Validating Community for Successful Ageing (ComSA) BioPsychoSocial Risk Screener Version II (BPS-RS II) with Diverse Multi-Ethnic Senior Populations in Singapore: A Mixed-Methods Study.

BACKGROUND

Accurately assessing biopsychosocial risk and vulnerability are the building blocks for better interventions and tailoring care for older people.

METHODS

Building on the previously published Community for Successful Ageing (ComSA) BioPsychoSocial Risk Version I Screener (BPS-RS I), we report a re-specified version (BPS-RS II) derived from interviews with older people (n = 40) in Singapore. A cross-sectional survey (n = 1,107) and Factor Analysis (FA) were used to identify items for BPS-RS II. Associations with health-related and quality of life (QoL) and comparisons to Version I were examined.

RESULTS

Fourteen questions generated from the qualitative findings clustered above the stipulated Kaiser-Meyer-Olkin (KMO) value of greater than 0.5. FA retained the BPS three factor structure. Items in the B domain were largely consistent with Version I, though new items in the P and S domains were identified. Adjusted multi-variate regression analyses replicated additive dose response effects found in BPS-RS I, with smoother gradients and narrower Confidence Intervals (CIs). Stronger associations with Length of Hospital Stay and QoL were detected in BPS-RS II compared to BPS-RS I for participants with BPS risk consisting of having 'overwhelming problems'. The relationship between this category and poor QoL was particularly evident (OR of 39.20, 95% CI: 37.73-40.66, p < 0.01) compared to no BPS risk.

CONCLUSIONS

Using BPS-RS II over I is recommended for biopsychosocial risk assessment and stratifying older people to interventions for population health management. The updated tool is theory-based, culturally sensitive to multi-ethnic contexts in Singapore, and shows improved associations with health-related outcomes, and strong associations with QoL.