Traumatic brain injury and cognitive impairment in men who are homeless

Abstract

Purpose: To examine cognitive performance among a sample of men in a residential unit of an urban homeless shelter and to compare cognitive performance between those with and without a history of traumatic brain injury (TBI). Methods: An exploratory, quantitative study of participants recruited through convenience sampling. Participants were screened for TBI using the Brain Injury Screening Questionnaire, and cognitive function using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Data were analyzed to examine associations between TBI status and cognitive performance. Results: Thirty-four participants were recruited for the study: n = 12 with a positive and n = 22 with a negative screen for TBI. Both groups performed below norms in all cognitive domains measured by the RBANS. Those with a positive screen for TBI performed significantly worse on attention tasks than those with a negative screen for TBI (p = 0.026). RBANS scores were not associated with either mental health or substance abuse status. Conclusions: A history of TBI was associated with generally poorer cognitive performance in the study sample. An improved awareness of TBI and cognitive dysfunction among service providers and routine TBI screening could improve treatment and service delivery for this population.Implications for RehabilitationThe prevalence of traumatic brain injury among homeless populations is greater than that observed in the general population.Validated screening measures are available to screen for a history of traumatic brain injury among individuals who are homeless.A history of traumatic brain injury among adult men in a long-term residential unit of a homeless shelter was associated with poorer performance on the attention domain of a validated cognitive screening measure.