Modeling Age-Friendly Environment, Active Aging, and Social Connectedness in an Emerging Asian Economy

Examining dynamic developmental trends: the interrelationship between age-friendly environments and healthy aging in the Chinese population-evidence from China Health and Retirement Longitudinal Study, 2011-2018

BACKGROUND

The objective of this research is to investigate the dynamic developmental trends between Age-Friendly Environments (AFE) and healthy aging in the Chinese population.

METHODS

This study focused on a sample of 11,770 participants from the CHARLS and utilized the ATHLOS Healthy Aging Index to assess the level of healthy aging among the Chinese population. Linear mixed model (LMM) was used to explore the relationship between AFE and healthy aging. Furthermore, a cross-lagged panel model (CLPM) and a random-intercept cross-lagged panel model (RI-CLPM) were used to examine the dynamic developmental trends of healthy aging, taking into account both Between-Person effects and Within-Person effects.

RESULTS

The results from LMM showed a positive correlation between AFE and healthy aging (β = 0.087, p < 0.001). There was a positive interaction between the geographic distribution and AFE (central region * AFE: β = 0.031, p = 0.038; eastern region * AFE: β = 0.048, p = 0.003). In CLPM and RI-CLPM, the positive effect of healthy aging on AFE is a type of Between-Person effects (β ranges from 0.147 to 0.159, p < 0.001), while the positive effect of AFE on healthy aging is Within-Person effects (β ranges from 0.021 to 0.024, p = 0.004).

CONCLUSION

Firstly, individuals with high levels of healthy aging are more inclined to actively participate in the development of appropriate AFE compared to those with low levels of healthy aging. Furthermore, by encouraging and guiding individuals to engage in activities that contribute to building appropriate AFE, can elevate their AFE levels beyond the previous average level, thereby improving their future healthy aging levels. Lastly, addressing vulnerable groups by reducing disparities and meeting their health needs effectively is crucial for fostering healthy aging in these populations.

The impact of the built environment on loneliness: A systematic review and narrative synthesis

Loneliness is a pressing public health issue. Although quintessentially individual, it is shaped by wider environmental, cultural, socio-economic, and political circumstances. Using a systematic review methodology, this paper draws on interdisciplinary research to conceptualise the relationship between the built environment and loneliness. We present a narrative synthesis of 57 relevant studies to characterise the body of evidence and highlight specific built-environment elements. Our findings demonstrate the need for further conceptual and empirical explorations of the multifaceted ways in which built environments can prevent loneliness, supporting calls for investment into this public-health approach.

How does neighbourhood environment influence loneliness in later life in Urban China? The role of financial status

This study aimed to examine whether older adults' financial status moderated the association between neighbourhood environment (i.e. physical and social environment) and loneliness among older adults in urban China. A cross-sectional survey was collected from urban communities of Shanghai in mid-2020. The final analytic sample was 459 older adults (age range = 60-91 years; proportion of women: 55.8%). Multiple group analysis was applied to test the hypothesised model. A measurement model of community social capital (i.e. cognitive and structural dimensions of social capital), a crucial indicator of neighbourhood social environment, was first established in both high-income and low-income groups. Factor loading invariance was established in these two groups. The results show that structural social capital (i.e. organisation memberships, volunteering, social participation and citizenship activities) was negatively associated with loneliness among older respondents from the high-income group only, whereas better community security was significantly associated with lower levels of loneliness among low-income older respondents only. The findings imply that both structural social capital and household income should be considered as important indicators in needs assessment among lonely older adults. Future social policies and interventions should pay attention to enhancing the role of both social and physical neighbourhood environment among older adults.

