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Delhey LM, Shi X, Morgenstern LB, Brown DL, Smith MA, Case EC, Springer MV, Lisabeth LD. Neighborhood Resources and Health Outcomes Among Stroke Survivors in a Population-Based Cohort. J Am Heart Assoc 2024:e034308. [PMID: 38958125 DOI: 10.1161/jaha.124.034308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 06/05/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Stroke survivors believe neighborhood resources such as community centers are beneficial; however, little is known about the influence of these resources on stroke outcomes. We evaluated whether residing in neighborhoods with greater resource density is associated with favorable post-stroke outcomes. METHODS AND RESULTS We included Mexican American and non-Hispanic White stroke survivors from the Brain Attack Surveillance in Corpus Christi project (2009-2019). The exposure was density of neighborhood resources (eg, community centers, restaurants, stores) within a residential census tract at stroke onset. Outcomes included time to death and recurrence, and at 3 months following stroke: disability (activities of daily living/instrumental activities of daily living), cognition (Modified Mini-Mental State Exam), depression (Patient Health Questionnaire-8), and quality of life (abbreviated Stroke-Specific Quality of Life scale). We fit multivariable Cox regression and mixed linear models. We considered interactions with stroke severity, ethnicity, and sex. Among 1786 stroke survivors, median age was 64 years (interquartile range, 56-73), 55% men, and 62% Mexican American. Resource density was not associated with death, recurrence, or depression. Greater resource density (75th versus 25th percentile) was associated with more favorable cognition (Modified Mini-Mental State Exam mean difference=0.838, 95% CI=0.092, 1.584) and among moderate-severe stroke survivors, with more favorable functioning (activities of daily living/instrumental activities of daily living=-0.156 [95% CI, -0.284 to 0.027]) and quality of life (abbreviated Stroke-Specific Quality of Life scale=0.194 [95% CI, 0.029-0.359]). CONCLUSIONS We observed associations between greater resource density and cognition overall and with functioning and quality of life among moderate-severe stroke survivors. Further research is needed to confirm these findings and determine if neighborhood resources may be a tool for recovery.
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Affiliation(s)
- Leanna M Delhey
- Department of Epidemiology University of Michigan School of Public Health Ann Arbor MI USA
| | - Xu Shi
- Department of Biostatistics University of Michigan School of Public Health Ann Arbor MI USA
| | - Lewis B Morgenstern
- Department of Epidemiology University of Michigan School of Public Health Ann Arbor MI USA
- Stroke Program, University of Michigan Medical School Ann Arbor MI USA
| | - Devin L Brown
- Stroke Program, University of Michigan Medical School Ann Arbor MI USA
| | - Melinda A Smith
- Department of Epidemiology University of Michigan School of Public Health Ann Arbor MI USA
| | - Erin C Case
- Department of Epidemiology University of Michigan School of Public Health Ann Arbor MI USA
| | | | - Lynda D Lisabeth
- Department of Epidemiology University of Michigan School of Public Health Ann Arbor MI USA
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Stroope J, Garn AC, Morin AJS. A cross-cultural investigation of active transportation and community participation: Results from the WHO survey of Global Ageing and Adult Health. Health Place 2024; 89:103285. [PMID: 38875962 DOI: 10.1016/j.healthplace.2024.103285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/31/2024] [Accepted: 06/02/2024] [Indexed: 06/16/2024]
Abstract
Little is known about how the associations between active transportation and community participation may vary across national contexts. Using representative datasets from China, Ghana, India, Mexico, Russia, and South Africa collected in the Study on Global Ageing and Adult Health (N = 33,535), we estimated multi-group confirmatory factor analyses, tests of measurement invariance, and predictive models. Standardized coefficients were equivalent across countries and showed a modest positive association between active transportation and community participation (the variance explained by active transportation ranged from 1.3% to 7.5% across countries). These results suggest that supporting active transportation can help mitigate negative environmental and health changes associated with increased vehicular travel and support social capital via community participation.
