Scoping study of definitions of and instruments measuring vulnerability in older adults: Toward research, policy and practice fostering social participation and health equity

Abstract

Abstract: It is important to foster social participation and health equity especially for older adults in situations of vulnerability Despite growing interest in the concept of vulnerability there is no consensus regarding how to define or measure it This paper provides an inventory and synthesis of definitions and instruments measuring vulnerability in older adults Using a scoping study framework eight databases Abstracts in Social Gerontology Academic Search Complete AgeLine CINAHL MEDLINE SocINDEX PsycInfo Scopus were searched with relevant keywords Vulnerab AND Concept Defin Meaning Terminology Measurement Assessment Indicator Instrument Scale Questionnaire OR Test AND Aging Ageing Elder Gerontolog Older OR Senior Thirty-one original definitions and five measurement instruments were identified content-analyzed and compared Vulnerability definitions mostly focused on people under conditions that increased their risk of being harmed because of individual physical factors or the social environment Considering these definitions experts in the field of aging including two representing older adults took part in a workshop and a consensus was reached to define a situation of vulnerability as a set of circumstances in which one or more individuals experience at a specific moment in time one or multiple physiological psychological socioeconomic or social difficulties that may interact to increase their risk of being harmed or having coping problems that lead to negative consequences on their life Although none of the measures fully targeted this definition the Perceived Vulnerability Scale PVS was judged best at operationalizing the concept with 22 items considering feelings of vulnerability toward personal and environmental factors it also has good psychometric properties The proposed definition and the PVS help to provide a common language and measure in health and social sciences research policy and practice identifying and reaching older adults in situations of vulnerability and intervening to foster social participation and health equity.