{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:45:31Z","timestamp":1789523131292,"version":"build-2803163510"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T00:00:00Z","timestamp":1731283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["RF1 AG058595"],"award-info":[{"award-number":["RF1 AG058595"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Alzheimer\u2019s Association Research Fellowship","award":["AARFD-231151386"],"award-info":[{"award-number":["AARFD-231151386"]}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["NIA U01AG009740"],"award-info":[{"award-number":["NIA U01AG009740"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Objectives<\/jats:title>\n                  <jats:p>Alzheimer\u2019s disease and related dementias (ADRD) remain a pressing concern in the United States, which also has one of the highest incarceration rates worldwide. Existing research has analyzed dementia risk and care among currently incarcerated and homeless populations; this paper fills a gap by examining later-life cognitive disparities facing formerly incarcerated and\/or homeless individuals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research Design and Methods<\/jats:title>\n                  <jats:p>Using Health and Retirement Study data (1998\u20132018), we tested whether formerly homeless and\/or incarcerated people had earlier onset of cognitive decline, and whether they were more likely to have modifiable risk factors for ADRD than those without such experiences. We estimated prevalence of mild cognitive impairment (MCI), dementia, and self-reported ADRD diagnosis. We also used repeated observations of cognitive functioning coupled with nested nonlinear regression to examine the onset of accelerated cognitive decline.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Adjusting for demographic variables, formerly homeless and\/or incarcerated participants have increased odds of having risk factors for dementia, including smoking, drinking alcohol, depression, mental illness, and discrimination from healthcare providers and police. Diagnosis of MCI and ADRD were more common among participants reporting a history of incarceration or homelessness. Nested nonlinear regression revealed that previous experiences of incarceration or homelessness\u2014alone or together\u2014are associated with earlier onset of accelerated cognitive decline compared with those who experienced neither.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion and Implications<\/jats:title>\n                  <jats:p>This study suggests that, even if they occur earlier in life, homelessness and incarceration experiences may increase risk of poorer cognitive health in late life. Future work is warranted to understand the lifelong consequences linked to this adversity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/geront\/gnae166","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T11:31:16Z","timestamp":1731324676000},"source":"Crossref","is-referenced-by-count":6,"title":["The Intersecting Effects of Lifetime Experiences of Homelessness and Incarceration on Cognitive Aging and Dementia Risk Factors in the United States"],"prefix":"10.1093","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2186-5540","authenticated-orcid":false,"given":"Douglas William","family":"Hanes","sequence":"first","affiliation":[{"name":"Program in Public Health, Renaissance School of Medicine, Stony Brook University , Stony Brook, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6124-0329","authenticated-orcid":false,"given":"Sean A P","family":"Clouston","sequence":"additional","affiliation":[{"name":"Program in Public Health, Renaissance School of Medicine, Stony Brook University , Stony Brook, New York ,","place":["USA"]},{"name":"Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University , Stony Brook, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,11,11]]},"reference":[{"issue":"11","key":"2025052714100707800_CIT0001","doi-asserted-by":"publisher","first-page":"2065","DOI":"10.1111\/jgs.15521","article-title":"Cognition and incarceration: Cognitive impairment and its associated outcomes in older adults in jail","volume":"66","author":"Ahalt","year":"2018","journal-title":"Journal of the American Geriatrics