Dataset Information

Social Vulnerability, Frailty, and Their Association With Mortality in Older Adults Living in Rural Tanzania.

ABSTRACT:

Background

Social vulnerability correlates with frailty and is associated with mortality and disability. However, few studies have investigated this relationship outside of high-income country settings. This study aimed to produce and analyze a culturally adapted social vulnerability index (SVI) to investigate the relationship between social vulnerability, frailty, and mortality in older adults in Tanzania.

Methods

An SVI was produced using data from a cohort study investigating frailty in older adults in Tanzania. Variables were selected based on previous SVI studies using the categories established by Andrew et al. from the Canadian Study of Health and Aging, and National Population Health Survey. The SVI distribution was examined and compared with a frailty index (FI) produced from the same sample, using mutually exclusive variables. Cox regression survival analysis was used to investigate the association between social vulnerability, frailty, and mortality.

Results

A stratified cohort of 235 individuals were included in the study at baseline, with a mean age of 75.2 (SD 11.5). Twenty-six participants died within the follow-up period, with a mean of 503 days (range: 405-568) following the initial assessment. The SVI had a median score of 0.47 (interquartile range: 0.23, range: 0.14-0.86). Social vulnerability significantly predicted mortality when adjusting for age and gender, but not when also adjusting for frailty.

Conclusions

Social vulnerability can be successfully operationalized and culturally adapted in Tanzania. Social vulnerability is associated with mortality in Tanzania, but not independently of frailty.

SUBMITTER: Cooper F

PROVIDER: S-EPMC9536438 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Publications

Social Vulnerability, Frailty, and Their Association With Mortality in Older Adults Living in Rural Tanzania.

Cooper Fiona F Lewis Emma Grace EG Urasa Sarah S Whitton Louise L Collin Harry H Coles Selina S Wood Greta Karen GK Ali Ali Mohamed AM Mdegella Deborah D Mkodo Joyce J Zerd Francis F Dotchin Catherine C Gray William K WK Walker Richard W RW

The journals of gerontology. Series A, Biological sciences and medical sciences 20221001 10

<h4>Background</h4>Social vulnerability correlates with frailty and is associated with mortality and disability. However, few studies have investigated this relationship outside of high-income country settings. This study aimed to produce and analyze a culturally adapted social vulnerability index (SVI) to investigate the relationship between social vulnerability, frailty, and mortality in older adults in Tanzania.<h4>Methods</h4>An SVI was produced using data from a cohort study investigating f ...[more]

PMID: 35291011

Similar Datasets

Project description:BackgroundSocial vulnerability is related to the health of elderly people, but its measurement and relationship to frailty are controversial. The aims of the present study were to operationalize social vulnerability according to a deficit accumulation approach, to compare social vulnerability and frailty, and to study social vulnerability in relation to mortality.Methods and findingsThis is a secondary analysis of community-dwelling elderly people in two cohort studies, the Canadian Study of Health and Aging (CSHA, 1996/7-2001/2; N = 3707) and the National Population Health Survey (NPHS, 1994-2002; N = 2648). Social vulnerability index measures that used self-reported items (23 in NPHS, 40 in CSHA) were constructed. Each measure ranges from 0 (no vulnerability) to 1 (maximum vulnerability). The primary outcome measure was mortality over five (CHSA) or eight (NPHS) years. Associations with age, sex, and frailty (as measured by an analogously constructed frailty index) were also studied. All individuals had some degree of social vulnerability. Women had higher social vulnerability than men, and vulnerability increased with age. Frailty and social vulnerability were moderately correlated. Adjusting for age, sex, and frailty, each additional social 'deficit' was associated with an increased odds of mortality (5 years in CSHA, odds ratio = 1.05, 95% confidence interval: 1.02-1.07; 8 years in the NPHS, odds ratio = 1.08, 95% confidence interval: 1.03-1.14). We identified a meaningful survival gradient across quartiles of social vulnerability, and although women had better survival than men, survival for women with high social vulnerability was equivalent to that of men with low vulnerability.ConclusionsSocial vulnerability is reproducibly related to individual frailty/fitness, but distinct from it. Greater social vulnerability is associated with mortality in older adults. Further study on the measurement and operationalization of social vulnerability, and of its relationships to other important health outcomes, is warranted.

Project description:BackgroundSocial frailty, a multidimensional construct encompassing various social behaviors, resources, and needs, significantly impacts cognitive health in older adults. Despite existing studies linking specific social factors to cognitive function, the association between social frailty and long-term cognitive trajectories remains underexplored. This study aims to evaluate the longitudinal association between social frailty and trajectory of cognitive function in dementia-free older adults.MethodsThis prospective cohort study used data from the National Health and Aging Trends Study (NHATS). Social frailty was assessed using the Makizako Social Frailty Index. According to the presence of social components, individuals were categorized into social frailty (≥ 2), pre-social frailty (1), and robust (0), respectively. Cognitive function was annually evaluated through memory, orientation, and executive function tests from 2011 to 2018. Mixed-effects linear models were employed to assess the associations between social frailty and changes in global and domain-specific cognitive function, adjusting for relevant covariates.ResultsIn this study, 4956 dementia-free older adults (mean age 76.57 [7.41]) with complete at least 2 times of cognitive tests were included. Compared with the robust, social frailty was associated with significantly faster decline in global cognitive function (β = -0.041, 95% CI [-0.047, -0.036] z score per year) and domain-specific cognitive function (βmemory = -0.045, 95% CI [-0.055, -0.036] z score per year; βorientation = -0.027, 95% CI [-0.034, -0.020] z score per year; βexecutive = -0.042, 95% CI [-0.053, -0.032] z score per year) over the follow-up. Additionally, pre social frailty was associated with significantly faster decline in global cognitive function (β = -0.016, 95% CI [-0.021, -0.012] z score per year), memory function (β= -0.045, 95% CI [-0.055, -0.036] z score per year), and orientation function (β= -0.027, 95% CI [-0.034, -0.020] z score per year) over the follow-up.ConclusionsSocial frailty is associated with faster decline in cognition in older adults, underscoring the necessity for enhanced social support and engagement to mitigate cognitive deterioration in vulnerable populations.

Dataset Information

Social Vulnerability, Frailty, and Their Association With Mortality in Older Adults Living in Rural Tanzania.

Background

Methods

Results

Conclusions

Publications

Social Vulnerability, Frailty, and Their Association With Mortality in Older Adults Living in Rural Tanzania.

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