PT - JOURNAL ARTICLE AU - Jacob L Stubbs AU - Andrea A Jones AU - Daniel Wolfman AU - Ryan C Y Chan AU - Fidel Vila-Rodriguez AU - Alexandra T Vertinsky AU - Manraj K Heran AU - Wayne Su AU - Donna J Lang AU - Thalia S Field AU - Kristina M Gicas AU - Melissa L Woodward AU - Allen E Thornton AU - Alasdair M Barr AU - Olga Leonova AU - William MacEwan AU - Alexander Rauscher AU - William G Honer AU - William J Panenka TI - Differential age-associated brain atrophy and white matter changes among homeless and precariously housed individuals compared with the general population AID - 10.1136/bmjno-2022-000349 DP - 2023 Jan 01 TA - BMJ Neurology Open PG - e000349 VI - 5 IP - 1 4099 - http://neurologyopen.bmj.com/content/5/1/e000349.short 4100 - http://neurologyopen.bmj.com/content/5/1/e000349.full SO - BMJ Neurol Open2023 Jan 01; 5 AB - Background Homeless or precariously housed individuals live with poor health and experience premature mortality compared with the general population, yet little is known about age-related brain changes among these individuals. We evaluated whether MRI measures of brain structure are differentially associated with age and selected risk factors among individuals who are homeless or precariously housed compared with a general population sample.Methods We compared T1-weighted and diffusion tensor imaging measures of brain macrostructure and white matter microstructure in a well-characterised sample of 312 precariously housed participants with a publicly available dataset of 382 participants recruited from the general population. We used piecewise and multiple linear regression to examine differential associations between MRI measures and between the samples, and to explore associations with risk factors in the precariously housed sample.Results Compared with the general population sample, older age in the precariously housed sample was associated with more whole-brain atrophy (β=−0.20, p=0.0029), lower whole-brain fractional anisotropy (β=−0.32, p<0.0001) and higher whole-brain mean diffusivity (β=0.69, p<0.0001). Several MRI measures had non-linear associations with age, with further adverse changes after age 35–40 in the precariously housed sample. History of traumatic brain injury, stimulant dependence and heroin dependence was associated with more atrophy or alterations in white matter diffusivity in the precariously housed sample.Conclusions Older age is associated with adverse MRI measures of brain structure among homeless and precariously housed individuals compared with the general population. Education, improvements in care provision and policy may help to reduce the health disparities experienced by these individuals.No data are available. Data cannot be made publicly available due to possible privacy breaches and other ethical and legal obligations to the study participants. Inquiries regarding data use or data sharing can be made to the corresponding author.