Society"},{"issue":"11","key":"2025052714100707800_CIT0002","doi-asserted-by":"publisher","first-page":"2404","DOI":"10.1177\/07334648221109747","article-title":"Associations between homelessness and Alzheimer\u2019s disease and related dementia: A systematic review","volume":"41","author":"Babulal","year":"2022","journal-title":"Journal of Applied Gerontology"},{"issue":"12","key":"2025052714100707800_CIT0003","doi-asserted-by":"publisher","first-page":"2141","DOI":"10.1093\/geronb\/gbad136","article-title":"The prevalence of cognitive impairment and dementia in incarcerated older adults","volume":"78","author":"Baillargeon","year":"2023","journal-title":"The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences"},{"issue":"Volume 1, 2018","key":"2025052714100707800_CIT0004","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1146\/annurev-criminol-032317-092458","article-title":"The politics, promise, and peril of criminal justice reform in the context of mass incarceration","volume":"1","author":"Beckett","year":"2018","journal-title":"Annual Review of Criminology"},{"issue":"5","key":"2025052714100707800_CIT0005","doi-asserted-by":"publisher","first-page":"1509","DOI":"10.1177\/1471301218801715","article-title":"The impact of dementia in the prison setting: A systematic review","volume":"19","author":"Brooke","year":"2020","journal-title":"Dementia (London, England)"},{"issue":"4","key":"2025052714100707800_CIT0006","doi-asserted-by":"publisher","first-page":"gnw011","DOI":"10.1093\/geront\/gnw011","article-title":"Geriatric conditions in a population-based sample of older homeless adults","volume":"57","author":"Brown","year":"2016","journal-title":"The Gerontologist"},{"issue":"Volume 44, 2023","key":"2025052714100707800_CIT0007","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1146\/annurev-publhealth-071521-034016","article-title":"Public health and prisons: Priorities in the age of mass incarceration","volume":"44","author":"Cloud","year":"2023","journal-title":"Annual Review of Public Health"},{"issue":"4","key":"2025052714100707800_CIT0008","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1016\/j.trci.2017.09.001","article-title":"Traumatic exposures, posttraumatic stress disorder, and cognitive functioning in World Trade Center responders","volume":"3","author":"Clouston","year":"2017","journal-title":"Alzheimer\u2019s & Dementia (New York, N.Y.)"},{"issue":"n\/a","key":"2025052714100707800_CIT0009","doi-asserted-by":"publisher","first-page":"5540","DOI":"10.1002\/alz.14053","article-title":"Inequalities in accelerated cognitive decline: Resolving observational window bias using nested non-linear regression","volume":"20","author":"Clouston","year":"2024","journal-title":"Alzheimer\u2019s & Dementia"},{"issue":"3","key":"2025052714100707800_CIT0010","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1177\/0022146515594188","article-title":"Educational inequalities in health behaviors at midlife: Is there a role for early-life cognition","volume":"56","author":"Clouston","year":"2015","journal-title":"Journal of Health and Social Behavior"},{"issue":"7","key":"2025052714100707800_CIT0011","doi-asserted-by":"publisher","first-page":"e151","DOI":"10.1093\/geronb\/gbz053","article-title":"Education and cognitive decline: An integrative analysis of global longitudinal studies of cognitive aging","volume":"75","author":"Clouston","year":"2019","journal-title":"The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences"},{"issue":"12","key":"2025052714100707800_CIT0012","doi-asserted-by":"publisher","first-page":"e247","DOI":"10.1093\/geronb\/gbac138","article-title":"The role of incarceration as a risk factor for cognitive impairment","volume":"77","author":"Cox","year":"2022","journal-title":"The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences"},{"issue":"Suppl 1","key":"2025052714100707800_CIT0013","doi-asserted-by":"publisher","first-page":"i162","DOI":"10.1093\/geronb\/gbr048","article-title":"Assessment of cognition using surveys and neuropsychological assessment: The Health and Retirement Study and the Aging, Demographics, and Memory Study","volume":"66","author":"Crimmins","year":"2011","journal-title":"The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences"},{"issue":"9","key":"2025052714100707800_CIT0014","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1001\/jamaneurol.2023.2120","article-title":"Dementia