Social Deprivation Assessment in Older Adults

Study Overview
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Brief Summary
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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
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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.

Official Title
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Social Deprivation Assessment in Older Adults: Results From the Canadian Longitudinal Study on Aging

Conditions
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Geriatrics, Social Deprivation

Intervention / Treatment
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* Other: Data Collection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participants of the comprehensive CLSA assessment. Exclusion Criteria: No information on social status No information on social, psychological, and health outcomes

Ages Eligible for Study
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Minimum Age: 45 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| 45-54 years of age<br>Divided into two subgroups: individuals who are and are not socially deprived | Other: Data Collection<br>* Telephone interview questionnaire, in-home face-to-face interview, and data from the Collection Site<br>|
| 54-64 years of age<br>Divided into two subgroups: individuals who are and are not socially deprived | Other: Data Collection<br>* Telephone interview questionnaire, in-home face-to-face interview, and data from the Collection Site<br>|
| 65-74 years of age<br>Divided into two subgroups: individuals who are and are not socially deprived | Other: Data Collection<br>* Telephone interview questionnaire, in-home face-to-face interview, and data from the Collection Site<br>|
| 75-85 years of age<br>Divided into two subgroups: individuals who are and are not socially deprived | Other: Data Collection<br>* Telephone interview questionnaire, in-home face-to-face interview, and data from the Collection Site<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Social Deprivation | 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 | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Polypharmacy | 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 | 1 day | 
| Comorbidities | Number of comorbidities | 1 day | 
| Mortality | Incident mortality | 1 day | 
| Depression | 10 items from the Center for Epidemiological Studies' Short Depression Scale (CES-D) score ≥10 | 1 day | 
| Falls | Number (if any) of falls | 1 day | 
| Mobility aid | Is a mobility aid used | 1 day | 
| Mobility | Difficulty walking 2 to 3 neighbourhood blocks | 1 day | 
| Activities daily living (ADL) | ADL score out of 6. Where a score of 3-5 is indicative of mild stages of neurocognitive disorders. | 1 day | 
| Instrumental activities of daily living (IADL) scales | IADL score out of 8. Where a score of 4-7 is indicative of mild stages of neurocognitive disorders. | 1 day | 
| Self-reported happiness, perception of health and mental health | Scored as excellent, very good, good, fair, or poor | 1 day | 
| Income | Personal income before tax | 1 day | 
| Social interaction/the availability of social support | Variables selected from the: social participation (SPA) questionnaire, social network (SN) questionnaire, social support availability (SSA) questionnaire | 1 day | 
| Place of living | Participants place of living is coded as home versus institution | 1 day | 
| Cognitive performance | Cognitive Module Assessment of the CLSA study from baseline assessment (e.g. the Animal Fluency Test) | 1 day |