无家可归人群的加速衰老：脆弱性流行率和决定因素的快速综述。
Accelerated aging in people experiencing homelessness: A rapid review of frailty prevalence and determinants.
机构信息
School of Population Health, Faculty of Medicine and Health, University of New South Wales (UNSW), Sydney, NSW, Australia.
UNSW Ageing Futures Institute, University of New South Wales (UNSW), Sydney, NSW, Australia.
出版信息
Front Public Health. 2023 Mar 16;11:1086215. doi: 10.3389/fpubh.2023.1086215. eCollection 2023.
INTRODUCTION
Older people experiencing homelessness (PEH) are a rapidly growing population at risk of accelerated aging and the early onset of geriatric conditions. One construct that shows promise in predicting age-related decline is frailty. Better understanding the rates and causes of frailty in PEH may improve understanding of its antecedents, thereby facilitating more targeted health and aged care service interventions. The aim of this study was to conduct a rapid review on the prevalence and determinants of frailty in adult PEH.
METHODS
We conducted a rapid review of primary research papers studying PEH and frailty or frailty-related concepts.
RESULTS
Fourteen studies were included, which indicate that frailty presents earlier and at higher rates in PEH than community-dwelling cohorts. A notable difficulty for many aging PEH was early-onset cognitive impairment which was associated with a range of negative functional outcomes. Another recurrent theme was the negative impact that drug and alcohol use and dependence can have on the health of PEH. Further, psychosocial and structural determinants such as loneliness, living in an impoverished neighborhood and being female had statistically significant associations with frailty and functional decline in PEH.
DISCUSSION AND IMPLICATIONS
PEH in their 40s and 50s can be frail and experience geriatric conditions, including cognitive impairment. Factors that have important relationships to frailty and functional decline in PEH include cognitive deficits, drug and alcohol dependence and loneliness, as well as upstream determinants such as gender and ethnicity. More targeted data and research on these factors, including cohort studies to better investigate their potentially causal effects, is important for researchers and practitioners assessing and treating frailty in PEH, particularly those interested in early intervention and prevention.
PROSPERO REGISTRATION ID
CRD42022292549.
简介
无家可归的老年人（PEH）是一个快速增长的群体，他们面临着加速衰老和老年疾病早期发病的风险。预测与年龄相关下降的一个有前途的结构是脆弱性。更好地了解 PEH 中的脆弱性的发生率和原因可能会提高对其前身的理解，从而促进更有针对性的健康和老年护理服务干预。本研究的目的是对成年 PEH 中脆弱性的流行率和决定因素进行快速综述。
方法
我们对研究 PEH 和脆弱性或与脆弱性相关概念的主要研究论文进行了快速综述。
结果
共纳入 14 项研究，表明 PEH 中的脆弱性比社区居住队列更早且发生率更高。许多衰老的 PEH 的一个显著困难是早期认知障碍，这与一系列负面的功能结果有关。另一个反复出现的主题是药物和酒精使用和依赖对 PEH 健康的负面影响。此外，社会心理和结构决定因素，如孤独、生活在贫困社区和女性，与 PEH 中的脆弱性和功能下降具有统计学显著关联。
讨论与启示
40 多岁和 50 多岁的 PEH 可能身体虚弱，患有老年疾病，包括认知障碍。与 PEH 中的脆弱性和功能下降有重要关系的因素包括认知缺陷、药物和酒精依赖以及孤独，以及性别和种族等上游决定因素。对于评估和治疗 PEH 中脆弱性的研究人员和从业者来说，包括队列研究以更好地调查其潜在的因果效应，针对这些因素进行更有针对性的数据和研究非常重要，特别是对于那些对早期干预和预防感兴趣的人。
PROSPERO 注册号：CRD42022292549。
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