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Affiliation(s)
- Jessica Stroope
- Louisiana State University AgCenter, School of Nutrition & Food Sciences, 202N Knapp Hall, Baton Rouge, LA, 70803, USA.
| | - Alex C Garn
- University of Minnesota, School of Kinesiology, Cooke Hall 111, 1900 University Ave SE, Minneapolis, MN 55455, USA.
| | - Alexandre J S Morin
- Concordia University, Substantive Methodological Synergy Research Laboratory, Department of Psychology, 7141 Sherbrooke W, Montreal, QC, H4B1R6, Canada.
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Fields NL, Dabelko-Schoeny H, Murphy IE, Highfill C, Cao Q, White K, Sheldon M, Jennings C, Kunz-Lomelin A. Social Cognitive Theory, Driving Cessation, and Alternative Transportation in Later Life. J Appl Gerontol 2023; 42:2252-2260. [PMID: 37230489 PMCID: PMC10583478 DOI: 10.1177/07334648231177215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Having viable alternative transportation options could help individuals stop driving when appropriate. This study employs the Social Cognitive Theory (SCT) to understand the barriers and facilitators of alternative transportation among a sample of adults aged 55 and older (N = 32). Using a daily transportation data collection app, MyAmble, the research team asked participants questions structured around environmental, individual, and behavioral factors as outlined in the SCT framework. Responses were analyzed using directed content analysis. Findings suggest a substantial reliance on motor vehicles and it was evident that many participants had never seriously considered what they would do if they could no longer drive. We posit that SCT principles may be applied to help older adults build self-efficacy to transition to driving cessation when needed.
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Affiliation(s)
- Noelle L. Fields
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
| | | | - Ian E. Murphy
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Christine Highfill
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
| | - Qiuchang Cao
- Pepper Institute on Aging and Public Policy& Claude Pepper Center, Florida State University, Tallahassee, FL, USA, USA
| | - Katie White
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Marisa Sheldon
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | | | - Alan Kunz-Lomelin
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
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Delhey LM, Shi X, Morgenstern LB, Brown DL, Smith MA, Case EC, Springer MV, Lisabeth LD. Association of Neighborhood Recreation Centers and Poststroke Outcomes in a Population-Based Cohort. Stroke 2023; 54:2583-2592. [PMID: 37706339 PMCID: PMC10530069 DOI: 10.1161/strokeaha.122.041852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 08/14/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Higher neighborhood socioeconomic status has been favorably associated with stroke outcomes. This may be due to these areas having more beneficial resources such as recreational centers. We aimed to determine if neighborhood density of recreation centers is favorably associated with stroke outcomes. METHODS We conducted analyses of data from the Brain Attack Surveillance in Corpus Christi project, a cohort of stroke survivors ≥45 years of age residing in Nueces County, TX (2009-2020). We included non-Hispanic White and Mexican American incident stroke survivors, who were not institutionalized prestroke and completed baseline and follow-up assessments (N=1392). We calculated the density of fitness and recreational sports centers within their residential census tract during the year of their stroke. Outcomes included function (self-ratings on activities of daily living and instrumental activities of daily living), cognition (modified mini-mental state exam), depression (Patient Health Questionnaire-8), and quality of life (abbreviated Stroke-Specific Quality of Life Scale). We fit confounder-adjusted gamma-distributed mixed generalized linear models with a log link for each outcome and considered interaction with stroke severity. RESULTS On average, participants were 65 years old, 53% male, and 63% Mexican American. Median recreational centers were 1.60 per square mile (interquartile range, 0.41-3.06). Among moderate-severe stroke survivors, greater density of recreation centers (75th versus 25th percentile) was associated with more favorable function and possibly quality of life (activities of daily living/instrumental activities of daily living, 4.8% change [95% CI, -0.11% to -9.27%]; Stroke-Specific Quality of Life Scale, 3.7% change [95% CI, -0.7% to 8.2%]). Minimal nonsignificant differences were observed among the overall stroke population and those with mild stroke. CONCLUSIONS The availability of recreation centers may be beneficial for poststroke function and quality of life among those with moderate-severe stroke. If further research confirms recreation centers to be beneficial, this could inform rehabilitation following stroke.
