Social vulnerability underlying disability amongst older adults: A systematic review

Abstract

Background: Older adults face radical changes in their social life during ageing, dealing with several age-related social adaptations. The aim of this review is to systematically explore the literature on social vulnerability (SV) and its association with functional decline activity of daily living (ADL)/instrumental activities of daily living (IADL) as an endpoint in older adults. Methods: We searched for relevant studies in three different databases: PubMed, Ovid Medline and PsychInfo. Inclusion criteria included: prospective cohort studies assessing SV correlation; studies in English, Italian, French and Spanish to the end of March 2018; a general population aged >65 years living in a community setting and/or studies including younger participants if the mean age was >65 years; and basic ADL and/or IADL by Katz and Lawton, respectively, as functional decline and clinical outcomes. Results:We identified 65 manuscripts that assessed the role of SV in functional decline. Our systematic analysis showed that 26, 36 and 19 studies observed a correlation between Basic Social Needs, Social Resources and Social Behaviour and Activity, respectively, and the onset of ADL/IADL functional decline. Twenty-six studies explored the correlation between General Social Resources and the onset of ADL/IADL functional decline. Conclusions: When examining a wide set of social variables, the "quality," rather than just structure, and "type" of social relationship represents the core feature of SV that predicts functional decline in older adults. By defining individual SV, its measurement and evaluation, we can plan effective social interventions aimed at preventing or delaying functional decline or death. K E Y W O R D Sfrailty, functional decline, older adults, social vulnerability 2 of 12 | CAPPELLI Et AL.

Differential moderation effects of ApoE and 5-HTTLPR genotypes on social vulnerability in predicting mortality among community-dwelling middle-aged and older adults: a nationwide population-based study

“…The potential cohort effect may explain the higher SVI values noted in Taiwan compared with other Western countries. The dose-responsive effects between SVI and depressive symptoms, cognitive impairment, physical dependency, and multimorbidity were identified in this study, and these results were similar to those noted in previous studies [ 10 , 34 , 35 ].…”

Socioeconomic vulnerability and frailty among community-dwelling older adults: cross-sectional findings from longitudinal aging study in India, 2017–18

“…However, this potential in wealthy and higher social groups is challenged by the lack of specific public interventions of proven effectiveness and efficacy in socioeconomically poor frail individuals [ 42 ]. This may be substantiated by studies on the association of lack of social resources among the poor people with their functional decline in old age [ 43 ]. The previous findings in India suggesting that rural populations are disproportionately affected by poor health outcomes due to barriers to diagnosis also suggest their increased vulnerability to physical frailty in old age [ 44 ].…”

Influence of Social Adversity on Perceived Health Status and Depressive Symptoms among Portuguese Older People

“…Comorbidities and frailty, that arise with increasing age [ 11 ], are linked with rising risks of the onset of ill health and disability [ 5 , 8 , 12 ]. Studies showed that in general, older age, being women, lower education, lower economic status and not living with a partner are social adversity factors that were associated with worse health and quality of life [ 13 , 14 , 15 , 16 , 17 , 18 ].…”