Dataset Information

Neighborhood amenities and mobility in older adults.

ABSTRACT: Diversity of neighborhood amenities may promote the mobility of older adults. A 2010 community-based sample of 510 adults aged ?65 years in Philadelphia, Pennsylvania, and geospatial data from the Esri Business Analyst database (Esri, Inc., Redlands, California) were used to assess associations of neighborhood amenity diversity with mobility. Neighborhoods were defined by census tract, and diversity of amenities was derived by using the Leadership in Energy and Environmental Design's neighborhood development index (US Green Building Council, Washington, DC). Generalized estimating equations adjusted for demographic, socioeconomic, and neighborhood characteristics were used to estimate differences in mobility score by tertile of amenity diversity. Analyses were stratified by participants' routine travel habits (stayed at home, stayed in home zip code, or traveled beyond home zip code). We found that for those who spent most of their time in their home neighborhoods, mobility scores (from the Life-Space Assessment, which ranges from 0 to 104 points) were 8.3 points higher (95% confidence interval: 0.1, 16.6) among those who lived in neighborhoods with the most amenity diversity compared with those who lived in neighborhoods with the least amenity diversity. No significant associations between amenity diversity and mobility were observed for those who did not leave home or who regularly traveled outside their neighborhoods. Neighborhoods with a high diversity of amenities may be important promoters of mobility in older adults who do not routinely travel outside their neighborhoods.

SUBMITTER: Rosso AL

PROVIDER: S-EPMC3817453 | biostudies-literature | 2013 Sep

REPOSITORIES: biostudies-literature

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Neighborhood amenities and mobility in older adults.

Rosso Andrea L AL Grubesic Tony H TH Auchincloss Amy H AH Tabb Loni P LP Michael Yvonne L YL

American journal of epidemiology 20130510 5

Diversity of neighborhood amenities may promote the mobility of older adults. A 2010 community-based sample of 510 adults aged ≥65 years in Philadelphia, Pennsylvania, and geospatial data from the Esri Business Analyst database (Esri, Inc., Redlands, California) were used to assess associations of neighborhood amenity diversity with mobility. Neighborhoods were defined by census tract, and diversity of amenities was derived by using the Leadership in Energy and Environmental Design's neighborhoo ...[more]

PMID: 23666814

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Project description:ObjectivesTo determine the relationship between neighborhood-level socioeconomic characteristics, life-space mobility, and incident falls in community-dwelling older adults.DesignProspective, observational cohort study with a baseline in-home assessment and 6-month telephone follow-up.SettingCentral Alabama.ParticipantsCommunity-dwelling adults aged 65 and older recruited from a random sample of Medicare beneficiaries (N = 1,000).MeasurementsNeighborhood disadvantage was measured using a composite index derived from baseline neighborhood-level residential census tract socioeconomic variables. Data on individual-level socioeconomic characteristics, clinical variables, and life-space collected at baseline were included as covariates in a multivariate model using generalized estimating equations to assess the association with incident falls in the 6 months after baseline.ResultsOf the 940 participants who completed baseline and follow-up assessments, 126 (13%) reported one or more new falls in the 6 months after baseline. There was an independent nonlinear association between neighborhood disadvantage (according to increasing quartiles of disadvantage) and incident falls after adjusting for confounders: The lowest quartile served as reference; 2nd quartile odds ratio (OR) = 2.4, 95% confidence interval (CI) = 1.2-4.6; 3rd quartile OR = 1.9, 95% CI = 1.0-3.7; 4th quartile OR = 3.2, 95% CI = 1.7-6.0. Each 10-point decrement in life-space (OR = 1.2, 95% CI = 1.0-1.3) was associated with a higher risk of falls.ConclusionGreater neighborhood disadvantage was associated with greater risk of falls. Life-space also contributes separately to fall risk. Community-dwelling older adults in disadvantaged neighborhoods, particularly those with limited mobility, may benefit from a more-rigorous assessment of their fall risk by healthcare providers. Neighborhood level socioeconomic characteristics should also be an important consideration when identifying vulnerable populations that may benefit the most from fall prevention programs.

