MedPath

Social Deprivation Assessment in Older Adults

Active, not recruiting
Conditions
Social Deprivation
Geriatrics
Interventions
Other: Data Collection
Registration Number
NCT04105036
Lead Sponsor
Jewish General Hospital
Brief Summary

Social deprivation is a state to which older adults may be exposed, leading to adverse social, psychological, and health outcomes. Social deprivation may be more sensitive than socioeconomic status for predicting adversity while using only a few items for evaluation. However, there is no practical assessment for social deprivation in older Canadian adults. Two indices that capture a broad picture of social vulnerability have previously been developed for older Canadians. Using participants in the Canadian Longitudinal Study on Aging (CLSA), the overall objective is to examine and compare the associations of the COAD score and index, as well as the Keefe et al. and Andrew et al. indices with prevalent and incident adverse social, psychological, and health outcomes in participants at baseline assessment.

Detailed Description

Social deprivation is a state in which individuals are at risk for adverse health, as well as psychological and social outcomes. Social deprivation emphasises relative rather than absolute conditions, taking into account cultural standards of living in its classification of individuals. Increasing age is associated with increasing prevalence of social deprivation, putting older adults at risk for negative outcomes such as poor quality of life and ill-being. Rapid apprehension of social deprivation states by researchers and healthcare providers could improve management, favour proactivity, and increase understanding of health and social trends in older individuals.

No Canadian clinical assessment of social deprivation exists. There are only two social vulnerability indices that have been associated with incident health outcomes. On the other hand, the Evaluation of Deprivation and Inequalities in Health Examination Centres (EPICES: Évaluation de la Précarité et des Inégalités de santé dans les Centres d'Examens de Santé) is a brief social deprivation assessment developed and validated in France. The Canadian Older Adult Deprivation (COAD) scale is a modified EPICES assessment. Using participants in the Canadian Longitudinal Study on Aging (CLSA), the global objective of this study is to examine whether the COAD score is in fact associated with social deprivation and its association with adverse social, psychological, and health outcomes.

Social deprivation is considered the state of an individual experiencing social withdrawal, poor economic conditions, and cultural deprivation; it exposes individuals to adverse social, health, and psychological outcomes. Social deprivation has been found to be influenced with many factors, including an individual's socioeconomic status (SES), gender, ethnicity and age, to name a few. The Canadian population is unique in its composition, with large immigrant, diverse, and ageing populations. This emphasises the need for a simple assessment specific to the Canadian population that can quickly yet accurately identify socially deprived older individuals. Currently, such a scale does not exist in the Canadian context. To bridge this gap, the French social deprivation assessment Evaluation of Deprivation and Inequalities in Health Examination Centres (EPICES: Évaluation de la Précarité et des Inégalités de santé dans les Centres d'Examens de Santé) will be adapted to the Canadian context, creating the Canadian Older Adult Deprivation (COAD) scale. Moreover, as two Canadian social vulnerability and isolation indices have been previously created, the potential overlap between these indices and the COAD scale will be examined.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
30000
Inclusion Criteria
  • Participants of the comprehensive CLSA assessment.
Exclusion Criteria
  • No information on social status
  • No information on social, psychological, and health outcomes

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
45-54 years of ageData CollectionDivided into two subgroups: individuals who are and are not socially deprived
75-85 years of ageData CollectionDivided into two subgroups: individuals who are and are not socially deprived
54-64 years of ageData CollectionDivided into two subgroups: individuals who are and are not socially deprived
65-74 years of ageData CollectionDivided into two subgroups: individuals who are and are not socially deprived
Primary Outcome Measures
NameTimeMethod
Social Deprivation1 day

EPICES ( Évaluation de la Précarité et des Inégalités de santé dans les Centres d'Examens de Santé) scale, the cutoff 30.17 will be used

Secondary Outcome Measures
NameTimeMethod
Depression1 day

10 items from the Center for Epidemiological Studies' Short Depression Scale (CES-D) score ≥10

Mortality1 day

Incident mortality

Falls1 day

Number (if any) of falls

Mobility aid1 day

Is a mobility aid used

Polypharmacy1 day

The number of prescription medications taken on a daily basis, and in particular any number above 4 per day and the use of psychoactive drugs including benzodiazepines, antidepressants or neuroleptics

Mobility1 day

Difficulty walking 2 to 3 neighbourhood blocks

Instrumental activities of daily living (IADL) scales1 day

IADL score out of 8. Where a score of 4-7 is indicative of mild stages of neurocognitive disorders.

Comorbidities1 day

Number of comorbidities

Activities daily living (ADL)1 day

ADL score out of 6. Where a score of 3-5 is indicative of mild stages of neurocognitive disorders.

Self-reported happiness, perception of health and mental health1 day

Scored as excellent, very good, good, fair, or poor

Income1 day

Personal income before tax

Social interaction/the availability of social support1 day

Variables selected from the: social participation (SPA) questionnaire, social network (SN) questionnaire, social support availability (SSA) questionnaire

Place of living1 day

Participants place of living is coded as home versus institution

Cognitive performance1 day

Cognitive Module Assessment of the CLSA study from baseline assessment (e.g. the Animal Fluency Test)

Trial Locations

Locations (1)

Jewish General Hospital

🇨🇦

Montréal, Quebec, Canada

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