risk and disadvantaged neighborhoods","volume":"80","author":"Dintica","year":"2023","journal-title":"JAMA Neurology"},{"issue":"1","key":"2025052714100707800_CIT0015","doi-asserted-by":"publisher","first-page":"e3, Article e3","DOI":"10.1192\/j.eurpsy.2021.2261","article-title":"Attention-deficit\/hyperactivity disorder as a risk factor for dementia and mild cognitive impairment: A population-based register study","volume":"65","author":"Dobrosavljevic","year":"2022","journal-title":"European Psychiatry"},{"key":"2025052714100707800_CIT0016","volume-title":"Toward dignity: Understanding older adult homelessness in the California statewide study of people experiencing homelessness","author":"Espinoza","year":"2024"},{"issue":"6","key":"2025052714100707800_CIT0017","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1093\/geront\/gny104","article-title":"A framework of minority stress: From physiological manifestations to cognitive outcomes","volume":"59","author":"Forrester","year":"2018","journal-title":"The Gerontologist"},{"issue":"2","key":"2025052714100707800_CIT0018","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1377\/hlthaff.2023.01039","article-title":"Mortal systemic exclusion yielded steep mortality-rate increases in people experiencing homelessness, 2011\u201320","volume":"43","author":"Fowle","year":"2024","journal-title":"Health Affairs"},{"issue":"15","key":"2025052714100707800_CIT0019","doi-asserted-by":"publisher","first-page":"2677","DOI":"10.3390\/ijerph16152677","article-title":"LGBTIQ+ homelessness: A review of the literature","volume":"16","author":"Fraser","year":"2019","journal-title":"International Journal of Environmental Research and Public Health"},{"issue":"6","key":"2025052714100707800_CIT0020","doi-asserted-by":"publisher","first-page":"2119","DOI":"10.1007\/s13524-018-0717-0","article-title":"Racial and ethnic disparities in the lifetime prevalence of homelessness in the United States","volume":"55","author":"Fusaro","year":"2018","journal-title":"Demography"},{"issue":"1","key":"2025052714100707800_CIT0021","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/s40352-018-0062-9","article-title":"Older adults in jail: High rates and early onset of geriatric conditions","volume":"6","author":"Greene","year":"2018","journal-title":"Health Justice"},{"issue":"8","key":"2025052714100707800_CIT0022","doi-asserted-by":"publisher","first-page":"e620","DOI":"10.1093\/geront\/gnz135","article-title":"Precarity and aging: A scoping review","volume":"60","author":"Grenier","year":"2019","journal-title":"The Gerontologist"},{"key":"2025052714100707800_CIT0023","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1093\/geront\/gnaa107","article-title":"Ask again: Including gender identity in longitudinal studies of aging","volume":"61","author":"Hanes","year":"2020","journal-title":"The Gerontologist"},{"key":"2025052714100707800_CIT0024","volume-title":"RAND HRS Longitudinal File 2018","author":"Health and Retirement Study","year":"2018"},{"issue":"2","key":"2025052714100707800_CIT0025","doi-asserted-by":"publisher","first-page":"44","DOI":"10.7758\/rsf.2015.1.2.04","article-title":"Homelessness and housing insecurity among former prisoners","volume":"1","author":"Herbert","year":"2015","journal-title":"The Russell Sage Foundation Journal of the Social Sciences"},{"key":"2025052714100707800_CIT0026","volume-title":"LHMS user guide 2015-2017","author":"Jacqui","year":"2022"},{"issue":"4","key":"2025052714100707800_CIT0027","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnad114","article-title":"\u201cWe\u2019re Not Patients. We\u2019re Inmates\u201d: Older Black Women\u2019s experience of aging, health, and illness during and after incarceration","volume":"64","author":"James","year":"2023","journal-title":"The Gerontologist"},{"issue":"8","key":"2025052714100707800_CIT0028","doi-asserted-by":"publisher","first-page":"1707","DOI":"10.1111\/jgs.15993","article-title":"Homeless veterans in nursing homes: Care for complex medical, substance use, and social needs","volume":"67","author":"Jutkowitz","year":"2019","journal-title":"Journal of the American Geriatrics