The association of perceived neighborhood walkability and environmental pollution with frailty among community-dwelling older adults in rural areas

Abstract

OPS 31: Health effects of multiple environmental stressors, Room 412, Floor 4, August 27, 2019, 1:30 PM - 3:00 PM Background/Aim: Frailty is one of the most problematic expression of population ageing. Older adults are often targeted for interventions to prevent frailty, especially interventions that focus on physical activity and socialization. However, the role of neighborhood environments in influencing old people’s physical activity levels, social participation and accessibility has not been fully investigated. The aim of this study was to evaluate the association of perceived neighborhood walkability and environmental pollution with frailty among community-dwelling older adults in rural areas. Methods: Participants were 807 community-dwelling men and women aged 65 years and older in two rural towns. Comprehensive information, including demographics, socioeconomic status, grip strength, polypharmacy, perceived neighborhood environments (walkability and environmental pollution), and frailty, was collected using face-to-face interviews in June 2018 to August 2018. Walkability was measured using 20 items selected and revised from the Neighborhood Environment Walkability Scales (NEWS), the Physical Activity Neighborhood Environment Survey (PANES), and the Neighborhood Walkability Checklist from National Heart Foundation in Australia. The Kaigo-Yobo Checklist was used to assess participants’ frailty. Results: The overall prevalence of frailty in this community-dwelling population was 35.6%. Compare to the non-frail participants, the frail individuals were female, older, living alone, having lower education level, unemployed, having poor grip strength, taking more than three medicines. Frailty was associated with lower perceived neighborhood walkability (odds ratio [OR] = 0.881, 95% confidence interval [CI] = 0.834-0.932, p < 0.001) and worse perceived neighborhood environmental pollution (OR = 1.051, 95% CI = 1.017-1.087, p = 0.003) after adjustment for sex, age, solitariness, education level, employment status, monthly income, grip strength, and polypharmacy. Conclusions: It is needed to improve local environments as well as personal physical, mental, and social health to prevent or reverse frailty in rural areas where population ageing is more severe and built environment is worse than urban areas.