A Meta-Analysis on the Influence of Age-Friendly Environments on Older Adults' Physical and Mental Well-Being

The importance of age-friendly environments (AFEs) for older adults has been empirically and theoretically highlighted by the extant literature. However, the strength of the association between environments and older adults’ well-being has not been comprehensively quantified. Given the different attributes of the physical and mental dimensions, this meta-analysis aims to synthesise and quantify the association between AFEs and the physical and mental well-being of older adults. Fourteen eligible studies were included in this analysis: among which eight explored the link between AFEs and physical well-being, and eleven investigated AFEs in association with mental well-being. A random-effects model showed a small but significant correlation between AFEs and the mental well-being of older adults (r = 0.160, 95% CI [0.084, 0.224], p < 0.001), and the correlation between AFEs and physical well-being was also significant (r = 0.072, 95% CI [0.026, 0.118], p < 0.01). The number of environmental factors involved in AFEs moderated the association with physical well-being, from which the association was only significant among studies focusing on fewer environmental factors (n < 6). Results of this meta-analysis indicated that AFEs may be more effective in promoting the emotions of older adults, compared to ameliorating their physical functioning. The limitations of current empirical studies and directions for future research in the field of environmental gerontology were also discussed.

Assessment of Environmental Demands of Age-Friendly Communities from Perspectives of Different Residential Groups: A Case of Wuhan, China

Age-friendly communities (AFCs) are an important measure for fostering active aging. The key to achieving an age-friendly living environment is to construct or renovate it according to the residents’ demands. To date, very few studies have attempted to delve into the AFCs’ environmental demand from different groups’ perspectives. Based on the theory of place attachment, the aim of this paper is to explore the demand diversity of different groups for the AFC environment. This study employs the nonparametric test and the Ordinal Priority Approach (OPA) to investigate the demands from the residents’ perspectives, and is enhanced by incorporating experts’ opinions. The empirical analysis shows that residents have a high level of demand for the physical environment (indoor and outdoor) and social environment (community services and social participation). At the same time, experts advocate the importance of using digital technologies to support people aged 45–65 who have higher requirements for a community environment than older adults. The findings also show that other backgrounds, such as gender, living arrangements, and year of the community establishment, lead to different demands. However, the impact of residents’ education level, occupation, income, and self-care ability on the environmental demands is low. Based on the research findings, the paper provides some practical suggestions for the future design and development of AFCs.

Voronoi Diagrams for Senior-Friendly Cities

Motives: Active aging places (AAP) should be identified during the COVID-19 pandemic to ensure the sanitary safety of seniors, prevent older adults from feeling excluded, and eliminate health threats that discourage seniors from being active. Aim: The aim of this study was to apply a new analytical approach with the use of Voronoi diagrams in GIS tools to spatially identify the AAP in the context of apparent social dynamics. Methods: An empirical study was conducted with the use of qualitative (literature review, questionnaire survey, AAP classification, visualization of AAP location with GIS tools) and quantitative methods (AAP ranking based on a statistical analysis of survey responses). Results: Voronoi diagrams were used to determine the accessibility of selected objects in the city of Olsztyn and identify spaces that belong to the social logic of space.

Impacts of biophilic design on the development of gerotranscendence and the Profile of Mood States during the COVID-19 pandemic

To live in a good mood is not only a key consideration for future age-friendly communities, but also a critical necessity for positive ageing. Despite growing evidence of correlations between contact with nature and stress reduction, little is known about the effect of nature integration in indoor environments. Thus, this study aimed to answer the following research questions: (a) How do biophilic characteristics of home environments correlate with older adults’ experience of the multiple levels of the theory of gerotranscendence? and (b) What is the relationship between these experiences and the mood states of these older adults? The study was based on a comparative analysis to scrutinise the impact of the COVID-19 pandemic on these questions. The data were gathered through questionnaires with 450 older adults aged between 65 and 95 years, and stratified by the biophilic characteristics of their living environments: indoor biophilic, outdoor biophilic and non-biophilic. Two sets of data were collected with the same participants, respectively, before the COVID-19 pandemic (June to October 2018) and during the COVID-19 pandemic (June to October 2020). It found that the biophilic characteristics of home environments are correlated dynamically with older adults’ ageing experience and mood states. The study indicates that outdoor biophilic features facilitate the recovery of tension mood effects of the COVID-19 pandemic, whereas indoor biophilic features facilitate recovery from depression and anger.

Modelling age-friendly environment for social connectedness: a cross-sectional study

Background: The increase in aged populations in Malaysia has brought unprecedented challenges to families, policy makers, scholars, and business organisations.  This paper adapted the WHO 2007 framework of features of age-friendly cities to examine age-friendly environment constructs and their linkages with social connectedness from the perspective of Malaysian middle-aged and older adults caring for themselves.

