Do Community Social Capital and Built Environment Associate With Homebound in Older Adults? The JAGES Niigata Study

Background: Homebound status is one of the most important risk factors associated with functional decline and long-term care in older adults. Studies show that neighborhood built environment and community social capital may be related to homebound status. This study aimed to clarify the association between homebound status for community-dwelling older adults and community environment-including social capital and neighborhood built environment-in rural and urban areas. Methods: We surveyed people aged 65 years and older residing in three municipalities of Niigata Prefecture, Japan, who were not certified as requiring long-term care. The dependent variable was homebound status; explanatory variables were communitylevel social capital and neighborhood built environment. Covariates were age, sex, household, marital status, socioeconomic status, instrumental activities of daily living, the Geriatric Depression Scale-15, self-rated health, number of diseases under care, and individual social capital. The association between community social capital or neighborhood built environment and homebound status, stratified by rural=urban areas, was investigated using multilevel logistic regression analysis. Results: Among older adults (n = 18,099), the homebound status prevalence rate was 6.9% in rural areas and 4.2% in urban areas. The multilevel analysis showed that, in rural areas, fewer older adults were homebound in communities with higher civic participation and with suitable parks or pavements for walking and exercising. However, no significant association was found between community social capital or neighborhood built environment and homebound status for urban older adults. Conclusion: Community social capital and neighborhood built environment were significantly associated with homebound status in older adults in rural areas.

Automated summary

This study aimed to investigate the association between community social capital, neighborhood built environment, and homebound status in community-dwelling older adults in rural and urban areas. The results showed that in rural areas, higher civic participation and suitable parks or pavements were associated with fewer homebound older adults. However, no significant association was found in urban areas.