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Affiliation(s)
- Leanna M Delhey
- Department of Epidemiology (L.M.D., L.B.M., M.A.S., E.C.C., L.D.L.), University of Michigan School of Public Health, Ann Arbor
| | - Xu Shi
- Department of Biostatistics (X.S.), University of Michigan School of Public Health, Ann Arbor
| | - Lewis B Morgenstern
- Department of Epidemiology (L.M.D., L.B.M., M.A.S., E.C.C., L.D.L.), University of Michigan School of Public Health, Ann Arbor
- Stroke Program, University of Michigan Medical School, Ann Arbor (L.B.M., D.L.B., M.V.S.)
| | - Devin L Brown
- Stroke Program, University of Michigan Medical School, Ann Arbor (L.B.M., D.L.B., M.V.S.)
| | - Melinda A Smith
- Department of Epidemiology (L.M.D., L.B.M., M.A.S., E.C.C., L.D.L.), University of Michigan School of Public Health, Ann Arbor
| | - Erin C Case
- Department of Epidemiology (L.M.D., L.B.M., M.A.S., E.C.C., L.D.L.), University of Michigan School of Public Health, Ann Arbor
| | - Mellanie V Springer
- Stroke Program, University of Michigan Medical School, Ann Arbor (L.B.M., D.L.B., M.V.S.)
| | - Lynda D Lisabeth
- Department of Epidemiology (L.M.D., L.B.M., M.A.S., E.C.C., L.D.L.), University of Michigan School of Public Health, Ann Arbor
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Pope ND, Gibson A, Engelhardt E, Ratliff S, Lewinson T, Loeffler DN. Conversations about Community, Connection to Place, and Housing Preferences among Aging Adults in Lexington, Kentucky. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:64-82. [PMID: 35815714 DOI: 10.1080/01634372.2022.2097756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
While many researchers have called for housing to be addressed in age-friendly cities and communities, little research exists to guide communities through this process. To maximize the potential for adults to age in place, researchers partnered with a local Age-Friendly community initiative to conduct focus groups and learn more about residents' preferences related to housing and residential space. The focus group data offered a glimpse into aging residents' perspectives on housing to inform planning and development of housing in a mid-size city. This second phase of a sequential mixed methods study included qualitative focus groups with 19 aging individuals. Focus group sessions sought to better understand previously identified housing preferences, aging adults' sense of community, and their connection to place. Findings suggest that aging participants cared not only about the physical structure of their home, but also the community-based aspects of where they live. Study implications suggest that social workers, working with and alongside community members and aging-service providers who have local knowledge, can support age-friendly housing models that consider the housing preferences of older residents, as well as the resources and limitations of their community.