Methods: A face-to-face cross-sectional survey was conducted on 402 middle-aged and older adults caring for themselves across selected states in west Malaysia, selected via purposive sampling. Firstly, features of age-friendly cities were explored through exploratory factor analysis involving 82 respondents. Subsequently, structural equation modelling was performed, involving 320 respondents.

Results: The results indicated that the constructs of an age-friendly environment were built environment, community support and health services, civic participation, and employment as well as communication and information. The structural model provided evidence that implementing age-friendly initiatives relating to built environment, community support and health services, civic participation and employment as well as communication and information enables the ageing population to improve their connectedness with society. These findings supported the ecological theories, agreeing that age-friendly environments help middle-aged and older adults caring for themselves to increase their adaptability and reduce perceived pressure from the environment. This result was in line with the current literature in which an age-friendly environment is a form of support and an enabling environment to cultivate positive social relationships and connectivity.

Conclusions: Creating an age-friendly environment that supports active and healthy living for middle-aged and older adults caring for themselves allows them to continue to share their experiences, knowledge, and wisdom. This is helpful and beneficial for societal well-being and economic development as well as for the future generations.

A Study on Supply-Demand Satisfaction of Community-Based Senior Care Combined with the Psychological Perception of the Elderly

Based on Maslow’s hierarchy of needs theory and customer satisfaction theory, we constructed a satisfaction model for supply–demand satisfaction for community-based senior care (SSCSC) combined with the psychological perspective of the elderly, and four dimensions of basic living needs (BLNs), living environment (LE), personal traits (PTs), and livability for the aged (LA) were selected to construct the model. The data were obtained from 296 questionnaires from seniors over 50 years old (or completed by relatives on their behalf, according to their actual situation). Twenty-two observed variables were selected for the five latent variables, and their interactions were explored using structural equation modeling. The results showed that LA was the most significant factor influencing SSCSC, and it was followed by BLNs and LE. PTs did not show a direct effect on LA, but they could have an indirect effect on SSCSC through influencing BLNs and LE. Based on the current state of community aging satisfaction, we propose to establish a community elderly care service system based on the basic needs of the elderly population, providing differentiated and refined elderly care services and improving the level of aging-friendly communities. This study provides references for the government to formulate relevant policies and other supply entities to make strategic decisions and has important implications for further enhancing community elderly services to become an important part of the social security system for the elderly.

Social network moderators of the association between Ghanaian older adults' neighbourhood walkability and social activity

This study examined the moderating influences of active social networks (ASN), sedentary social networks (SSN) and ASN lost on the relationship between neighbourhood walkability and social activity in community-dwelling older adults aged 60 years or more in Accra, Ghana. A total of 863 individuals participated after G*Power 3.1 was utilized to calculate the minimum sample size. We analysed the data with Pearson's correlation test and hierarchical linear regression models. A sensitivity analysis was conducted to select the ultimate confounding variables. The study found a positive influence of neighbourhood walkability on social activity after the covariate adjustment (β = 0.18; t = 5.2; p = 0.000). The positive influence of neighbourhood walkability on social activity was significantly reduced by ASN lost and SSN. ASN did not have a significant moderating influence on the primary relationship. The study concludes that the positive influence of walkable neighbourhoods on social activity decreases as SSN and ASN lost increase.

The Impacts of the Neighborhood Built Environment on Social Capital for Middle-Aged and Elderly Koreans

The purpose of this study was to investigate the relationship between the neighborhood built environment (NBE) aspects of age-friendly cities and communities (AFCCs) and social capital in the Korean context. We described and compared age differences when analyzing misfits of AFCC NBE and impacts on social capital. We collected the data (N = 1246) from two Korean communities; our multiple and binary logistic regression outcomes show that AFCC NBE aspects such as outdoor spaces, transportation, and housing are significant predictors of different subcategories of social capital. For the older group, the outdoor spaces misfit was significant for all three subcategories of social capital, but transportation and housing misfits were significant for the social trust and reciprocity index scores. For the middle-aged group, the outdoor spaces misfit was significant for social networking and participation, and a transportation misfit was significant for participation and social trust and reciprocity. Fewer misfits or better fits of outdoor spaces and transportation encouraged more networking, participation, social trust, and reciprocity. Dwelling type was important to predict social capital, especially for the older group. The present study confirmed the importance of AFCC NBE in predicting social capital and unique factors in the Korean context.

