Repeated Administration of Social and Structural Determinants of Health (SSDOH) Questions in an Alzheimer's Disease Research Center: The Aging Brain Study (ABC) Life Experience Survey.

Social and structural determinants of health (SSDOH) must be measured longitudinally to understand how lived experiences shape trajectories of Alzheimer's disease and related dementias (ADRD). This study evaluated the feasibility of administering an SSDOH survey to cognitively unimpaired older adults, examining response consistency, changes over time, and missing data patterns. A follow-up survey was conducted with participants in the UPenn Alzheimer's Disease Research Center clinical cohort an average of 1.7 years after the initial survey. The 225-item questionnaire covered domains including education, social networks, and stressors. At follow-up, markers of feasibility included a 60% completion rate (81 of 135 participants), high item completion (>93%), and minimal missing data (<3% missed more than 10% of data). Logistic regression identified gender, social network size, and social readjustment experiences as predictors of nonrandom missingness. Response changes between administrations were likely due to ambiguity in item phrasing, instructions, or changes in participants' experiences. Overall, repeated administration of the SSDOH survey was feasible. The response rate was reasonable but lower than expected for a volunteer research sample, suggesting multiple modes of completion may increase engagement. Repeated administration also helped identify ambiguous items and methods for improving the validity and reliability of SSDOH measures.