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J R Soc Med 2004;97:375-379
doi:10.1258/jrsm.97.8.375
© 2004 Royal Society of Medicine

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J R Soc Med 2004;97:375-379
© 2004 The Royal Society of Medicine

Cognitive dysfunction in homeless adults: a systematic review

Sean Spence MD MRCPsych   Richard Stevens PhD     Randolph Parks PhD  

Academic Clinical Psychiatry, Division of Genomic Medicine, University of Sheffield, The Longley Centre, Norwood Grange Drive, Sheffield S5 7JT, UK

Correspondence to: Dr Sean Spence E-mail: s.a.spence{at}sheffield.ac.uk

Homelessness is associated with multiple adversities that might impact upon brain function. We performed a review of published work to assess evidence of cognitive dysfunction among adults who are homeless. Despite liberal inclusion criteria only seventeen publications were identified, these describing eighteen samples mainly from the USA. Although the total number of individuals studied is small (about 3300) and the samples are heterogeneous, most studies indicate a considerable burden of cognitive dysfunction among homeless people. Such dysfunction might be expected to impact upon their ability to reintegrate into society, thereby undermining policies of inclusiveness. In clinical practice, assessment of homeless adults should include their cognitive state.


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