Traumatic brain injury in Vancouver’s unstably housed persons: incidence, risks, and effects.
We have been following a cohort of over 500 housing-insecure, marginalized participants from Vancouver’s downtown eastside neighbourhood since 2010. Tenants revolve in and out of homelessness and experience high mortality, profound social and occupational marginalization, and neurocognitive impairments arising from multimorbidities. Our goal is to identify drivers of disability that reveal modifiable mechanisms contributing to poor outcomes to inform effective interventions.
Emerging from our recent work is the powerful contribution of Traumatic Brain Injury (TBI) ) to poor outcomes. Brain MRI patterns suggest structural brain changes that appear decades earlier than expected, with attendant cognitive decline. These changes may be harbingers of neurodegeneration associated with various disorders, e.g., chronic traumatic encephalopathy, vascular dementia, and Alzheimer’s neuropathology.