Pilot study of social and structural determinants of health (SSDOH) measures in the UPENN Alzheimer’s disease research center

Abstract

Background
To mitigate health and healthcare disparities in Alzheimer’s disease and Alzheimer’s disease related dementias (AD/ADRD) research and care, scientists must be able to characterize and measure social and structural determinants of health (SSDoH) that may help explain heterogeneity in cognitive, functional, and interventional outcomes in AD/ADRD.

Method
Participants (n = 70) were members of the UPENN ADRC clinical cohort with unimpaired cognition who completed the SSDoH measures via an online survey. SSDoH measures were chosen based on content and psychometric properties. Self‐report measures are in the following categories: (1) Education, (2) Occupation, (3) Economic Status and Strain, (4) Stressors and Subjective Stress, (6) Subjective Social Support and Status, and (7) Sociodemographic data, which included self‐report of age, race, language, disability, neighborhood, sex, sexual orientation, and gender identity questions.

Result
Results describe piloting the measures, the gaps and strengths of measures, and plans for future collection and analysis. The response rate was 74% (52 out of 70 participants started the survey). Most participants completed the survey within 25 to 30 minutes. Most participants reported being satisfied with the battery, and a few reached out to ADRC staff to express interest in volunteering additional data. Some revision to the longitudinal record of neighborhoods was needed.

Conclusion
A multidomain battery of SSDoH measures was feasible to implement in the UPENN ADRC clinical cohort. Routine collection of SSDoH may help researchers better understand factors that create disparities in AD/ADRD outcomes and develop interventions to mitigate them.