The Course of Functional Impairment in Older Homeless Adults: Disabled on the Street.

Abstract

Over the past 25 years, the proportion of the homeless population 50 years of age and older has increased rapidly, from 11% in 19901 to nearly 50% today.2 Older homeless adults experience early onset of age-related conditions relative to the general population, including difficulty performing basic self-care activities that are considered essential for independence, such as bathing and dressing.3 Such difficulty, or “functional impairment,” occurs in 30% of homeless adults in their fifties and early sixties, a prevalence exceeding that of housed adults 20 years older.3 However, it is unknown if functional impairment among older homeless adults is transient or persistent, and thus what types of interventions are needed to address these deficits. If functional impairment persists or worsens in a substantial number of older homeless adults, more units of accessible permanent supportive housing and personal care attendants may be needed. In contrast, if most functional impairment is transient in this population, different types of interventions may be appropriate. We examined the characteristics and persistence of functional impairment in a cohort of homeless adults age 50 and older and identified risk factors for persistent or worsened functional impairment.