Built urban environment and functional incapacity: Enabling healthy aging

Background: This study aimed to assess the associations among neighborhood walkability and functional disability in older adults. Methods: The study included a community-based, random sample of 410 community-dwelling adults aged >= 60 years old in Vicosa, Minas Gerais, Brazil. The dependent variable was functional disability, which was assessed by investigating the difficulty in performing or the requirement of help to perform the activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Older adults with functional disability were those who reported difficulty in performing six or more activities or a complete inability to perform at least three activities. The environmental are also evaluated. Confounding variables were selected using directed acyclic graphs, and multilevel logistic regression models were used to test the associations between the variables. Results: Older adults living in areas with higher walkability had lower odds ratios for functional disability, even after adjustment for possible confounding variables. Conclusions: While additional research is required to evaluate these neighborhood features in more detail and determine the causality, promoting simple changes in the built environment may be more effective in minimizing disability as the population ages than the efforts to change risk factors at the individual level.