Abstract
Our study examined the associations between neighborhood walkability, frailty, and the incidence of long-term care insurance (LTCI) service needs using a prospective cohort survey in a suburban town in Japan. The final sample for analyses comprised 2867 community-dwelling older adults (mean age: 73.0 years). Neighborhood walkability was measured using the Walk Score®. A total of 387 participants (13.5%) exhibited frailty. The odds of frailty, adjusted for the covariates (sex, age, educational status, marital status, residential status, employment status, subjective economic status) among participants who lived in somewhat walkable/very walkable areas, was 0.750 (95% Confidence Interval, CI: 0.597–0.943) versus those who lived in car-dependent areas. During the 23-month follow-up, 102 participants needed LTCI services (19.0 per 1000 person-years), 41 of whom (21.0 per 1000 person-years) lived in car-dependent areas, and 61 of whom (17.9 per 1000 person-years) lived in somewhat walkable/very walkable areas. As compared with participants who lived in car-dependent areas, the incidence of LTCI service needs was not significantly lower than that of those who lived in somewhat walkable/very walkable areas. Walk Score® can provide the critical information for the strategies to improve walkability and prevent older adults’ frailty in less walkable areas, contributing to achieving the United Nation’s Sustainable Development Goals (SDGs).
Highlights
The present study examined the associations between neighborhood walkability and both frailty and the incidence of long-term care insurance (LTCI) service needs among older adults, in a suburban town, in Japan
The risk of frailty among older adults who live in an area classified as a walker’s paradise would be lower than the risk of frailty among older adults who live in less walkable areas because this study found a negative linear association between Walk Score® and frailty
The present study found a negative association between neighborhood walkability, assessed by Walk Score®, and frailty
Summary
The number of people aged 65 or older is projected to triple from an estimated 524 million in 2010 to nearly 1.5 billion in the world in 2050 [1]. With the rapid growth of the aging population, the World Health Organization has indicated that health is one of the most important goals of successful sustainable development in any city [2]. Frailty is common among older adults and a strong predictor of long-term care and medical care utilization [3,4,5,6,7]. A recent study reported that the national prevalence of frailty was approximately 9% in community-dwelling older adults in Japan [6]. It is essential to improve strategies for preventing frailty among older adults.
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