Age-friendly Communities Research Articles

Age-Friendly Communities and Life Satisfaction Among the Elderly in Urban China.

This study aims to examine the extent to which older adults' perceptions of environmental age-friendliness are associated with their life satisfaction. We used a national representative sample ( N = 9,965) with elders aged 60 and above from urban China and structural equation modeling to analyze the relationship among community characteristics, socioeconomic status (SES), and life satisfaction. Results showed that older people's perceptions of housing conditions, local amenities, and social inclusion were significantly associated with general life satisfaction. Multigroup comparison tests indicated that no disparities in the aforementioned relationships among SES subgroups. However, the socioeconomically disadvantaged elderly population was shown to have the lowest assessment of community age-friendliness. Findings emphasized the potential role of age-friendly communities as having an influential force on older adults' subjective well-being, regardless of their SES. Meanwhile, policy makers and practitioners should pay special attentions to improve the living environments of disadvantaged elders.

Social research and co-production with older people: Developing age-friendly communities

The aging of the population, together with the need for more inclusive and responsive policies and services, has contributed to a burgeoning interest in co-production and co-research with older people. To date, however, only a limited number of studies have addressed how the participation of older persons as research partners can be practically realized in community-based research. The purpose of this article is to provide insights into the process of co-producing a research project with older residents living in low-income neighborhoods in Manchester, United Kingdom. The project was unique in involving and training eighteen older people as co-researchers who took a leading role in all phases of a study aimed at developing “age-friendly” communities. The co-researchers also completed 68 interviews with residents aged 60 and over who were experiencing social isolation within their neighborhood. This paper describes the methodological approach developed for the study together with a description of the recruitment and training of co-researchers. It then presents findings based upon four reflection meetings with the co-researchers, focusing on their motivations for working on the project and their relationship with the interviewees. The article concludes with a discussion of the implications of the findings for developing co-production work with older people in age-friendly research, policy and practice.

Getting Started: An Empirically Derived Logic Model for Age-Friendly Community Initiatives in the Early Planning Phase

ABSTRACTAge-friendly community initiatives (AFCIs) foster efforts across stakeholders to make localities more supportive and inclusive of older adults, and potentially better for residents of all ages. This study drew on in-depth interviews with leaders of nine newly forming AFCIs in northern New Jersey to develop an empirically based logic model for the initiatives in the early planning phase. The results obtained from a conventional content analysis indicated three main activities in the early planning phase: assessing the community; meeting; and communicating with stakeholders; and facilitating communitywide communications. These activities worked toward two outputs: increased understanding of aging in the community and more engaged stakeholders in aging. Participants described leveraging the contributions of lead staff, consultants, elected officials, organizational partners, volunteers, interns, funders, and other AFCIs to engage in their focal activities. Based on these findings, a logic model for AFCIs in the early planning phase is presented. AFCI leaders can draw on this model to evaluate AFCI processes and outcomes in their formative stages, as well as to strategically plan for the start of an AFCI within a given locality. Findings also suggest important directions for future research on the development of AFCIs and the community changes that they seek to influence.

Aligning age-friendly and dementia-friendly communities in the UK

PurposeThe purpose of this paper is to set out the history and origins of dementia-friendly communities (DFCs) and age-friendly communities (AFCs) in the UK, the differing frameworks and how they compare, and set out some key messages about how they might learn from each other.Design/methodology/approachThis paper is a summary piece written by leaders in the two fields.FindingsIt aims to reduce potential confusion around AFCs and DFCs, and provides some practical ways that the two initiatives might work together and find common ground. By learning from each other, both age-friendly and DFCs can grow their reach and their impact as complementary, and not competing, programmes.Originality/valueThe original development of some of the ideas in this paper comes from a paper Natalie Turner co-wrote with Lydia Morken at AARP (www.aarp.org/content/dam/aarp/livable-communities/documents-2016/Better-Together-Research-Report.pdf). For this paper, the authors reviewed the approach within the UK context and have furthered and added to the original insights.