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Affiliation(s)
- Natalie D Pope
- College of Social Work, University of Kentucky, Lexington, Kentucky, USA
| | - Allison Gibson
- College of Social Work, University of Kentucky, Lexington, Kentucky, USA
| | - Ethan Engelhardt
- College of Social Work, University of Kentucky, Lexington, Kentucky, USA
| | - Stephanie Ratliff
- College of Social Work, University of Kentucky, Lexington, Kentucky, USA
| | - Terri Lewinson
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire, USA
| | - Diane N Loeffler
- College of Social Work, University of Kentucky, Lexington, Kentucky, USA
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Gimie AM, Castillo AIM, Mullins CD, Falvey JR. Epidemiology of public transportation use among older adults in the United States. J Am Geriatr Soc 2022; 70:3549-3559. [PMID: 36137460 PMCID: PMC9771957 DOI: 10.1111/jgs.18055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/09/2022] [Accepted: 08/20/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Attending healthcare appointments and participating in social activities are important for older adults, but these activities are often limited by transportation barriers. Public transportation may bridge these gaps, but little is known about older public transportation users. This study compares the characteristics of older adults who use public transportation to those who do not. DESIGN Cross-sectional analysis of data from Round 5 of the National Health and Aging Trends Study (NHATS). We identified 5696 urban community dwelling older adults, and calculated national estimates of those who reported public transportation use in the last month and those who used transit to see their regular doctor. We evaluated the age and sex-adjusted associations between economic and clinical characteristics and recent use of public transportation using survey-weighted logistic regression. RESULTS Nearly 1 in 10 (n = 555/5696, weighted n = 3,122,583) urban-dwelling older adults in the United States reported use of public transportation in the last month, and over 20% of users (weighted n = 658,850) relied on transit to see their regular doctor. Compared to non-users, those who reported using transit were significantly more likely to be younger and identify as non-Hispanic Black or Hispanic. Financially strained older adults were more likely to have recently relied on public transportation (adjusted odds ratio [aOR] 1.62, 95% confidence interval [CI] 1.07-2.44), but frailty (aOR = 0.61, 95% CI 0.41-0.91) and living in an area with cracked or broken sidewalks (aOR = 0.35, 95% CI 0.27-0.46) were both associated with lower odds of public transportation use. CONCLUSION More than 3 million older adults in the United States reported recently using public transportation, with over 600,000 relying on these services to visit their doctor. With increasing investment in public infrastructure on the horizon, centering the unique medical, economic, and social needs of older transit users is critical to ensure urban communities remain age-friendly.
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Affiliation(s)
- Afnan M. Gimie
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD
| | - Andrea I. Melgar Castillo
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
| | - C. Daniel Mullins
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
| | - Jason R. Falvey
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
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Seekins T, Traci MA, Hicks EC. Exploring environmental measures in disability: Using Google Earth and Street View to conduct remote assessments of access and participation in urban and rural communities. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:879193. [PMID: 36189065 PMCID: PMC9397703 DOI: 10.3389/fresc.2022.879193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 07/06/2022] [Indexed: 11/25/2022]
Abstract
The Americans with Disabilities Act has been in place since 1990. Yet, we still do not know the actual levels of accessibility in the nation, how access varies across communities or over time, or how it influences participation in community life. The present two studies explored the use of Google Earth (GE) and Google Street View (GSV) imagery as a database for examining the accessibility of rural and urban cities and towns in the United States. We developed procedures for selecting places in a community to observe multiple access features. Study 1 reports the findings from assessments of 25 communities across 17 states. We observed ≈50,000 m (31 miles) of pathways through the observed places. The Combined Access Score (CAS) averaged 65% across these communities. In Study 2, we evaluated 22 towns and cities in a large rural state. We observed ≈77,000 m (48 miles) of pathways through the Central Business Districts observed as core areas connecting people to community life. The CAS averaged 83.9% across these communities. We noted a Rural Access Penalty (RAP), such that rural areas tended to be less accessible, leading to less community participation. The method for using GSV to examine accessibility is discussed. This study demonstrates an inexpensive and reliable method for evaluating the accessibility of communities and participation in them. Future research should be conducted to gather a larger sample of communities in order to create a baseline from which to monitor changes in accessibility of infrastructure over time.
