4.5 Article

Objective and subjective measures of the neighbourhood environment: Associations with frailty levels

Journal

ARCHIVES OF GERONTOLOGY AND GERIATRICS
Volume 92, Issue -, Pages -

Publisher

ELSEVIER IRELAND LTD
DOI: 10.1016/j.archger.2020.104257

Keywords

Built environment; Frailty scale; Neighbourhood environment; Physical activity; Geographical information systems

Funding

  1. Resthaven GTRAC Research Grant Scheme
  2. National Health and Medical Research Council Postgraduate Research Scholarship (2017-2018)
  3. Joint PhD Program, Beacon of Enlightenment Scholarship, University of Adelaide
  4. Hospital Research Foundation Mid-Career Research Fellowship
  5. National Health and Medical Research Council Centre of Research Excellence Scheme [APP 1102208]

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The study found that frailty in older adults is associated with neighborhood characteristics such as residential density, traffic safety, green cover, and crime rate. Strategies to address frailty should consider the impact of the neighborhood environment.
Objectives: The aim of this study was to investigate whether perceptions of the neighbourhood environment (NE) and objective measures of the NE were associated with frailty in older adults. Methods: A cross-sectional study in Adelaide, Australia, recruited a sample of 115 community-dwelling adults aged >= 60 years. Respondents' perceptions of their NEs were assessed using the Neighbourhood Environment Walkability Scale (NEWS). An objective assessment of these NEWS survey questions was conducted using seven variables: residential density, land use mix diversity, street connectivity, accessibility, seasonal persistent green cover, road crash density and crime rate. Frailty was evaluated using the FRAIL (fatigue, resistance, ambulation, illnesses and loss of weight) scale. Multivariable linear regression analyses were employed to assess the associations between NEWS and frailty, and to assess the associations between objective neighbourhood variables and frailty. Results: Frail and pre-frail older adults were more likely to live in areas with lower residential density, lower density of road crashes, and higher accessibility than robust participants. Additionally, a poorer perception of the overall environment, worse land-use mix and accessibility and worse crime safety were associated with frailty and pre-frailty after adjustment of covariates and objective GIS variables. Discussion: Neighbourhood characteristics, both objective and perceived, are associated with frailty levels in older adults, and that strategies to tackle frailty must consider the impact of the neighbourhood environment.

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