Developing indicators for the Age-Friendly Cities and Counties Programme in Ireland

PurposeThe purpose of this paper is to describe a study undertaken in Ireland to develop a set of local age-friendly indicators which have been used to support the Age-Friendly Cities and Counties Programme.Design/methodology/approachA concept-validation approach was used to translate the principles and domains of age-friendly communities into a quantitative indicator set. This iterative process involved five steps: identifying potential indicators; consultation; survey testing; data collection and fieldwork; and finalising the indicator set. A participatory approach was also taken to involve local stakeholders in the development and subsequent use of the indicator set and associated data set. A multi-arm approach to communicating and translating these indicators was taken in order to build capacity within multi-stakeholder groups to engage with and appraise quantitative local evidence in this field.FindingsA set of 120 local age-friendly indicators that can be reported nationally and disaggregated to the local authority level was developed. There were challenges faced in communicating the results and supporting the translation of these indicators into local actions. These challenges included indicator, user, and policy factors and involved instrumental, conceptual, and political issues.Originality/valueThe resulting indicator set is the first of its kind in Ireland and fills and important data gap in the local data landscape. Future work will focus on planning for sustaining collection of local data and building capacity among local stakeholders in the management and use of these indicators.

Older Coresearchers Exploring Age-Friendly Communities: An "Insider" Perspective on the Benefits and Challenges of Peer-Research.

A growing body of work suggests that co- or peer-research may contribute to understanding the complex health and social problems experienced in later life. Yet, only a limited number of studies have involved older persons as partners in the research process. Moreover, in conflict with the philosophy of participatory research, the views of those acting as coresearchers tend to be ignored. This paper gives an "insider" account of the process of coresearch, drawing upon the experiences of older people trained to undertake a community-based research project. Eighteen older adults were recruited and trained as coresearchers to take a leading role in a study aimed at developing "age-friendly" communities in Manchester, UK. The coresearchers completed 68 interviews with residents aged 60 years and over who were experiencing isolation within their neighborhood. The findings are based upon four reflection meetings held with the coresearchers, all of which were transcribed with thematic analysis conducted using Atlas.ti. Coresearchers identified a range of advantages associated with the coresearch approach, these linked to the recruitment of participants, quality of data, potential for social change as well as personal benefits. They also identified ethical, methodological, and practical issues encountered during the research. The study demonstrates the contribution of coresearch for expanding methodological diversity, accessing seldom heard populations, and utilizing the skills and resources of older people. The research also highlights the opportunities for partnerships between older people and local stakeholders to facilitate community change and social action.

The Social Construction of "Emerging Elders": Implications for Age-Friendly Community Assessments.

The term “emerging elders” has surfaced in age-friendly community assessment tools to denote a subset of older adults; however, limited guidance is provided on its application to aging populations. The goal of this study was to develop a data-driven conceptualization of “emerging elders” as part of an age-friendly community assessment. Adults, aged 55 years and above, were asked about their subjective meaning of “emerging elder” within the context of a larger study of aging well in a large U.S. metropolitan city. Using inductive and deductive methods, the researchers analyzed qualitative data (N = 38) collected from individual interviews with homebound older adults (n = 15) and participants of three focus groups (n = 23). Four themes suggest that emerging elderhood is related to chronological age, functional ability, transitions, and self-identity. Findings suggest that the term emerging elderhood may foster negative images of older adults consistent with Western cultural discourse, despite the positive connotations associated with “emerging elder” in indigenous and spiritual communities. Findings underscore the need to further refine age-friendly community assessments that take into account the social constructions ascribed to older adults and need for strategies to engage emerging elders in future research of age-friendly communities.

Age-Friendly Communities Matter for Older People\u2019s Well-Being

This study aims to identify relationships between age-friendly environments (in terms of social and physical neighborhood attributes) and older people’s overall well-being, as well as the underlying instrumental goals to achieve overall well-being. A sample of 945 community-dwelling older adults living in Rotterdam’s districts Lombardijen, Lage Land/Prinsenland, Oude Westen, and Vreewijk was asked to complete a questionnaire in 2013. A total of 588 (62%) responded. The majority (56%) of respondents was female, 19% had low educational levels, 35% were married, and 85% were born in the Netherlands. Mean age was 77.1 ± 5.3 (range 70–93) years. Levels of age-friendliness and older people’s ability to realize the instrumental goals to achieve overall well-being varied tremendously among neighborhoods, with older people living in less age-friendly communities reporting lower levels of well-being. These differences in well-being resulted especially from differences in affection, behavioral confirmation, and comfort. Higher-educated older persons were more critical regarding the domains civic participation, transportation, and communication and information in their neighborhoods, suggesting a socioeconomic gradient in the perceived lack of neighborhood attributes facilitating aging in place. Currently, physical and social neighborhood attributes enabling aging in place seem to satisfy the needs for affection, behavioral confirmation, and comfort in some, but not all, neighborhoods. Levels of age-friendliness in neighborhoods did not explain differences in opportunities for older people to realize the instrumental goals of status and stimulation.