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Twardzik E, Clarke PJ, Lisabeth LD, Brown SH, Roth DL, Judd SE, Colabianchi N. Enhanced Street Crossing Features are Associated with Higher Post-Stroke Physical Quality of Life. Top Stroke Rehabil 2022:1-11. [PMID: 35924680 PMCID: PMC9898471 DOI: 10.1080/10749357.2022.2108970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Features of the physical environment may affect post-stroke recovery, but empirical evidence is limited. This study examines associations between features of the physical environment and post-stroke physical quality of life (PH-QOL). METHODS The study sample included stroke survivors enrolled in the Caring for Adults Recovering from the Effects of Stroke project, a prospective cohort. Features of the physical environment surrounding participants' home addresses were audited using Google Earth. Audits captured information about crossings (e.g. curb-cuts; range 0-4), street segments (e.g. sidewalks; range 0-17.5), and a route (e.g. parks; range 0-27) near participants' home. Summary scores were categorized into tertials representing "few," "some," and "many" pedestrian-friendly features. Post-stroke PH-QOL was measured by the SF-12 (range 0-100) around 6 to 12-, 18-, 27-, and 36-months post-stroke. Linear mixed models were used to estimate PH-QOL over time. Chained multiple imputation was used to account for missing data. RESULTS Two hundred and seventy-five participants were eligible, among whom 210 had complete data. Most participants lived in areas with "few" features to promote outdoor mobility. Participants living in environments with "some" crossing features had a 4.90 (95% CI: 2.32, 7.48) higher PH-QOL score across the observation period in comparison to participants living in environments with "few" crossing features. Features of the physical environment along street segments and routes were not associated with post-stroke PH-QOL. CONCLUSION Crossing features are associated with post-stroke PH-QOL. Modifying features of the physical environment at nearby crossings, such as curb-cuts, may be a promising strategy for increasing PH-QOL.
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Affiliation(s)
- Erica Twardzik
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA,School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Philippa J. Clarke
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA,Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Lynda D. Lisabeth
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Susan H. Brown
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - David L. Roth
- Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Suzanne E. Judd
- Department of Biostatistics, University of Alabama at Birmingham, AL
| | - Natalie Colabianchi
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA,Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Twardzik E, Clarke PJ, Lisabeth LL, Brown SH, Hooker SP, Judd SE, Colabianchi N. The Relationship Between Environmental Exposures and Post-Stroke Physical Activity. Am J Prev Med 2022; 63:251-261. [PMID: 35361506 PMCID: PMC9310088 DOI: 10.1016/j.amepre.2022.01.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/10/2022] [Accepted: 01/14/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Post-stroke physical activity has widespread health benefits. Environmental exposures may shape post-stroke physical activity behavior. This study investigates the relationships between environmental exposures and post-stroke physical activity. METHODS Stroke survivors (n=374) from a cohort of Black and White adults with post-stroke accelerometer data (2009-2013) were eligible for this study. Participants' home addresses were linked with secondary data to capture environmental characteristics, including annual density of neighborhood resources (e.g., parks, physical activity facilities, and intellectual stimulation destinations), 2010 neighborhood SES, 2010 neighborhood crime, and daily information on extremely cold days. Post-stroke light physical activity and moderate-to-vigorous physical activity were captured using accelerometers over a 7-day period. Linear regression and 2-part/hurdle models were used to estimate the relationship between the density of neighborhood resources with light physical activity and with moderate-to-vigorous physical activity, respectively. Analyses were conducted in 2021. RESULTS A 10% increase in the number of extremely cold days was associated with 6.37 fewer minutes of daily light physical activity (95% CI= -11.37, -1.37). A 1-SD increase in neighborhood SES was associated with greater odds (OR=1.10, 95% CI=1.02, 1.19) of doing any moderate-to-vigorous physical activity. Among participants obtaining any moderate-to-vigorous physical activity, a 1-unit (count/km2) increase in destinations for intellectual stimulation was associated with 0.99 (95% CI=0.02, 1.97) more minutes of daily moderate-to-vigorous physical activity. All other environmental exposures were not associated with post-stroke light physical activity or moderate-to-vigorous physical activity. CONCLUSIONS Environmental exposures may facilitate physical activity participation among stroke survivors. This study found that weather, neighborhood SES, and proximity to destinations for intellectual stimulation were associated with physical activity over and above individual factors.
