{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T11:09:12Z","timestamp":1770980952596,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.nationalarchives.gov.uk\/doc\/open-government-licence\/version\/2\/"}],"funder":[{"name":"de Tornyay Center for Healthy Aging"},{"name":"University of Washington School of Nursing Research and Intermural Funding Program"},{"name":"Pacific Hospital Development Fund-Nimble Grant Award"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Objectives<\/jats:title>\n                  <jats:p>Formerly homeless older adults residing in Permanent Supportive Housing (PSH) represent an invisible subsector of two distinct, yet related populations: the homeless population and the elderly population. Little research is focused on the complex health concerns facing this aging population within the homelessness response system. Of particular concern is the identification and support of individuals with cognitive impairment and co-occurring chronic conditions. We collaborated with a leading housing services provider to develop a systematic screening system for case managers to capture the cognitive, physical, and psychosocial health of older adults served within homeless housing programs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research Design and Methods<\/jats:title>\n                  <jats:p>PSH residents aged \u226550 years in four sites screened as being without cognitive impairment on the Mini-Cog were enrolled. A brief demographic survey and selected PROMIS measures were used to characterize participants\u2019 demographics, cognition, global physical and mental health, physical functioning, self-efficacy for social interactions, and instrumental support. PSH case managers were trained to recruit participants and collect data. PROMIS scales were scored using the Health Measures Scoring Service. Descriptive statistics, correlations, and one sample t-tests were performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Fifty-three residents (mean age = 60.8 years, range 50\u201376 years) participated. The majority self-identified as male and were military veterans; 60% reported having a history of two or more episodes of homelessness. All PROMIS scores were significantly (p &amp;lt; .05) lower than reference U.S. population means, with global mental health and cognition having the lowest scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion and Implications<\/jats:title>\n                  <jats:p>Self-reported cognitive functioning and global mental health were residents\u2019 greatest concerns. Strengthening housing case manager capacity to assess residents\u2019 cognitive and health status could increase support for older adults in PSH. It is feasible to train PSH staff to conduct structured interviews to identify resident cognitive and health needs to help support this \u201cinvisible\u201d population to successfully age in place.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/geroni\/igz049","type":"journal-article","created":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T02:18:59Z","timestamp":1577845139000},"source":"Crossref","is-referenced-by-count":11,"title":["Cognition, Health, and Social Support of Formerly Homeless Older Adults in Permanent Supportive Housing"],"prefix":"10.1093","volume":"4","author":[{"given":"Anita M","family":"Souza","sequence":"first","affiliation":[{"name":"Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny Hsin-Chin","family":"Tsai","sequence":"first","affiliation":[{"name":"Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth C","family":"Pike","sequence":"first","affiliation":[{"name":"Office of Nursing Research, University of Washington School of Nursing, Seattle"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Martin","sequence":"first","affiliation":[{"name":"Solutions4community llc, Harwich, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan M","family":"McCurry","sequence":"first","affiliation":[{"name":"Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,1,1]]},"reference":[{"key":"2020040407360074200_CIT0001","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1111\/asap.12004","article-title":"The age structure of contemporary homelessness: Evidence and implications for public policy","volume":"13","author":"Culhane","year":"2013","journal-title":"Anal Soc Iss Pub Pol"},{"key":"2020040407360074200_CIT0002","first-page":"1","article-title":"Geriatric conditions in a population-based sample of older homeless adults","volume":"11","author":"Brown","year":"2016","journal-title":"Gerontologist"},{"key":"2020040407360074200_CIT0003","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1111\/j.1525-1497.2005.0142.x","article-title":"Self-reported comorbidities, perceived needs, and sources for usual care for older and younger homeless adults","volume":"20","author":"Garibaldi","year":"2005","journal-title":"J Gen Intern Med"},{"key":"2020040407360074200_CIT0004","author":"Seattle & King County Public Health.","year":"2016"},{"key":"2020040407360074200_CIT0005","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1016\/j.drugalcdep.2017.06.002","article-title":"Factors associated with cognitive impairment in a cohort of older homeless adults: Results from the HOPE HOME study","volume":"178","author":"Hurstak","year":"2017","journal-title":"Drug Alcohol Depend"},{"key":"2020040407360074200_CIT0006","first-page":"1110","article-title":"Identification of cognitive impairment and mental illness in elderly homeless men: Before and after access to primary health care","volume":"55","author":"Joyce","year":"2009","journal-title":"Can Fam Physician"},{"key":"2020040407360074200_CIT0007","first-page":"S11","article-title":"Housing as a socio-economic determinant of health: Findings of a national needs, gaps and opportunities assessment","volume":"97","author":"Dunn","year":"2006","journal-title":"Can J Pub Health"},{"key":"2020040407360074200_CIT0008","author":"U.S. Department of