Social Deprivation Assessment in Older Adults

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

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.

Study Overview

• Status: Active, not recruiting
• Conditions: Geriatrics; Social Deprivation
• Intervention / Treatment: Other: Data Collection

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.

• Study Type: Observational
• Enrollment (Estimated): 30000

Contacts and Locations

Study Locations

• Canada
  • Quebec
    • Montréal, Quebec, Canada, H3T 1E2
      • Jewish General Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 45 years to 85 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Individuals eligible for this study will be the participants of the CLSA

Description

Inclusion Criteria:

• Participants of the comprehensive CLSA assessment.

Exclusion Criteria:

• No information on social status
• No information on social, psychological, and health outcomes

Study Plan

How is the study designed?

Number of groups / cohorts

4

Cohorts and Interventions

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

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: Jewish General Hospital
• Investigators: Principal Investigator: Olivier Beauchet, MD, McGill University

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2020
• Primary Completion (Estimated): March 1, 2024
• Study Completion (Estimated): March 1, 2025

Study Registration Dates

• First Submitted: September 23, 2019
• First Submitted That Met QC Criteria: September 24, 2019
• First Posted (Actual): September 26, 2019

Study Record Updates

• Last Update Posted (Actual): February 28, 2024
• Last Update Submitted That Met QC Criteria: February 27, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Other Study ID Numbers: 2020-1956

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No