Age-friendly environments and psychosocial wellbeing: a study of older urban residents in Ireland

OBJECTIVE

This article aims to estimate the association between age-friendly urban environments and psychosocial wellbeing in adults aged 55+ living in four Irish cities.

METHOD

Data is from the Healthy and Positive Ageing Initiative 'Age-friendly Cities and Counties Survey' from four cities; Dublin, Cork, Limerick, and Galway (n = 2,094). The Age-friendly Urban Index (AFUI), a perception-based measure of safety, access to services, and walkability, is used to measure urban environment quality on a scale of 35 (least favourable) to 105 (most favourable). Wellbeing was estimated using the following composite measures: quality of life (comprising hedonic (pleasure) and eudaimonic (control, autonomy, self-realisation) wellbeing); affective (depressive mood); and social (loneliness). Multivariate regression analyses (negative binomial and Poisson regression) were used to investigate the association between the AFUI and each wellbeing indicator. Models were fully adjusted for known demographic (age, gender, household structure, marital status), socio-economic (material deprivation, employment/occupation, education), social (social engagement, community activities) and health (self-rated health, mobility limitations) correlates of psychosocial wellbeing.

RESULTS

Older people living in cities with higher AFUI score were more likely to report higher quality of life overall, and higher hedonic and eudaimonic wellbeing. These adults also had lower depressive mood scores and reported lower loneliness levels. Results remain significant in the fully adjusted model.

LIMITATIONS

Causal conclusions cannot be made because of cross-sectional data.

CONCLUSION

This study provides evidence of the relationship between the age-friendliness (safety, services, and walkability) of urban environments and multiple aspects of psychosocial wellbeing for older adults in Ireland.

SITE SELECTION ASSESSMENT OF VACANT CAMPUS SPACE TRANSFORMING INTO DAILY CARE CENTERS FOR THE AGED

Taiwan is facing the dual severe social problems of an aging population coupled with a low birth rate. Aging has given rise to an urgent need for future long-term care and daytime care, while the low birth rate has led to a large number of vacant classrooms on campus. The government is actively developing the policy of reusing idle campuses as daily care centers for the aged. However, the implementation of this policy lacks a set of complete evaluation mechanisms. The purpose of this study was to propose a three-stage site selection assessment model to construct site selection assessment indicators, construct indicator weights using the analytic hierarchical process (AHP), and rank the campuses most suitable for transformation into daily care centers for the aged according to the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method. The results showed that the convenience of family members’ transportation, access to medical treatment, service life of school buildings, barrier-free spaces, and ventilation condition are all key factors regarding the future transformation of vacant campus spaces into daily care centers. The assessment model could provide a reference to accelerate the decision-making benefits regarding the sustainable reuse of idle campus spaces.

Giving Voice to the Environment as the Silent Partner in Aging: Examining the Moderating Roles of Gender and Family Structure in Older Adult Wellbeing

Gerontological scholarship has long seen the environment to be a silent partner in aging. Environmental Gerontology, an established approach in Social Gerontology, has shown how the everyday lives of older adults are deeply entangled in socio-spatial environments. Adopting an Environmental Gerontology approach, we explore social and cultural dimensions of the association between out-of-home mobility and wellbeing among older adults in a north western city of India. This was established by combining high resolution time-space data collected using GPS receivers, questionnaire data and time diaries. Following a multi-staged analytical strategy, we first examine the correlation between out-of-home mobility and wellbeing using bivariate correlation. Second, we introduce gender and family structure into regression models as moderating variables to improve the models' explanatory power. Finally, we use our results to reinterpret the Ecological Press Model of Aging to include familial structure as a factor that moderates environmental stress. Findings emphasize the central role that social constructs play in the long-established relationship between the environment and the wellbeing of older adults.

