has worked considerably in the field of dementia in diverse groups, including people experiencing homelessness, on brain health, pathways to dementia diagnosis and dementia risk reduction.

Annabelle Wilson

Annabelle Wilson is an Associate Professor and Advanced Accredited Practicing Dietician (advAPD) in the Discipline of Population Health at Flinders University, South Australia. Annabelle has extensive experience in Aboriginal and Torres Strait Islander public health and food systems research. Annabelle is a senior researcher with a corresponding public health teaching role at Flinders University.

Liz Withall

Liz Withall holds a BND (HONS) and is research assistant in the College of Medicine and Public Health, Flinders University, Adelaide, South Australia. In addition to her university position, Liz has worked extensively in the development of dementia friendly communities in South Australia.

Monica Cations

Monica Cations is a clinical psychology registrar and epidemiologist who has worked in the ageing and dementia field for many years. Her research is translational with a focus on psychological wellbeing in aged care environments. Monica is a senior research fellow in the College of Education, Psychology and Social Work at Flinders University, supported by a Hospital Research Foundation Early Career Fellowship and NHMCR/MRFF Emerging Leadership Investigator Grant.