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A Piece of My Mind
February 6, 2013

Falling Off the Edge

Author Affiliations

A Piece of My Mind Section Editor: Roxanne K. Young, Associate Senior Editor.

Author Affiliations: Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School (Dr Inouye; agingbraincenter@hsl.harvard.edu); Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife (Dr Inouye and Ms Puelle); Department of Medicine, Massachusetts General Hospital, Harvard Medical School (Dr O’Connell); Boston Healthcare for the Homeless Program (Drs Inouye and O’Connell); Boston, Massachusetts.

JAMA. 2013;309(5):451-452. doi:10.1001/jama.2012.214089

One evening as I (S.K.I.) was clearing the tables in the soup kitchen where I was volunteering, I struck up a conversation with a homeless man. With his long white beard, stooped posture, and limping gait, I was sure he was older than 70 years. I was surprised to learn he was only 48. As a geriatrician with more than 25 years of clinical experience, I am usually pretty good at telling how old someone is. But after this scenario repeated itself several times, I began to wonder whether chronic homelessness might be associated with accelerated aging. Could exposure to the elements and the constant stress of the relentless daily struggle to survive lead to more rapid aging, along with its attendant functional and cognitive decline?