Canadian policy perspectives on promoting physical activity across age-friendly communities: lessons for advocacy and action

ABSTRACTPopulation ageing combined with physical inactivity has critical implications for the public health of communities in the twenty-first century. In the last decade, the World Health Organization launched the age-friendly cities agenda, aiming to address population ageing through whole-systems, rights-based, health equity-focused approaches. An important intervention for age-friendly communities is modifying built environments to support population-level physical activity. Physical activity can help mitigate impacts of chronic diseases and social isolation on older adults. Need for advocacy and action in this area raises questions of how to develop supportive environments for physical activity across age-friendly community types. In Canada, a substantial proportion of older adults live outside large urban municipalities, for which scant research exists on fostering age-friendly built environments. To this end, we conducted qualitative research involving semi-structured interviews with 21 municipal policy influencers in Alberta, Canada to gather perspectives on development and early implementation of an age-friendly policy framework in the small urban and rural context. Our findings are organised by three main themes providing key lessons for advocacy and action, namelypursuing comprehensive planning,promoting public engagementandprioritising the needs of older adults. This research informs advocacy and action priorities in promoting built environment modification for routine physical activity as part of an age-friendliness agenda for small urban and rural regions of Canada and other countries.

Toward psychosocial health in age-friendly communities: The fountain of health peer-led education series

BackgroundThe Fountain of Health (FoH) Initiative translates evidence-based science of brain health and resilience to the public with the goal of increasing awareness about optimal aging and promoting positive self-perceptions of aging, as well as preventing dementia, late life mental illnesses and supporting psychological health and development later in life, in alignment with Age-Friendly Communities principles. MethodsThis was an observational study. Five peer-led education series about brain health and resilience were offered to community-dwelling seniors in Nova Scotia, Canada. Each series lasted six weeks, 90-minutes per session. Outcome measures included a pre and post quality assurance self-report questionnaire for group participants, and a self-report questionnaire completed by group facilitators. ResultsFifty-one participants attended six group sessions run in five different series. All (100%) completed the pre- and 27 (52.9%) the post-series questionnaire. Highly significant (p<0.001) improvements in knowledge of the FoH, application of FoH information, and knowledge of evidence-based lifestyle interventions were observed. There was also significant (p<0.05) improvement in attitudes toward aging, knowledge on the impact of genetics on longevity, and increased confidence in goal setting ability. ConclusionsThe FoH peer-led educational series appears to be a useful health promotion program aligned with Age Friendly Communities. Larger studies are needed to further assess the impact of such an approach on behavior change and long-term impacts on longevity and quality of life.

The promise of documentary theatre to counter ageism in age-friendly communities

This paper discusses an innovative theatre-arts collaboration that was created to provoke public discourse about aging in a community located in the Southeastern United States in which more than one-half of residents are age 50 or older. The development and execution of the documentary theatre production are explicated and the post-performance talk-backs with the audience are shared to illustrate how it facilitated insight and dialogue among its largely older audiences. Experience with this production suggests that academics can collaborate with professional artists to promote the subjective experience of aging as a positive appreciation of self. Consequently, the play holds promise to counter deeply ingrained negative self-beliefs about aging and foster greater acceptance about the experience of others. In addition, the play represents a unique community-based effort to enhance respect and social inclusion, a core domain of livability in the age-friendly community movement.

AGE FRIENDLY COMMUNITIES’ UTILIZATION OF THE HUMANITIES AND ARTS

The humanities and the arts are being utilized in age-friendly communities internationally to break down isolation and to improve quality of life through social engagement and advances in community and home design. This paper will delineate effective practices that map and leverage assets in the humanities and the arts to bring resources to older people in their homes and community centers. Research will be presented from surveying participating age-friendly communities to illustrate current practices in the United States and other participating countries in this World Health Organization project. The survey results demonstrate the important role humanities and the arts play in the formation of age-friendly communities.

