Predictors of one-year cognitive decline in a marginally housed, multimorbid sample

Marginal housing is associated with high prevalence of several morbidities, including viral infection, psychiatric diagnosis and substance use, each of which is known to compromise cognition. The nature or course of cognition in marginally housed persons is understudied, and the impact of comorbidity on cognition is often unaddressed in the literature. Over a period of one year, participants recruited from the Downtown Eastside of Vancouver evidenced generally stable cognitive performance, except for a slight improvement in sustained attention and a slight decline in cognitive flexibility. HIV seropositive individuals showed declines in memory and response inhibition, while cannabis dependence was marginally associated with decline in memory. Given the negative impact of cognitive impairment on functioning, these results can inform prioritization of treatment targets in multimorbid populations.