Social Deprivation Assessment in Older Adults

Geriatrics, Social Deprivation

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.

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.

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