Social Determinants of Health for Older Adults with Dual Sensory Loss: A Scoping Review

Research Objectives: To synthesize the literature on the social determinants of health (SDH) for older adults with dual sensory loss (DSL) and identify knowledge gaps and experiences of health inequities. The World Health Organization (WHO) defines SDH as non-medical factors that impact health outcomes such as food insecurity, education, income, and social protection. DSL is a combination of varying degrees of hearing and vision loss, which affect an individual’s access to information, communication, mobility, and functional independence. Globally, around 150 million people, including 15 million in North America, experience some form of DSL. As the global population ages, understanding the link between SDH and health disparities in older adults is paramount to design rehabilitation programs catered to the needs of older adults with DSL.

Design: Using the Arksey and O’Malley five-stage scoping review framework, an extensive review of scientific and grey literature was conducted. Five scientific databases (Medline, Embase, CINAHL, PsycINFO, and Central) were systematically searched for the last ten years, with the last search updated in February 2024. Using the Covidence screening tool, articles were assessed at the title/abstract and full-text level. Studies were included if the studied population was older adults with DSL and if the article covered aspects related to SDH.

Setting: Global scientific and grey literature

Participants: Older adults with DSL

Interventions: Not applicable

Main Outcome Measures: Relationship between SDH and the experiences of older adults with DSL

Results: Out of the initial 81 articles screened, 37 met the inclusion criteria for the final review. Among the 10 SDH outlined by the WHO, income and social protection, education, housing, basic amenities, environment, access to affordable healthcare, and disability were commonly addressed in the studies. The findings revealed that older adults with DSL often had lower educational attainment, received increased care in long-term care settings, and faced heightened risks of developing additional health conditions and disabilities. Notably, the studies did not extensively analyze working conditions, food insecurity, structural conflict, or racial disparities among older adults with DSL.

Conclusions: The existing evidence literature linking SDH and DSL is limited. The review found that the experiences of each individual with DSL varied based on other SDH, leading to the intersectionality between each SDH. This review identified a significant knowledge gap and underscored the need for further research to develop a robust understanding of how inequities based on SDH influence health and rehabilitation outcomes for older adults with DSL.

Author(s) Disclosures: No conflicts to declare