Project description:Aim: To determine the relevance of features located close to home and further away, our aim was to study associations between older adults' physical activity and self-reported neighborhood destinations and barriers to outdoor mobility categorized by presence and maximal distance from home. Methods: Cross-sectional analyses comprising men and women 79-94 years old (57%) living independently in Central Finland (n = 185). Self-reported physical activity was categorized into lower (?3 h moderate activity a week) and higher (?4 h moderate or intense activity a week) activity. Assisted by interviewers, participants located on an interactive map destinations perceived to facilitate and barriers perceived to hinder outdoor mobility in their neighborhood. Participants' home addresses were geolocated. Euclidean distances between home and reported locations were computed, and the maximal distance from home to neighborhood destinations and barriers, respectively, was categorized based using four common buffer distances, i.e., 250 m, 500 m, 750 m, and 1 km. Participants reporting destinations or barriers within and beyond the respective distance were compared with those reporting none. Results: About 80% of participants reported neighborhood destinations and 55% neighborhood barriers to outdoor mobility. Barriers were generally located closer to home than destinations [median 166 m (range 25 m-6.10 km) vs. 492 m (5 m-2.7 km)]. Logistic regression analyses adjusted for age, sex, and physical performance showed that neighborhood destinations increased the odds for higher physical activity when located beyond 500 m from home [OR 2.95, 95% confidence interval (CI) 1.02-8.54], but not when located solely within 500 m (OR 1.70, 95% CI 0.30-9.61), in comparison with when reporting no destinations. In contrast, neighborhood barriers decreased the odds for higher physical activity when solely located within 500 m (OR 0.31, 95% CI 0.14-0.72), but not when any barrier was located beyond 500 m (OR 0.96, 95% CI 0.23-3.99), compared with when reporting no barriers. Associations were similar for 250-m buffer distances, but not robust for 750-m and 1,000-m buffers because of lower prevalence. Conclusion: Neighborhood barriers to outdoor mobility located close to home were associated with lower physical activity of older adults, whereas barriers further away were not. Attractive destinations for outdoor mobility located further away from home correlated with higher physical activity, potentially by motivating one to go out and be physically active. Temporal relationships warrant further study.

Project description:ObjectivesCross-sectional studies have found some built environmental attributes to be associated with residents' lower levels of mobility (functional capacity to walk outside the home). However, less is known about what environmental attributes are related to mobility decline. This longitudinal study examined area-level associations of specific environmental attributes with mid-to-older aged adults' changes in walking mobility.MethodsData collected from 4,088 adults (aged 46-71 years at baseline) who participated in a cohort study in Brisbane, Australia were used. The outcome was the change in self-reported mobility score (SF-36) from 2013 to 2016, which were aggregated at the neighborhood (N = 156) and suburb (N = 99) levels, due to the known lack of sensitivity in SF-36 subscales to individual changes. Linear regression analysis examined associations of mobility change with seven environmental attributes measured at baseline (residential density, intersection density, land use mix, density of walking/bike paths, park density, bus stop density, density of social incivilities), adjusting for confounding variables.ResultsParticipants on average reported 4% of mobility decline during the 3-year study period. It was found that greater land use diversity was consistently associated with less decline in walking mobility, while greater density of social incivilities was associated with more decline in walking mobility. The latter finding was significant only at the neighborhood level. No consistent associations were observed for residential density, intersection density, density of walking/bike paths, park density, and bus stop density.DiscussionOur findings suggest that mid-to-older aged adults who live in areas with lower land use diversity and more social incivilities may be at risk of developing mobility limitations. Recommended policies to slow residents' mobility decline and to achieve aging in place include improving these environmental attributes where needed and advising older adults to relocate to safer, mixed-use neighborhoods.

Project description:BackgroundUnderstanding the factors that influence hospital mobility, especially in the context of a heightened focus on falls prevention, is needed to improve care.ObjectiveThis qualitative study uses a socioecological framework to explore factors that influence hospital mobility in older adults.DesignQualitative research PARTICIPANTS: Semi-structured interviews and focus groups were conducted with medically-ill hospitalized older adults (n = 19) and providers (hospitalists, nurses, and physical and occupational therapists (n = 48) at two hospitals associated with an academic health system.ApproachInterview and focus group guides included questions on perceived need for mobility, communication about mobility, hospital mobility culture, and awareness of patients' walking activity. Data were analyzed thematically and mapped onto the constructs of the socioecological model.Key resultsA consistent theme among patients and providers was that "mobility is medicine." Categories of factors reported to influence hospital walking activity included intrapersonal factors (patients' health status, fear of falls), interpersonal factors (patient-provider communication about mobility), organizational factors (clarity about provider roles and responsibilities, knowledge of safe patient handling, reliance on physical therapy for mobility), and environmental factors (falls as a never event, patient geographical locations on hospital units). Several of these factors were identified as potentially modifiable targets for intervention. Patients and providers offered recommendations for improving awareness of patient's ambulatory activity, assigning roles and responsibility for mobility, and enhancing education and communication between patients and providers across disciplines.ConclusionPatients and providers identified salient factors for future early mobility initiatives targeting hospitalized older adults. Consideration of these factors across all stages of intervention development and implementation will enhance impact and sustainability.

Dataset Information

Neighborhood amenities and mobility in older adults.

Publications

Neighborhood amenities and mobility in older adults.

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