Abstract
Purpose The purpose of this paper is to assess frailty, geriatric conditions and multimorbidity in people experiencing homelessness (PEH) using holistic evaluations based on comprehensive geriatric assessment (CGA) and draw comparisons with general population survey data. Design/methodology/approach Cross-sectional observational study conducted in a London-based hostel for single PEH over 30 years old in March–April 2019. The participants and key workers completed health-related questionnaires, and geriatric conditions were identified using standardised assessments. Frailty was defined according to five criteria in Fried’s phenotype model and multimorbidity as the presence of two or more long-term conditions (LTCs). Comparisons with the general population were made using data from the English Longitudinal Study of Ageing and the Health Survey for England. Findings A total of 33 people participated with a mean age of 55.7 years (range 38–74). Frailty was identified in 55% and pre-frailty in 39%. Participants met an average of 2.6/5 frailty criteria, comparable to 89-year-olds in the general population. The most common geriatric conditions were: falls (in 61%), visual impairment (61%), low grip strength (61%), mobility impairment (52%) and cognitive impairment (45%). All participants had multimorbidity. The average of 7.2 LTCs (range 2–14) per study participant far exceeds the average for even the oldest people in the general population. Originality/value To the best of authors’ knowledge, this is the first UK-based study measuring frailty and geriatric conditions in PEH and the first anywhere to do so within a CGA-type evaluation. It also demonstrates the feasibility of conducting holistic evaluations in this setting, which may be used clinically to improve the health outcomes for PEH.
Highlights
Homelessness is associated with extremely poor health outcomes, and cohort studies report mortality rates of 3–6 times the general population (Fitzpatrick et al, 2013; Queen et al, 2017; Bowen et al, 2019; Lewer et al, 2019)
The number of people experiencing homelessness (PEH) in the UK has been steadily rising throughout the past decade (Bramley, 2017; Office for National Statistics, 2019)
The purpose of this study is to determine the extent of frailty and geriatric conditions in people living in a hostel, drawing comparisons with general population surveys
Summary
Homelessness is associated with extremely poor health outcomes, and cohort studies report mortality rates of 3–6 times the general population (Fitzpatrick et al, 2013; Queen et al, 2017; Bowen et al, 2019; Lewer et al, 2019). The number of older people in this situation is increasing, but their health and social needs and the impact of homelessness on the ageing process are inadequately understood (Gelberg et al, 1990; Centre for Policy on Ageing, 2017). Practitioners working in the field of inclusion health anecdotally report signs of premature ageing among those who have experienced multiple (Information about the authors can be found at the end of this article.). The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/ legalcode
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