Dementia care and mortality in people experiencing homelessness: A matched cohort study
Bibliographic record
Abstract
INTRODUCTION: People experiencing homelessness are disproportionately affected by dementia, yet little is known about their dementia care and mortality rates after a diagnosis. METHODS: Homeless (n = 559) and housed (n = 2002) individuals newly diagnosed with dementia were matched on age, sex, diagnosis date, and health region within the province of Ontario, Canada. Dementia care, long-term care admissions, health service use, and mortality rates within 1 year of diagnosis were compared between groups. RESULTS: Homeless individuals were more often admitted to long-term care and less often received cholinesterase inhibitors. They also had higher rates of unscheduled emergency department visits, hospital bed days without acute care needs, and mortality compared to housed individuals. DISCUSSION: Individuals experiencing homelessness have higher use of hospital-based services and elevated mortality. They are also more frequently admitted to long-term care, reinforcing the importance of developing integrated care models that combine health care, social services, and housing support. HIGHLIGHTS: Homeless individuals diagnosed with dementia face higher mortality and care gaps. Most are not placed in long-term care within a year of diagnosis. Tailored care models linking health care, housing, and social services are needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".