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McKenzie K, Murray G, Metcalfe D, Robson R, Kaczmar M, Shirley A. Using the learning disability screening questionnaire to help identify people with an intellectual disability in homeless services. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:1319-1325. [PMID: 37635318 DOI: 10.1111/jar.13150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/29/2023] [Accepted: 07/31/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND We explored the accuracy of using the learning disability screening questionnaire (LDSQ) in services for people experiencing homelessness in the United Kingdom. METHOD We examined the concordance between the LDSQ outcomes and assessments of intellectual disability. Seventy adults experiencing homelessness completed the LDSQ. Staff completed the LDSQ and a measure of adaptive functioning for 38 of this group. Nine participants received an intellectual assessment. RESULTS Sensitivity and specificity for the LDSQ when completed by staff was 83% and 96% respectively and 50% and 92% when completed by the individual. Seven people had intellectual and adaptive functioning in the intellectual disability range. CONCLUSION The results suggest that the LDSQ would be an appropriate and beneficial screening tool to use within services for people experiencing homelessness. More accurate results would be likely if it were completed by staff.
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Affiliation(s)
- Karen McKenzie
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | | | - Dale Metcalfe
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
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Maye JE, Van Patten R, Lykins HC, Vella L, Mahmood Z, Clark JMR, Twamley EW. Memory, fluid reasoning, and functional capacity in adults experiencing homelessness. Clin Neuropsychol 2023; 37:1441-1454. [PMID: 36154911 PMCID: PMC10039959 DOI: 10.1080/13854046.2022.2125906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 09/13/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND AND OBJECTIVE In individuals experiencing homelessness, determinants of functional capacity (i.e. the ability to perform activities of daily living) are poorly understood. Identifying potentially modifiable correlates of functional capacity, such as cognitive abilities, may inform treatment targets to address independence and housing stability. This study aimed to identify the strongest neuropsychological predictors of variance in functional performance in 100 adults living in a homeless shelter. METHODS Participants completed a brief cognitive screening test, from which four composite scores were derived, as well as tests of processing speed, fluid reasoning, premorbid intellectual function, and performance-based functional capacity. We conducted a hierarchical linear regression to predict variance in functional capacity. RESULTS Beyond the impact of education and premorbid intellectual function, better memory and fluid reasoning predicted better functional performance. CONCLUSIONS Although our cross-sectional design does not permit causal inference, it is possible that interventions targeting memory and fluid reasoning may improve functional ability in individuals experiencing homelessness.
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Affiliation(s)
- Jacqueline E. Maye
- Research Service, VA San Diego Healthcare System
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System
- Department of Psychiatry, University of California San Diego
| | - Ryan Van Patten
- Department of Psychiatry and Human Behavior, Brown University
- VA Providence Healthcare System
| | | | - Lea Vella
- University of California San Francisco Health, Department of Quality and Patient Safety
| | - Zanjbeel Mahmood
- Research Service, VA San Diego Healthcare System
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology
| | - Jillian M. R. Clark
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System
- Mental Health Service, VA San Diego Healthcare System
| | - Elizabeth W. Twamley
- Research Service, VA San Diego Healthcare System
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System
- Department of Psychiatry, University of California San Diego
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Van Patten R, Mahmood Z, Nguyen TT, Maye J, Kim HC, Jeste DV, Twamley EW. Rates of Cognitive and Functional Impairments in Older Adults Residing in a Continuing Care Senior Housing Community. J Int Neuropsychol Soc 2022; 28:62-73. [PMID: 33749570 PMCID: PMC8455703 DOI: 10.1017/s1355617721000163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The current cross-sectional study examined cognition and performance-based functional abilities in a continuing care senior housing community (CCSHC) that is comparable to other CCSHCs in the US with respect to residents' demographic characteristics. METHOD Participants were 110 older adult residents of the independent living unit. We assessed sociodemographics, mental health, neurocognitive functioning, and functional capacity. RESULTS Compared to normative samples, participants performed at or above expectations in terms of premorbid functioning, attention span and working memory, processing speed, timed set-shifting, inhibitory control, and confrontation naming. They performed below expectation in verbal fluency and verbal and visual learning and memory, with impairment rates [31.4% (>1 SD below the mean) and 18.49% (>1.5 SD below the mean)] well above the general population (16% and 7%, respectively). Within the cognitive test battery, two tests of delayed memory were most predictive of a global deficit score. Most cognitive test scores correlated with performance-based functional capacity. CONCLUSIONS Overall, results suggest that a subset of older adults in the independent living sector of CCSHCs are cognitively and functionally impaired and are at risk for future dementia. Results also argue for the inclusion of memory tests in abbreviated screening batteries in this population. We suggest that CCSHCs implement regular cognitive screening procedures to identify and triage those older adults who could benefit from interventions and, potentially, a transition to a higher level of care.
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Affiliation(s)
- Ryan Van Patten
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Zanjbeel Mahmood
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Ct, San Diego, CA
| | - Tanya T. Nguyen
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Jacqueline Maye
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Ho-Cheol Kim
- Scalable Knowledge Intelligence, IBM Research – Almaden, San Jose, CA, United States
| | - Dilip V. Jeste
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego
- Department of Neurosciences, University of California San Diego, La Jolla, CA, United States
| | - Elizabeth W. Twamley
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Dr., San Diego, CA 92161
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