HOUSING FOR THE ELDERLY: ADDRESSING GAPS IN KNOWLEDGE THROUGH THE LENS OF AGE-FRIENDLY COMMUNITIES

As our society ages, there is increasing concern about housing for older adults. Although the last decade has brought expanded research in this area, major gaps in knowledge remain in this field. This paper presents a literature review of the elderly housing research, examining the limitations in knowledge and categorizing the most salient research gaps identified in the literature. These include gaps that have been previously defined and persist since the inception of environmental gerontology as well as new research opportunities, namely, age-friendly communities. In our review, we found seven categories that characterize the gaps in knowledge in housing for older adults: age-friendliness; aging in place; conceptualization of home; falls; housing as it relates to disability and health; person-environment fit; and housing programs and policy initiatives. Identification and review of these limitations provide a roadmap for investigation for researchers and areas to be strengthened for clinicians and policy makers.

EXPLORING COMMUNITY LIVING FROM A LIFECOURSE PERSPECTIVE: TOWARD LIFECOURSE POLICY OPTIONS

Ageing and disability are part of the lifecourse trajectory, with disability adding another dimension to the ageing process. Older people and persons with disabilities share a common vulnerability in respect of community living and in relation to maintaining autonomy and independence. Further, the ability of people belonging to each group to connect and interact is often stifled through inadequate policies that leave them susceptible to heightened risks of institutionalization. The ageing-disability nexus provides the rationale for greater cooperation between actors in each sector in order to achieve common goals such as inclusive, accessible and age-friendly communities. This paper presents the results from an emerging conceptual framework that has arisen from a documentary analysis of key Irish and international community living law and policy as well as evidence relating to independent living, ageing-in-place and the lifecourse. Evidence from the international literature suggests that older people and persons with disabilities express a common desire to live and age in their communities. However, in many countries, policies have often developed from silo-specific perspectives that do not necessarily support the aspirations of those for whom they are enacted. Understanding the conceptualization of community living is therefore important for policy innovation that seeks to support older people and persons with disabilities to realize, enhance and maintain meaningful community living. Exploring community living as refracted through the lens of the lifecourse perspective adds valuable depth of understanding to the interpretation of the intent and purpose of policy and how it may be better translated into practice.

KNOWLEDGE DEVELOPMENT FOR AGE-FRIENDLY COMMUNITY INITIATIVES

AbstractThis paper will provide an introduction to “age-friendly” as an emerging international field of research, policy, and practice. The presenters will provide a history of the age-friendly movement, including the World Health Organization’s initiative and how age-friendly efforts have emerged across diverse national contexts over the past decade. The presenters will then describe knowledge development concerning age-friendly community initiatives, noting that much of what has been written in this area has been published in the “gray” literature. While peer-reviewed publications on age-friendly efforts are growing in number, many remain descriptive or theoretical. Based on a review of the literature, this paper will identify opportunities for researchers to employ both qualitative and quantitative research methodologies to deepen systematic knowledge building concerning age-friendly community initiatives. The authors will describe how such knowledge development has the potential to strengthen age-friendly policies and practices, while also making meaningful advances to gerontological research more broadly.

Capturing how age-friendly communities foster positive health, social participation and health equity: a study protocol of key components and processes that promote population health in aging Canadians

