Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr-Jun;36(2):97-102.
doi: 10.1097/WAD.0000000000000505. Epub 2022 Apr 6.

Development of a Comprehensive Battery to Collect Social and Structural Determinants of Health (SSDOH) in Cognitively Normal or Very Mildly Impaired Persons

Marissa L Streitz  1 , Andrea Denny  1 , Chengjie Xiong  2 , Lena McCue  2 , Shana D Stites  3 , Sharnita Midgett  4 , Dawn Mechanic-Hamilton  5 , Krista L Moulder  1 , John C Morris  1 , Joyce Balls-Berry  1
Affiliations

Development of a Comprehensive Battery to Collect Social and Structural Determinants of Health (SSDOH) in Cognitively Normal or Very Mildly Impaired Persons

Marissa L Streitz et al. Alzheimer Dis Assoc Disord. 2022 Apr-Jun.

Abstract

Introduction: Research addressing Alzheimer disease and related dementias must examine nonbiological factors influencing the risk for and expression of Alzheimer disease and related dementias. These factors address the interplay of cognition with lived experiences and social and structural determinants of health (SSDOH). However, coordinated measures of SSDOH are limited.

Methods: The Knight Alzheimer Disease Research Center (ADRC) at Washington University in St. Louis developed and piloted a comprehensive battery to measure SSDOH. One hundred and twelve participants, very mildly cognitively impaired or unimpaired, enrolled in memory studies completed the electronic SSDOH battery. The Clinical Dementia Rating (CDR) determined the presence or absence of cognitive impairment.

Results: Four domains demonstrated above acceptable intraclass correlation scores for test-retest reliability (≥0.70), including adverse childhood events, discrimination, social status, and early education. Twenty very mildly impaired participants completed the electronic pilot study.

Conclusion: Our findings indicate that participants with early-stage symptomatic Alzheimer disease are able to participate in electronic SSDOH data collection. In collaboration with the University of Pennsylvania ADRC, we replaced/modified certain assessments to increase intraclass correlation. The resulting battery, Social and Structural Life-courses Influencing Aging and Dementia (SS-DIAD), can serve as a SSDOH collection tool and is currently utilized in cognitively impaired and unimpaired research participants at both ADRCs.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Wilkins CH, Schindler SE, Morris JC. Addressing Health Disparities Among Minority Populations: Why Clinical Trial Recruitment Is Not Enough. JAMA Neurol. 2020;77(9):1063–1064. - PMC - PubMed
    1. Schwartz BS, Glass TA, Bolla KI, et al. Disparities in cognitive functioning by race/ethnicity in the Baltimore Memory Study. Environ Health Perspect. 2004;112(3):314–320. - PMC - PubMed
    1. Clarke PJ, Weuve J, Barnes L, Evans DA, Mendes de Leon CF. Cognitive decline and the neighborhood environment. Ann Epidemiol. 2015;25(11):849–854. - PMC - PubMed
    1. Marmot M, Friel S, Bell R, Houweling TA, Taylor S, Commission on Social Determinants of H. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008;372(9650):1661–1669. - PubMed
    1. Barnes LL, Bennett DA. Alzheimer's disease in African Americans: risk factors and challenges for the future. Health Aff (Millwood). 2014;33(4):580–586. - PMC - PubMed

Publication types