Cross-sectional and Longitudinal Associations of Environmental Factors with Frailty and Disability in Older People

Purpose: To determine cross-sectional and longitudinal associations of environmental factors with frailty and disability. Methods: This study was conducted in a sample of Dutch citizens. At baseline the sample consisted of 429 subjects (aged >= 65 years); a subset of this sample participated again two and half years later (N = 355). The participants completed a web-based questionnaire, the Senioren Barometer, comprising seven scales for assessing environmental factors, and the Tilburg Frailty Indicator (TFI) and the Groningen Activity Restriction Scale (GARS), for assessing frailty and disability, respectively. Environmental factors of interest were: nuisance; housing; facilities; residents; neighborhood; stench/noise; and traffic. Results: Sequential regression analyses demonstrated that all environmental factors together explained a significant part of the variance of physical and social frailty and disability in performing activities of daily living (ADL) and instrumental activities of daily living (IADL), measured at Time 1 (T1) and Time 2 (T2). These analyses also showed that four of the environmental factors were associated with at least one of the outcome measures: housing, nuisance, residents, and neighborhood. Housing was the only environmental factor associated with three different outcome measures (social frailty, ADL disability, IADL disability), assessed at T1 and T2. Conclusion: The findings offer health-care and welfare professionals and also policymakers starting points for interventions. These interventions should focus, in particular, on housing, nuisance, residents, and neighborhood, because their impact on frailty and/or disability was the largest.