Abstract
Background: Social vulnerability occurs when individuals have been relatively disadvantaged by the social determinants of health. Complex interventions that reduce social vulnerability have the potential to improve health in older adults but robust evidence is lacking. Objective: To identify, appraise and synthesize evidence on the effectiveness of complex interventions targeting reduction in social vulnerability for improving health related outcomes (mortality, function, cognition, subjective health and healthcare use) in older adults living in the community. Methods: A mixed methods systematic review was conducted. Five databases and targeted grey literature were searched for primary studies of all study types according to predetermined criteria. Data were extracted from each distinct intervention and quality was assessed using the Mixed Methods Appraisal Tool. Effectiveness data were synthesized using vote counting by direction of effect, combining p values and Albatross plots. Results: Across 38 included studies, there were 34 distinct interventions categorized as strengthening social supports and communities, helping older adults and their caregivers navigate health and social services, enhancing neighbourhood and built environments, promoting education and providing economic stability. There was evidence to support positive influences on function, cognition, subjective health, and reduced hospital utilization. The evidence was mixed for non-hospital healthcare utilization and insufficient to determine effect on mortality. Conclusion: Despite high heterogeneity and varying quality of studies, attention to reducing an older adult’s social vulnerability assists in improving older adults’ health.
| Original language | English |
|---|---|
| Pages (from-to) | 447-465 |
| Number of pages | 19 |
| Journal | Clinical Interventions in Aging |
| Volume | 17 |
| DOIs | |
| Publication status | Published - 2022 |
Bibliographical note
Funding Information:The primary author’s graduate studies are supported by scholarships from the Pierre Elliot Trudeau Foundation, Dalhousie University's Department of Medicine’s Killam Postgraduate Medical Scholarship & University Internal Medicine Research Foundation Fellowship and Research Nova Scotia Scotia Scholars Award. The funders had no input to any aspect of the research conducted.
Funding Information:
KR is President and Chief Science Officer of DGI Clinical, which in the last five years has contracts with pharma and device manufacturers on individualized outcome measurement. In 2017 he attended an advisory board meeting with Lundbeck. Otherwise any personal fees are for invited guest lectures and academic symposia, received directly from event organizers, chiefly for presentations on frailty. He is Associate Director of the Canadian Consortium on Neurodegeneration in Aging, which is funded by the Canadian Institutes of Health Research, and with additional funding from the Alzheimer Society of Canada and several other charities, as well as, in its first phase (2013–2018), from Pfizer Canada and Sanofi Canada. He receives career support from the Dalhousie Medical Research Foundation as the Kathryn Allen Weldon Professor of Alzheimer Research, and research support from the Canadian Institutes of Health Research, the QEII Health Science Centre Foundation, the Capital Health Research Fund and the Fountain Family Innovation Fund of the QEII Health Science Centre Foundation. KR has asserted copyright of the Clinical Frailty Scale through Dalhousie University. Use is free for research, education or not-for-profit care (users are asked not to change it or charge for its use). MKA reports grants from Canadian Consortium on Neurodegeneration in Aging (CCNA), with funding from Canadian Institutes of Health Research (CIHR). MKA reports grant funding and honoraria from Sanofi, GSK, Pfizer and the Canadian Frailty Network for work relating to frailty and vaccine preventable illness. All other authors declare that they have no competing interests.
Funding Information:
The primary author?s graduate studies are supported by scholarships from the Pierre Elliot Trudeau Foundation, Dalhousie University's Department of Medicine?s Killam Postgraduate Medical Scholarship & University Internal Medicine Research Foundation Fellowship and Research Nova Scotia Scotia Scholars Award. The funders had no input to any aspect of the research conducted.
Publisher Copyright:
© 2022 Mah et al.
ASJC Scopus Subject Areas
- Geriatrics and Gerontology
PubMed: MeSH publication types
- Journal Article
- Review
- Systematic Review
