Do Walking-Friendly Built Environments Influence Frailty and Long-Term Care Insurance Service Needs?

Our study examined the associations between neighborhood walkability, frailty, and the incidence of long-term care insurance (LTCI) service needs using a prospective cohort survey in a suburban town in Japan. The final sample for analyses comprised 2867 community-dwelling older adults (mean age: 73.0 years). Neighborhood walkability was measured using the Walk Score(R). A total of 387 participants (13.5%) exhibited frailty. The odds of frailty, adjusted for the covariates (sex, age, educational status, marital status, residential status, employment status, subjective economic status) among participants who lived in somewhat walkable/very walkable areas, was 0.750 (95% Confidence Interval, CI: 0.597-0.943) versus those who lived in car-dependent areas. During the 23-month follow-up, 102 participants needed LTCI services (19.0 per 1000 person-years), 41 of whom (21.0 per 1000 person-years) lived in car-dependent areas, and 61 of whom (17.9 per 1000 person-years) lived in somewhat walkable/very walkable areas. As compared with participants who lived in car-dependent areas, the incidence of LTCI service needs was not significantly lower than that of those who lived in somewhat walkable/very walkable areas. Walk Score(R) can provide the critical information for the strategies to improve walkability and prevent older adults' frailty in less walkable areas, contributing to achieving the United Nation's Sustainable Development Goals (SDGs).

Automated summary

The study found that there is a certain association between neighborhood walkability and frailty as well as the need for long-term care insurance services among older adults. Older adults living in walkable areas have lower frailty rates, but their incidence of needing LTCI services is not significantly lower compared to those living in car-dependent areas.