Project 460538

We know that an individual's health conditions (aka "frailty") can independently determine health outcomes and utilization of health resources in patients with dementia. However, you can also predict an individual's health by looking at their social determinants of health. For example, people who are lonely or socially isolated, who have lower educational attainment or who have poorer socioeconomic status have worse health outcomes than those who are in those ways more fortunate. The term is called "social vulnerability". Social vulnerability is particularly relevant in the elderly population with cognitive impairment, who experience shrinking support groups, poorer health preventing social participation, and an ever- increasing need to rely on the health system. Social vulnerability is not only an important risk factor that contributes to poor health, but it can also have great practical relevance when organizing care services for patients and caregivers living with dementia. How best to understand the social factors that contribute to the health of individuals and groups can present a challenge for researchers and clinicians because social circumstances are complex and do not fit well within traditional medical models of disease-specific silos of care. There is a great need to better understand and measure how social circumstances relate to health and frailty, and how they contribute to vulnerability in outpatient settings. This is the heart of the issue that we propose to address. First, this project will address how social vulnerability influences the health outcomes (e.g. mortality, functional decline, hospitalization) of older adults living in the community with dementia. Second, this project will examine how social vulnerability influences use of home care resources and services. Finally, this study will comment on the societal implications and policy relevance of social vulnerability for community dwelling older adults with dementia.