How the Urban Neighborhood Environment Influences the Quality of Life of Chinese Community-Dwelling Older Adults: An Influence Model of “NE-QoL”

Relationship between person, environmental factors, and activities of daily living performance among physically disabled older adults living at home: a structural equation model

BACKGROUND

Older adults with physical disability need long-term services and support, which incur enormous costs. However, supportive environments may reduce disability and promote aging in place. It is unclear how the physical and social environment affect different types of functional impairments and influence the performance of activities of daily living (ADL) in physically disabled older adults.

OBJECTIVE

The purpose of this study was to examine the relationship between person, environmental factors, and ADL performance among physically disabled older adults living at home.

METHODS

This was a cross-sectional study. Using long-term care insurance claims data from a pilot city in China, we used a structural equation model to assess the potential paths among person, environmental factors, and ADL performance.

RESULTS

Education and income had different influences on the social environment and physical environment. The functional impairments had significant effects on ADL performance, either directly or through physical environment (with handrails) and social environment (family support).

CONCLUSIONS

The present findings offer crucial evidence for understanding the interactions between a person and the environment, as well as their influence on physical ADLs, suggesting the importance of a supportive environment and a subpopulation-targeting strategy for disabled older adults.

Characteristics of Physical Activities and Environmental Factor Preferences of Older Adults in Rural Resettlement Community in Ningbo, China

As physical mobility declines, older adults become increasingly dependent on their living environment. The relationship between physical activities and community environments for older adults has been studied to help promote physical and mental health and increase social connections among older adults, thereby improving their quality of life and health status. This study analyzed the daily outdoor physical activities of older adults in Nanyu New Village, China, using behavior mapping and questionnaire research for data collection, and conducting a comprehensive analysis of the spatial, temporal, and environmental elements of the physical activities. This research showed that the physical activity choices of older adults in rural resettlement neighborhoods vary significantly by time, gender, and space. In decreasing order, surrounding support, site security, space convenience, beautiful landscape, and diverse facilities influence the outdoor physical activities of older adults. This study provides new insights into the ongoing debate on age-friendly communities and provides a useful reference for the design of age-friendly retrofitting of outdoor environments in rural resettlement communities.

Neighborhood Attributes and Well-Being Among Older Adults in Urban Areas: A Mixed-Methods Systematic Review

Expanding urbanization rates have engendered increasing research examining linkages between urban environments and older adults' well-being. This mixed-methods systematic review synthesizes the evidence for the influence of urban neighborhoods' attributes on older adults' well-being. We searched for literature published up to December 2020 across six databases and performed quality assessment and thematic analysis. The results, based on 39 identified studies, showed that natural areas in neighborhoods and a sense of community are the attributes most often associated with positive effects on well-being. Transit-related variables, urban furniture, and access to healthcare are also positively related to well-being. Neighborhoods may promote well-being more effectively when these elements are considered. However, almost half of the studies did not include all environmental dimensions simultaneously, and self-reported instruments were largely preferred over more objective assessments of the environment. Future research should thus holistically examine physical, social, and service-related attributes to produce more robust evidence.

Multiple Linear Regression-Structural Equation Modeling Based Development of the Integrated Model of Perceived Neighborhood Environment and Quality of Life of Community-Dwelling Older Adults: A Cross-Sectional Study in Nanjing, China

Due to the poor functioning in daily living activities, community-dwelling older adults spend more time in their neighborhood environment. The perceived neighborhood environment is crucial to their quality of life (QoL). To explore the complex influences of perceived neighborhood environment on QoL, a questionnaire was designed to measure their perception of each factor of neighborhood environment and each domain of QoL. Based on collected data, the reliability test was applied to revise the questionnaire. Multiple linear regression (MLR) and structural equation modeling (SEM) were adopted to hypothesize and test the integrated model for community-dwelling older adults. The results show that community-dwelling older adults' perceptions of neighbor support, facilities related to physical exercise and recreation, and accessibility to facilities impact their overall QoL with diverse coefficients of 0.437, 0.312, and 0.295, respectively; neighbor support (0.207) on physical health; sidewalk condition (0.134), natural environment (0.260), and facilities related to daily life (0.165) on psychological health; and neighbor support (0.298), facilities related to daily life (0.206), and design-related safety (0.225) on social relationship. This revealed that perceptions of neighborhood environment have diverse impacts on their QoL. This study can provide targeted retrofit strategies for communities to enhance QoL of community-dwelling older adults efficiently.