Background. Homelessness is a serious public health problem that affects more than 31.000
people in Spain. It is a population that is aging, with important consequences for their health,
causing among other things a greater prevalence of chronic diseases. Also, within this aging
homeless population, there is a high proportion of people who use drugs, they are called "aging
drug users". This consumption adds a risk to an already vulnerable population.
Aim. Describe the population of aging problematic drug users regarding the age of onset of the
first chronic diseases and compare it with the rest of the homeless population depending on
drug use, both those who have a non-problematic consumption and those who do not use drugs.
Methods. A retrospective cohort study was conducted in the homeless population served in the
city of Girona from 2006 to 2016.The information includes clinical data from January 1, 2000 to
December 31, 2016, collected thanks to electronic records of primary care and the mental health
centre of Girona. Data included sociodemographic, chronic and infectious diseases, substance
misuse disorder. The average healthy months and years the person passes until the onset of the
first chronic diseases is compared in the 3 different groups of consumption using the Kruskal-
Walls test. The Kaplan-Meier test was used to determine the probability of being healthy over
time in the 3 consumption groups.
Results. The sample consisted of 492 participants. Homeless men were accounted for 84.5% of
the sample. The mean age of the cohort was 49.7 years (SD 11,09) for men and 49.29 years (SD
13,6) for women. In relation to drug use, 59.1% of the sample has no substance misuse problem,
31,9% had a non-problematic drug use, and 18,1% of the total were problem drug users. About
chronic diseases that were recorded in the electronic registry of the PCC, 152 people had al least
one. We focus now only on those people over 40, who represent 80% of the sample. Within this
older group, non-consumers still are the larger group, representing 44.9% of the people over 40.
Aging problematic drug users represent 14% of the sample and those people over 40 who use
other drugs represent 21,1% of the sample. Within this aging group, we have the date of
diagnosis of the different chronic diseases registered of 115 people. The age of onset of the first
chronic disease for each group is; 42,2 years for aging problematic drug users, 52,25 years for
other drug use group and 51,25 years for no substance misuse group.
Conclusions. We can conclude that there are differences in the time of appearance of chronic
diseases in individuals experiencing homelessness classified depending on their drug
consumption, being the "aging problematic drug users" those exposed to an earlier onset of
them. However, we cannot assure the association between consumption and the age of
appearance
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