Potentially modifiable risk factors for dementia in people experiencing homelessness: a scoping review

Protracted homelessness creates a biopsychosocial circumstance for poor health outcomes, including a worsening cognitive profile with an increased risk for dementia. Dementia is a global public health concern, and it is reported that up to 40% of all dementia may be attributed to potentially modifiable lifestyle risk factors. Whilst Alzheimer’s disease, vascular dementia, and frontotemporal dementia remain the most common types of dementia overall, the experience of homelessness may directly influence other dementias, including alcohol dementia and HIV-associated dementia to be more frequently seen. We searched five databases (CINAHL, PsycINFO, Informit, Web of Science, and PubMed) and followed scoping review methodology to identify studies exploring potentially modifiable risk factors for dementia in people experiencing homelessness. After excluding prevalence studies, reviews and articles that were not original research, we identified a total of seven studies. We included studies reporting on risk factors for cognitive impairment, itself being a risk factor for dementia. Our results show a paucity of literature examining how the experience of homelessness influences the risk for developing dementia. This contributes to a lack of understanding how potentially modifiable risk factors for dementia may, or may not, differ between people experiencing homelessness and the stably domiciled populations.