Housing and Urban Development.","year":"2017"},{"key":"2020040407360074200_CIT0009","article-title":"Assessment and findings of the Vulnerability Index (VI-SPDAT) survey of individuals experiencing homlessness in Travis County, TX","volume":"11","author":"King","year":"2018","journal-title":"UT School of Public Health Dissertation] (Open Access)"},{"key":"2020040407360074200_CIT0010","author":"Focus Strategies","year":"2016"},{"key":"2020040407360074200_CIT0011","author":"United Way of King County","year":"2016"},{"key":"2020040407360074200_CIT0012","author":"King County Department of Community and Human Services.","year":"2019"},{"key":"2020040407360074200_CIT0013","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1080\/01634372.2010.510169","article-title":"The complexities of elder homelessness, a shifting political landscape and emerging community responses","volume":"53","author":"Gonyea","year":"2010","journal-title":"J Gerontol Soc Work"},{"key":"2020040407360074200_CIT0014","author":"McDonald","year":"2009"},{"key":"2020040407360074200_CIT0015","author":"U.S. Department of Housing and Urban Development.","year":"2015"},{"key":"2020040407360074200_CIT0016","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1093\/geront\/gnr098","article-title":"The meaning of \u201caging in place\u201d to older people","volume":"52","author":"Wiles","year":"2012","journal-title":"Gerontologist"},{"key":"2020040407360074200_CIT0017","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnz040","article-title":"Eliciting life priorities of older adults living in permanent supportive housing","author":"Padgett","year":"2019","journal-title":"Gerontologist"},{"key":"2020040407360074200_CIT0018","author":"Seattle\/King County Coalition on Homelessness.","year":"2016"},{"key":"2020040407360074200_CIT0019","author":"United States Interagency Council on Homelessness.","year":"2019"},{"key":"2020040407360074200_CIT0020","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1046\/j.1532-5415.2003.51465.x","article-title":"The Mini-Cog as a screen for dementia: Validation in a population-based sample","volume":"51","author":"Borson","year":"2003","journal-title":"J Am Geriatrics Soc"},{"key":"2020040407360074200_CIT0021","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1097\/01.JGP.0000216181.20416.b2","article-title":"What is the best dementia screening instrument for general practitioners to use?","volume":"14","author":"Brodaty","year":"2006","journal-title":"Am J Geriatric Psychiatry"},{"key":"2020040407360074200_CIT0022","doi-asserted-by":"crossref","first-page":"855","DOI":"10.4140\/TCP.n.2007.855","article-title":"The Mini-Cog: A rapid dementia screening tool suitable for pharmacists\u2019 use","volume":"22","author":"Setter","year":"2007","journal-title":"Consult Pharm"},{"key":"2020040407360074200_CIT0023","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1016\/j.jclinepi.2010.04.011","article-title":"The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008","volume":"63","author":"Cella","year":"2010","journal-title":"J Clin Epidemiol"},{"key":"2020040407360074200_CIT0024","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1007\/s11136-009-9496-9","article-title":"Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items","volume":"18","author":"Hays","year":"2009","journal-title":"Qual Life Res"},{"key":"2020040407360074200_CIT0025","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1037\/0021-9010.88.5.879","article-title":"Common method biases in behavioral research: A critical review of the literature and recommended remedies","volume":"88","author":"Podsakoff","year":"2003","journal-title":"J Appl Psychol"},{"key":"2020040407360074200_CIT0026","article-title":"Old and on the street: The graying of America\u2019s homeless","author":"Nagourney","year":"2016","journal-title":"The New York Times"},{"key":"2020040407360074200_CIT0027","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1111\/j.1525-1497.2006.00493.x","article-title":"BRIEF REPORT: The aging of the homeless population: Fourteen-year trends in San Francisco","volume":"21","author":"Hahn","year":"2006","journal-title":"J Gen Intern Med"},{"key":"2020040407360074200_CIT0028","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1007\/s11606-011-1848-9","article-title":"Geriatric syndromes in older homeless adults","volume":"27","author":"Brown","year":"2012","journal-title":"J Gen Intern Med"},{"key":"2020040407360074200_CIT0029","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1007\/s11524-009-9388-x","article-title":"Multidimensional social support and the health of homeless individuals","volume":"86","author":"Hwang","year":"2009","journal-title":"J Urban Health Bull NY Acad Med"},{"key":"2020040407360074200_CIT0030","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1016\/j.socscimed.2011.11.023","article-title":"Psychological pathways linking social support to health outcomes: A visit with the \u201cghosts\u201d of research past, present, and future","volume":"74","author":"Uchino","year":"2012","journal-title":"Soc Sci Med (1982)"}],"container-title":["Innovation in Aging"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/innovateage\/article-pdf\/4\/1\/igz049\/33010187\/igz049.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/innovateage\/article-pdf\/4\/1\/igz049\/33010187\/igz049.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,4,4]],"date-time":"2020-04-04T11:37:18Z","timestamp":1586000238000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/innovateage\/article\/doi\/10.1093\/geroni\/igz049\/5687171"}},"subtitle":[],"editor":[{"given":"Steven M","family":"Albert","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2020,1,1]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/geroni\/igz049","relation":{},"ISSN":["2399-5300"],"issn-type":[{"value":"2399-5300","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,1]]},"published":{"date-parts":[[2020,1,1]]},"article-number":"igz049"}}