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Gerontologist. 2017 Aug 1;57(4):757-766. doi: 10.1093/geront/gnw011.

Geriatric Conditions in a Population-Based Sample of Older Homeless Adults.

Author information

Division of Geriatrics, University of California, San Francisco.
San Francisco VA Medical Center, California.
School of Medicine, Stony Brook University, New York.
Division of HIV/AIDS, San Francisco General Hospital, University of California.
Division of General Internal Medicine, San Francisco General Hospital, University of California.


Purpose of the Study:

Older homeless adults living in shelters have high rates of geriatric conditions, which may increase their risk for acute care use and nursing home placement. However, a minority of homeless adults stay in shelters and the prevalence of geriatric conditions among homeless adults living in other environments is unknown. We determined the prevalence of common geriatric conditions in a cohort of older homeless adults, and whether the prevalence of these conditions differs across living environments.

Design and Methods:

We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling in Oakland, CA. We evaluated participants for common geriatric conditions. We assessed living environment using a 6-month follow-back residential calendar, and used cluster analysis to identify participants' primary living environment over the prior 6 months.


Participants stayed in 4 primary environments: unsheltered locations (n = 162), multiple locations including shelters and hotels (n = 88), intermittently with family/friends (n = 57), and, in a recently homeless group, rental housing (n = 43). Overall, 38.9% of participants reported difficulty performing 1 or more activities of daily living, 33.7% reported any falls in the past 6 months, 25.8% had cognitive impairment, 45.1% had vision impairment, and 48.0% screened positive for urinary incontinence. The prevalence of geriatric conditions did not differ significantly across living environments.


Geriatric conditions were common among older homeless adults living in diverse environments, and the prevalence of these conditions was higher than that seen in housed adults 20 years older. Services that address geriatric conditions are needed for older homeless adults living across varied environments.


Cognitive impairment; Epidemiology; Functional status; Homeless persons; Sensory impairment

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