Here is a copy of my answer at MathStackExchange.
Almost nobody does this. There is a discussion in the Wikipedia article on spinor groups but it has too many mistakes and too few references. The only solid math reference (with a proof that I am not going to reproduce here) I know is in Chapter 5 (freely available from author's webpage here) in
Varadarajan, V. S., Supersymmetry for mathematicians: an introduction., Courant Lecture Notes in Mathematics 11. Providence, RI: American Mathematical Society (AMS); New York, NY: Courant Institute of Mathematical Sciences (ISBN 0-8218-3574-2/pbk). vi, 300 p. (2004). ZBL1142.58009.
It is useful if you read this answer in conjunction with my answer here.
To describe $Spin(p,q)$ as a 2-fold cover of $SO^+(p,q)$ ($p>1, q>1$) one has to look at the maximal compact subgroups since they carry all the homotopy information. The group $SO^+(p,q)$ has maximal compact subgroup $SO(p)\times SO(q)$ and
$$
\pi_1(SO^+(p,q))\cong \pi_1(SO(p)\times SO(q))\cong H_1\times H_2,
$$
where $H_1, H_2$ are cyclic groups (either infinite cyclic or ${\mathbb Z}_2$). In particular, if $h_1, h_2$ are generators of $H_1, H_2$, then there is a homomorphism
$$
\phi: H_1\times H_2\to {\mathbb Z}_2,
$$
sending both $h_1, h_2$ to the generator of ${\mathbb Z}_2$. It is clear that these homomorphisms are independent of the choices of generators. Let $H< H_1\times H_2$ denote the kernel of $\phi$, it is an index 2 subgroup in $\pi_1(SO(p)\times SO(q)\cong \pi_1(SO^+(p,q))$. Then $Spin(p,q)$ is the 2-fold cover of $SO^+(p,q)$ associated with the subgroup $H$ of the fundamental group. This is your topological description of the spinor group.
In Varadarajan's terminology, here is what's going on. The (unique up to conjugation) maximal compact subgroup of $Spin(p,q)$ is $(Spin(p)\times Spin(q))/G$, where $G\cong {\mathbb Z}_2$ is generated by an element $(a,b)\in Spin(p)\times Spin(q)$, where $a, b$ are the nontrivial central elements of $Spin(p), Spin(q)$ respectively, such that
$$
Spin(p)/\langle a\rangle = SO(p), Spin(q)/\langle b\rangle = SO(q).
$$
Hence, $(a,b)$ corresponds to the "diagonal" element $(h_1, h_2)$ of $H_1\times H_2$. Varadarajan proves in his book that the "usual" Clifford algebra definition of the spinor groups is equivalent to the one above.