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Affiliation(s)
- Erica Twardzik
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
| | - Philippa J Clarke
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan; Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Lynda L Lisabeth
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Susan H Brown
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan
| | - Steven P Hooker
- College of Health and Human Services, San Diego State University, San Diego, California
| | - Suzanne E Judd
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Natalie Colabianchi
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan; Institute for Social Research, University of Michigan, Ann Arbor, Michigan
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Santos NDS, Souza LFD, Fontanela LC, Freitas MA, Gonçalves C, Mendrano AL, Danielewicz AL, Avelar NCPD. A autopercepção do ambiente de vizinhança está associado à sarcopenia provável em idosos comunitários? FISIOTERAPIA E PESQUISA 2021. [DOI: 10.1590/1809-2950/20035028042021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO A associação da sarcopenia com fatores sociodemográficos e de saúde já foi previamente apresentada na literatura. Contudo, pouco se sabe sobre como os fatores ambientais que podem estar relacionados a essa condição. O objetivo do estudo foi avaliar a associação entre a autopercepção do ambiente de vizinhança e a sarcopenia provável em idosos comunitários. Este é um estudo transversal, de base domiciliar com amostra probabilística, que incluiu 306 idosos comunitários de ambos os sexos. O desfecho foi a sarcopenia provável, categorizada com o tempo de realização no teste de sentar e levantar da cadeira >15 segundos, conforme proposto pelo European Working Group on Sarcopenia in Older People. As variáveis preditoras foram avaliadas de acordo com o abbreviated neighborhood environment walkability scale (A-NEWS), que inclui questões relacionadas à infraestrutura e à segurança do bairro, ruas, calçadas e tipos de uso do solo. Foram realizadas análises de regressão logística multivariada. A presença de supermercado/loja de conveniência/mercadinho/armazém, feira livre (OR: 0,45; IC 95%: 0,22-0,91) e ponto de ônibus (OR: 0,23; IC 95%: 0,10-0,50) foram fatores de proteção para a sarcopenia provável. Já o acúmulo de lixo e locais com esgoto a céu aberto próximos à residência (OR: 2,17; IC 95%: 1,16-4,05) foram fatores de risco. Verificou-se associação de comércios locais e pontos de ônibus próximos ao local de residência para proteção contra a sarcopenia provável, enquanto o acúmulo de lixo e locais com esgoto a céu aberto próximos à residência se mostraram fatores de risco para a sarcopenia provável.
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Lyu Y, Forsyth A, Worthington S. Built Environment and Self-Rated Health: Comparing Young, Middle-Aged, and Older People in Chengdu, China. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 14:229-246. [PMID: 33397148 PMCID: PMC8212390 DOI: 10.1177/1937586720982566] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES This article explores how the building-scale built environment is associated with self-rated health, examining differences in this association among younger, middle-aged, and older age groups. Features examined included building type, building condition, and sidewalk presence in front of dwellings. BACKGROUND Understanding how the relationships between built environments and health vary across age groups helps to build a healthy environment for all. However, most studies have concentrated on the neighborhood or indoor environment, rather than whole buildings, and few have compared age groups. METHODS This study analyzed survey data from 1,019 adults living in 40 neighborhoods in Chengdu, China, recruited through a clustered random sampling approach. It used a Bayesian logistic mixed-effects model with interaction terms between age-group indicators and other variables. RESULTS Significant differences exist in the relationships of self-rated health with some environmental and other indicators among age groups. For older people, living in multi-floor buildings, having a household smoker, and undertaking fewer hours of weekly exercise were associated with lower odds of reporting good, very good, or excellent health. These relationships were not identified among middle-aged and younger people. More education was associated with higher odds of reporting better health among older and middle-aged groups. CONCLUSIONS Older people experience more health-related challenges compared to middle-aged and younger people. However, among the examined built environment factors, building type was the only significant factor related to self-rated health among older people. To promote health among older people, this study recommends adding elevators in the multi-floor buildings.
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Affiliation(s)
- Yingying Lyu
- Graduate School of Design, 1812Harvard University, Cambridge, MA, USA.,The Harvard-China Project on Energy, Economy and Environment, John A. Paulson School of Engineering and Applied Sciences, 1812Harvard University, Cambridge, MA, USA
| | - Ann Forsyth
- The Department of Urban Planning and Design, 1812Harvard University, Cambridge, MA, USA
| | - Steven Worthington
- The Institute for Quantitative Social Science, 1812Harvard University, Cambridge, MA, USA
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