Society"},{"issue":"7","key":"2025052714100707800_CIT0029","doi-asserted-by":"publisher","first-page":"1306","DOI":"10.1002\/alz.12476","article-title":"Prevalence of Alzheimer\u2019s disease and related dementias among veterans experiencing housing insecurity","volume":"18","author":"Jutkowitz","year":"2022","journal-title":"Alzheimer's & Dementia"},{"issue":"2","key":"2025052714100707800_CIT0030","doi-asserted-by":"publisher","first-page":"e12577","DOI":"10.1002\/dad2.12577","article-title":"Examining the propensity and nature of criminal risk behaviours in frontotemporal dementia syndromes and Alzheimer\u2019s disease","volume":"16","author":"Kumfor","year":"2024","journal-title":"Alzheimer's & Dementia (Amsterdam, Netherlands)"},{"key":"2025052714100707800_CIT0031","volume-title":"Toward a new understanding: The California statewide study of people experiencing homelessness","author":"Kushel","year":"2023"},{"issue":"Volume 36, 2010","key":"2025052714100707800_CIT0032","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1146\/annurev-soc-070308-115940","article-title":"The new homelessness revisited","volume":"36","author":"Lee","year":"2010","journal-title":"Annual Review of Sociology"},{"issue":"3","key":"2025052714100707800_CIT0033","doi-asserted-by":"publisher","first-page":"e190261","DOI":"10.1001\/jamanetworkopen.2019.0261","article-title":"Association of neuropathologically confirmed frontotemporal dementia and Alzheimer Disease with criminal and socially inappropriate behavior in a Swedish cohort","volume":"2","author":"Liljegren","year":"2019","journal-title":"JAMA Network Open"},{"issue":"10248","key":"2025052714100707800_CIT0034","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/S0140-6736(20)30367-6","article-title":"Dementia prevention, intervention, and care: 2020 report of the Lancet Commission","volume":"396","author":"Livingston","year":"2020","journal-title":"Lancet"},{"issue":"5","key":"2025052714100707800_CIT0035","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1007\/s11121-022-01385-1","article-title":"Is stress an overlooked risk factor for dementia? A systematic review from a lifespan developmental perspective","volume":"24","author":"Luo","year":"2023","journal-title":"Prevention Science"},{"issue":"116698","key":"2025052714100707800_CIT0036","doi-asserted-by":"publisher","first-page":"116698","DOI":"10.1016\/j.socscimed.2024.116698","article-title":"The association between incarceration and housing insecurity and advanced immune age during late life","volume":"347","author":"MacConnachie","year":"2024","journal-title":"Social Science & Medicine"},{"issue":"Volume 7, 2024","key":"2025052714100707800_CIT0037","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1146\/annurev-criminol-022422-020934","article-title":"Homelessness, offending, victimization, and criminal legal system contact","volume":"7","author":"McCarthy","year":"2024","journal-title":"Annual Review of Criminology"},{"issue":"2","key":"2025052714100707800_CIT0038","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1111\/j.1745-9133.2004.tb00031.x","article-title":"Homeless shelter use and reincarceration following prison release","volume":"3","author":"Metraux","year":"2004","journal-title":"Criminology & Public Policy"},{"key":"2025052714100707800_CIT0039","doi-asserted-by":"publisher","DOI":"10.3386\/w31843","article-title":"Life and death at the margins of society: The mortality of the U.S. homeless population","author":"Meyer","year":"2023"},{"key":"2025052714100707800_CIT0040","doi-asserted-by":"publisher","first-page":"562218","DOI":"10.3389\/fneur.2020.562218","article-title":"Neurodegenerative disease and the experience of homelessness","volume":"11","author":"Pi\u00f1a-Escudero","year":"2020","journal-title":"Frontiers in Neurology"},{"key":"2025052714100707800_CIT0041","volume-title":"Why are so many Americans in prison?","author":"Raphael","year":"2013"},{"issue":"1","key":"2025052714100707800_CIT0042","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13195-018-0453-0","article-title":"Alcohol use and dementia: A systematic scoping review","volume":"11","author":"Rehm","year":"2019","journal-title":"Alzheimer\u2019s Research & Therapy"},{"key":"2025052714100707800_CIT0043","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780190603823.001.0001","volume-title":"Prisons