Associations of City-Level Active Aging and Age Friendliness with Well-Being among Older Adults Aged 55 and Over in Taiwan

This study aims to identify the typology of city-level active aging and age-friendliness across cities in Taiwan and examine their effects on well-being in terms of life satisfaction (aged 55 and over) and health-related quality of life (HRQoL) (aged 65 and over) among older adults. The data were from the 2017 Taiwan Senior Citizen Condition Survey. Available indicators of Taiwan’s Active Aging Index and city age-friendliness were selected, and mixed linear models were analyzed. Active aging cities were classified into four categories—content, developed, participatory, and pioneer—and age-friendly cities into insecure, infrastructural, and tranquil. Life satisfaction was rated higher in content and participatory cities compared with the pioneer city, and related to individuals’ active aging status. Physical HRQoL was rated higher in infrastructural and tranquil cities, compared with insecure cities. City types of active aging and age-friendliness have different effects on well-being, but the effects are weaker than those of individuals’ characteristics.

Emerging evolution trends of studies on age-friendly cities and communities: a scientometric review

Population ageing, together with urbanisation, has become one of the greatest challenges throughout the world in the 21st century. Approximately one million people turn 60 each month worldwide. By 2050, more than 20 per cent of the global population is predicted to be 60 years old or above. Thus, an increasing need is evident for age-friendly communities, services and structures. Numerous studies on age-friendly cities and communities (AFCCs) have been conducted over the past decade. The large volume literature makes it necessary to figure out key areas and the evolution trends of studies on AFCCs. Therefore, this paper aims to provide a comprehensive review of existing literature pertaining to AFCCs. A total of 231 collected publications are analysed and visualised by CiteSpace. According to the keywords and document co-citation networks that are generated, the foundation, hot topics and domains of AFCC research are grouped. Three major themes, namely the characteristics of AFCCs, the application of the World Health Organization's framework in urban and rural areas worldwide, and the measurement of cities’ and communities’ age-friendliness, are identified. In addition, a roadmap of AFCC research is developed. The results of this research will therefore benefit researchers and practitioners.

Sense of Community Mediating Between Age-Friendly Characteristics and Life Satisfaction of Community-Dwelling Older Adults

The growth of age-friendly community initiatives underscores a paradigmatic shift from the individual to the community, addressing dynamic transactions between people and the environment they are living in. The purpose of the present study is to address the gap in existing research by examining the psycho-social effects of the sense of community in mediating between WHO domains of age-friendliness and the life satisfaction of older adults. Data were obtained from 898 participants in Hong Kong. Path analysis was conducted. Two AFC domains, Social Participation as well as Community Support and Health Services, were found to be associated with life satisfaction. Sense of community was found to mediate between these two domains and life satisfaction. The implications of these findings are discussed with reference to developing opportunities in social participation of older adults and enhancing community/health support services in the context of developing sustainability in the community.

Revisiting Social Work with Older People in Chinese Contexts from a Community Development Lens

Community development is an empowering and comprehensive method for social workers to address individual and societal challenges facing Chinese older people. This chapter explores the different meanings of community development in Chinese contexts, including communities in Mainland China and Chinese immigrant communities. When actualizing community development, social workers require theories to guide their actions, and this chapter proposes three interrelated theoretical bases: ecological system theory, empowerment theory, and anti-oppressive theory. Based on these theoretical bases, three practice directions are suggested to guide community development at different levels: “aging in place,” “age-friendly community,” and “gray power.” In particular, social workers need to adapt community development approaches to Chinese cultural contexts. Case examples are discussed to illustrate how to implement community development projects with older people in Chinese contexts and the roles of social workers in such projects.

Developing age-friendly city readiness: A case study from Depok City, Indonesia

Depok, as one of the largest cities in Indonesia, has great potential to be an age-friendly city. Before the formation of age-friendly city is established, eight dimensions of age-friendly cities had been studied by the World Health Organization in 2013, but since 2013 these dimensions have not been assessed. The study aimed to assess the preparedness of Depok to be an age-friendly city with a qualitative approach from the stakeholders’ point of view. This study used a qualitative design involving 50 informants through in-depth interviews and focus group discussion techniques using purposive sampling. The findings indicate that Depok was deemed not yet prepared to be an age-friendly city due to an abundance of infrastructure deficiencies. There were not many changes in the facilities, such as infrastructure improvements in age-friendly city indicators and existing Regional Regulations of age-friendly cities, except for buildings and open green spaces. In general, Depok still needs time to achieve the age-friendly city where the community will have a good place to live, grow, and age in it.