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Brief Research Report ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Public Health | doi: 10.3389/fpubh.2019.00270

Cognitive Impairment in Marginally Housed Youth: Prevalence and Risk Factors

 Kristina Waclawik1, Andrea A. Jones2, Skye P. Barbic2, 3,  Kristina M. Gicas2, Tiffany A. O'Connor1, Geoffrey N. Smith2, Olga Leonova2, Steve Mathias2, 3, Alasdair M. Barr2, Ric M. Procyshyn2,  Donna J. Lang2,  Melissa L. Woodward2, William MacEwan2,  William J. Panenka2, Aiko Yamamoto4, William G. Honer2 and  Allen E. Thornton1*
  • 1Simon Fraser University, Canada
  • 2University of British Columbia, Canada
  • 3Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Canada
  • 4St. Pauls Hospital, Canada

Objective: Homeless and marginally housed youth are particularly vulnerable members of society, and are known to experience numerous health problems, including psychiatric illness, substance use and viral infection. Despite the presence of these risk factors for cognitive compromise, there is limited research on the cognitive functioning of homeless and marginally housed youth. The present study examines the degree and pattern of cognitive impairment and associations with key risk factors in a sample of marginally housed young adults. Method: Participants (N =101) aged 20-29 years old were recruited from single-room occupancy hotels, and underwent cognitive, psychiatric, neurological, and serological assessments. Results: Forty percent of participants were identified as mildly cognitively impaired across multiple domains, and 16% were moderately-severely impaired. Deficits in memory and attention were most prevalent, while impairments in inhibitory control and cognitive flexibility were also present but tended to be less severe. Developmental and historical factors (premorbid cognitive functioning, neurological soft signs, earlier exposure to and longer duration of homelessness or marginal housing), as well as current health risks (stimulant dependence and hepatitis C exposure), were associated with cognitive impairment. Conclusions: The strikingly high rate of cognitive impairment in marginally housed young adults represents a major public health concern and is likely to pose a significant barrier to treatment and rehabilitation. These results suggest that the pathway to cognitive impairment involves both developmental vulnerability and modifiable risk factors. This study highlights the need for early interventions that address cognitive impairment and risk factors in marginalized young people.

Keywords: Cognition, Youth, young adults, Marginalization, Homeless, Premorbid IQ, neurological soft signs, substance use

Received: 04 Jun 2019; Accepted: 09 Sep 2019.

Copyright: © 2019 Waclawik, Jones, Barbic, Gicas, O'Connor, Smith, Leonova, Mathias, Barr, Procyshyn, Lang, Woodward, MacEwan, Panenka, Yamamoto, Honer and Thornton. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mx. Allen E. Thornton, Simon Fraser University, Burnaby, Canada,