RT Journal Article
SR Electronic
T1 Differential age-associated brain atrophy and white matter changes among homeless and precariously housed individuals compared with the general population
JF BMJ Neurology Open
JO BMJ Neurol Open
FD BMJ Publishing Group Ltd
SP e000349
DO 10.1136/bmjno-2022-000349
VO 5
IS 1
A1 Jacob L Stubbs
A1 Andrea A Jones
A1 Daniel Wolfman
A1 Ryan C Y Chan
A1 Fidel Vila-Rodriguez
A1 Alexandra T Vertinsky
A1 Manraj K Heran
A1 Wayne Su
A1 Donna J Lang
A1 Thalia S Field
A1 Kristina M Gicas
A1 Melissa L Woodward
A1 Allen E Thornton
A1 Alasdair M Barr
A1 Olga Leonova
A1 William MacEwan
A1 Alexander Rauscher
A1 William G Honer
A1 William J Panenka
YR 2023
UL http://neurologyopen.bmj.com/content/5/1/e000349.abstract
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.