Distinct Profiles of Memory Performance as a Function of Serial Position Recall in a Sample of Homeless and Precariously Housed Adults

Poor cognition is prominent in persons who are homeless, and memory dysfunction frequently emerges at the most pervasive impairment. The nature of this impairment is poorly understood, though prevalent issues of medical and psychiatric multimorbidity in homeless adults suggests that multiple factors may be contributing. This study investigated memory dysfunction in a homeless and precariously housed sample by subtyping unique profiles of serial position recall on a verbal learning and memory test using a latent profile analysis (LPA; N = 411). Subsequent logistic regression analyses were conducted in a subsample (N = 175) to examine whether regional brain volumes (i.e., dorsolateral prefrontal cortex, hippocampus, entorhinal cortex) and pathological markers (i.e., cerebral small vessel disease burden, hippocampal cavity volume) predicted serial position class membership. Secondary analyses explored between-class differences in attention, processing speed, cognitive control, and mental flexibility using linear regression. LPA identified two classes characterized by (1) reduced primacy relative to recency recall (RP); and (2) reduced recency relative to primacy recall (RR). Neuroanatomical and pathological markers did not emerge as significant predictors of class membership in the regression model. The RR class outperformed the RP class on measures of processing speed, sustained attention, and cognitive control. The present findings have implications for the way memory dysfunction is conceptualized in this complex group, supporting the substantial heterogeneity in their cognition and memory functioning and may aid in the development of discernible targets for interventions and strategies for rehabilitation.