and health in the age of mass incarceration","author":"Schnittker","year":"2022"},{"issue":"3","key":"2025052714100707800_CIT0044","doi-asserted-by":"publisher","first-page":"e124","DOI":"10.1016\/s2468-2667(18)30022-7","article-title":"Contribution of alcohol use disorders to the burden of dementia in France 2008\u201313: A nationwide retrospective cohort study","volume":"3","author":"Schwarzinger","year":"2018","journal-title":"The Lancet Public Health"},{"issue":"1","key":"2025052714100707800_CIT0045","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1093\/epirev\/mxx020","article-title":"The health of America\u2019s aging prison population","volume":"40","author":"Skarupski","year":"2018","journal-title":"Epidemiologic Reviews"},{"key":"2025052714100707800_CIT0046","volume-title":"HRS psychosocial and lifestyle questionnaire 2006\u20132016","author":"Smith","year":"2017"},{"issue":"4","key":"2025052714100707800_CIT0047","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1111\/jgs.12751","article-title":"\u201cMy Older Clients Fall Through Every Crack in the System\u201d: Geriatrics knowledge of legal professionals","volume":"62","author":"Soones","year":"2014","journal-title":"Journal of the American Geriatrics Society"},{"issue":"6","key":"2025052714100707800_CIT0048","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1111\/acps.13153","article-title":"Risk of dementia in bipolar disorder and the interplay of lithium: A systematic review and meta-analyses","volume":"141","author":"Velosa","year":"2020","journal-title":"Acta Psychiatrica Scandinavica"},{"issue":"100466","key":"2025052714100707800_CIT0049","doi-asserted-by":"publisher","first-page":"100466","DOI":"10.1016\/j.ssmph.2019.100466","article-title":"Examining the relationship between U.S. incarceration rates and population health at the county level","volume":"9","author":"Weidner","year":"2019","journal-title":"SSM \u2013 Population Health"},{"key":"2025052714100707800_CIT0050","doi-asserted-by":"publisher","DOI":"10.7758\/9781610448710","volume-title":"Homeward: Life in the year after prison","author":"Western","year":"2018"},{"issue":"10077","key":"2025052714100707800_CIT0051","doi-asserted-by":"publisher","first-page":"1464","DOI":"10.1016\/S0140-6736(17)30259-3","article-title":"Mass incarceration, public health, and widening inequality in the USA","volume":"389","author":"Wildeman","year":"2017","journal-title":"Lancet (London, England)"},{"key":"2025052714100707800_CIT0052","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780197548325.001.0001","volume-title":"Ungoverned and out of sight: Public health and the political crisis of homelessness in the United States","author":"Willison","year":"2021"},{"issue":"3","key":"2025052714100707800_CIT0053","doi-asserted-by":"publisher","first-page":"e0118333","DOI":"10.1371\/journal.pone.0118333","article-title":"Smoking is associated with an increased risk of dementia: A meta-analysis of prospective cohort studies with investigation of potential effect modifiers","volume":"10","author":"Zhong","year":"2015","journal-title":"PLoS One"}],"container-title":["The Gerontologist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/gerontologist\/advance-article-pdf\/doi\/10.1093\/geront\/gnae166\/60587145\/gnae166.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/gerontologist\/article-pdf\/65\/6\/gnae166\/60587145\/gnae166.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/gerontologist\/article-pdf\/65\/6\/gnae166\/60587145\/gnae166.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T18:10:19Z","timestamp":1748369419000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/gerontologist\/article\/doi\/10.1093\/geront\/gnae166\/7889307"}},"subtitle":[],"editor":[{"given":"Benjamin F","family":"Henwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,11,11]]},"references-count":53,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,5,10]]}},"URL":"https:\/\/doi.org\/10.1093\/geront\/gnae166","relation":{},"ISSN":["0016-9013","1758-5341"],"issn-type":[{"value":"0016-9013","type":"print"},{"value":"1758-5341","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,6]]},"published":{"date-parts":[[2024,11,11]]},"article-number":"gnae166"}}