Opioid use disorder, pain, and cognitive impairment in older adults who have experienced homelessness.

IF 4.3 3区医学 Q1 GERIATRICS & GERONTOLOGY

Innovation in Aging Pub Date : 2025-07-04 eCollection Date: 2025-07-01 DOI:10.1093/geroni/igaf075

Kelseanne Breder, Van Yu

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引用次数: 0

Abstract

Background and objectives: The population of older adults with lived experience of homelessness in the United States is growing. Homelessness is associated with accelerated aging and opioid misuse. Older adults who have experienced homelessness suffer from greater functional impairment than nonhomeless older adults. Opioid misuse may catalyze functional impairment in this population, yet little is known about the prevalence of opioid use disorder (OUD) among currently and formerly homeless older adults. We report findings about the prevalence of OUD and functionality that we hope will spur future research about longevity and OUD in this population.

Research design and methods: Using a secondary analysis of data collected in New York City through electronic medical records, we examined 253 patients who met three inclusion criteria: (a) aged 50 years and older, (b) history of homelessness, and (c) received community-based medical services. We summarize the prevalence of OUD in our cohort and present descriptive statistics about pain and cognitive function for a small subset measured by the Pain Enjoyment of Life and General Activity (PEG) and Mini-Cog scales.

Results: Twelve percent (n = 31) had OUD diagnoses (age range = 50-81; mean age = 65; median age = 65; female = 11; and receiving agonist therapy = 5). Of those, 18 completed Mini-Cog; two showed clinically important cognitive impairment; 14 completed PEG; and eight reported moderate to severe pain.

Discussion and implications: Our report is among the first to describe OUD among older adults who have experienced homelessness. Currently and formerly homeless older adults with OUD are younger, on average, and more likely to be female, than those without OUD. They are more likely to report pain but less likely to exhibit cognitive impairment. Possible explanations for these observations include care engagement, untreated pain, and a survivor effect wherein older adults with OUD who survive homelessness may have traits that protect them from cognitive decline and fatal overdose.

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无家可归的老年人的阿片类药物使用障碍、疼痛和认知障碍。

背景和目的：在美国，有过无家可归生活经历的老年人数量正在增长。无家可归与加速衰老和滥用阿片类药物有关。经历过无家可归的老年人比非无家可归的老年人遭受更大的功能损伤。阿片类药物滥用可能催化这一人群的功能损害，但目前和以前无家可归的老年人中阿片类药物使用障碍（OUD）的患病率知之甚少。我们报告了关于OUD患病率和功能的发现，我们希望这将促进未来关于该人群寿命和OUD的研究。研究设计和方法：我们对纽约市通过电子病历收集的数据进行了二次分析，检查了253名符合三项纳入标准的患者：(a) 50岁及以上，(b)无家可归史，(c)接受过社区医疗服务。我们总结了我们的队列中OUD的患病率，并提供了通过疼痛享受生活和一般活动（PEG）和Mini-Cog量表测量的一小部分疼痛和认知功能的描述性统计数据。结果：12% （n = 31）患有OUD诊断（年龄范围为50-81岁，平均年龄为65岁，中位年龄为65岁，女性为11岁，接受激动剂治疗者为5人）。其中18人完成了Mini-Cog；2例表现出临床上重要的认知障碍；完成PEG 14例；8人报告有中度到重度疼痛。讨论和影响：我们的报告是第一批描述无家可归的老年人中OUD的报告之一。平均而言，目前和以前无家可归的患有OUD的老年人比没有OUD的人更年轻，而且更有可能是女性。他们更有可能报告疼痛，但不太可能表现出认知障碍。对这些观察结果的可能解释包括护理参与、未经治疗的疼痛和幸存者效应，其中患有OUD的老年人在无家可归中幸存下来，可能具有保护他们免受认知能力下降和致命药物过量的特征。

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来源期刊

Innovation in Aging GERIATRICS & GERONTOLOGY-

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

15 weeks

期刊介绍： Innovation in Aging, an interdisciplinary Open Access journal of the Gerontological Society of America (GSA), is dedicated to publishing innovative, conceptually robust, and methodologically rigorous research focused on aging and the life course. The journal aims to present studies with the potential to significantly enhance the health, functionality, and overall well-being of older adults by translating scientific insights into practical applications. Research published in the journal spans a variety of settings, including community, clinical, and laboratory contexts, with a clear emphasis on issues that are directly pertinent to aging and the dynamics of life over time. The content of the journal mirrors the diverse research interests of GSA members and encompasses a range of study types. These include the validation of new conceptual or theoretical models, assessments of factors impacting the health and well-being of older adults, evaluations of interventions and policies, the implementation of groundbreaking research methodologies, interdisciplinary research that adapts concepts and methods from other fields to aging studies, and the use of modeling and simulations to understand factors and processes influencing aging outcomes. The journal welcomes contributions from scholars across various disciplines, such as technology, engineering, architecture, economics, business, law, political science, public policy, education, public health, social and psychological sciences, biomedical and health sciences, and the humanities and arts, reflecting a holistic approach to advancing knowledge in gerontology.