BackgroundTo address the challenges of the global aging population, the World Health Organization promoted age-friendly communities as a way to foster the development of active aging community initiatives. Accordingly, key components (i.e., policies, services and structures related to the communities’ physical and social environments) should be designed to be age-friendly and help all aging adults to live safely, enjoy good health and stay involved in their communities. Although age-friendly communities are believed to be a promising way to help aging Canadians lead healthy and active lives, little is known about which key components best foster positive health, social participation and health equity, and their underlying mechanisms.This study aims to better understand which and how key components of age-friendly communities best foster positive health, social participation and health equity in aging Canadians. Specifically, the research objectives are to:Describe and compare age-friendly key components of communities across CanadaIdentify key components best associated with positive health, social participation and health equity of aging adultsExplore how these key components foster positive health, social participation and health equityMethodsA mixed-method sequential explanatory design will be used. The quantitative part will involve a survey of Canadian communities and secondary analysis of cross-sectional data from the Canadian Longitudinal Study on Aging (CLSA). The survey will include an age-friendly questionnaire targeting key components in seven domains: physical environment, housing options, social environment, opportunities for participation, community supports and healthcare services, transportation options, communication and information. The CLSA is a large, national prospective study representative of the Canadian aging population designed to examine health transitions and trajectories of adults as they age. In the qualitative part, a multiple case study will be conducted in five Canadian communities performing best on positive health, social participation and health equity.DiscussionBuilding on new and existing collaborations and generating evidence from real-world interventions, the results of this project will help communities to promote age-friendly policies, services and structures which foster positive health, social participation and health equity at a population level.

Social Isolation in Chinese Older Adults: Scoping Review for Age-Friendly Community Planning.

Chinese older adults may be at increased risk of social isolation and loneliness, and a fragmented understanding exists about the challenges they face for social participation in their neighbourhoods and communities. A scoping review was undertaken to describe the current knowledge on social isolation and loneliness in urban-dwelling Chinese older adults living in Western societies to inform future research, practice, and policy in Canada. Nineteen articles met the inclusion criteria. The World Health Organization's age-friendly community framework contextualized the study findings. Studies identified issues related to (1) social participation; (2) community support and health services; (3) housing; (4) community and information; (5) respect and social inclusion; (6) outdoor spaces and public buildings; (7) civic participation and employment; and (8) transportation. Social isolation and loneliness is a growing concern in this population in Canada, and additional research is needed to identify its scope and effective interventions.

Conceptualizing Social Connectivity in the Context of Age-Friendly Communities

ABSTRACTIn 2011, colleagues and I (Menec, Means, Keating, Parkhurst, & Eales, 2011) conceptualized age-friendly communities from an ecological perspective in order to highlight key assumptions of the interplay between the person and the environment, including both the community environment and the larger policy and political environment. Moreover, we proposed that a basic benefit of an age-friendly community is that it creates social connectivity. Fundamentally, we argued, age-friendly communities create connections—between the older person and the environment in which he or she lives and vice versa. The purpose of the present article is to expand on the notion of social connectivity. By drawing on diverse bodies of literature, such as social epidemiology, community development, empowerment, and organizational effectiveness, I aim to conceptualize social connectivity in terms of four interrelated components: (1) creating connections; (2) empowerment; (3) social influence; and (4) access to material resources and services. Consistent with ecological theory, each of these components is described at the individual, organizational, and community level. Implications for implementing age-friendly initiatives and research are discussed.

Housing for the Elderly: Addressing Gaps in Knowledge Through the Lens of Age-Friendly Communities

ABSTRACTWe identify salient research gaps in the elderly housing research and respond to the lack of knowledge, guided by Menec, Means, Keating, Parkhurst, and Eales' (2011) age-friendly communities framework. These gaps in knowledge include age-friendliness, aging in place, conceptualization of home, falls, housing as it relates to disability and health, person-environment fit, and housing programs and initiatives. We discuss how the age-friendly paradigm can inform these areas of the literature and address problems presented in each. This review is intended to provide a roadmap for future researchers, administrators, clinicians, and policy makers.

Research on Age-Friendly Community Initiatives: Taking Stock and Moving Forward

ABSTRACTAge-friendly community initiatives (AFCIs) are a promising approach to supporting physical, cognitive, mental, and social health in later life, but to date, there are gaps in our understanding of these initiatives' development, implementation, sustainability, and effectiveness. In this article we describe existing scholarship on age-friendly community initiatives, focusing attention on conceptual and empirical knowledge development regarding what age-friendliness and AFCIs are, as well as AFCIs' inputs (i.e., the process of age-friendly community change), outputs (i.e., organizational and community changes), and outcomes (i.e., changes in individual older adults). We then discuss some of the barriers to integrating research and practice in this field, including AFCIs' multifaceted approach and limited funding for evaluation and research. We conclude with steps to advance knowledge that can help to promote more evidence-informed age-friendly policies and practices. Additional scholarship regarding what change processes work under what conditions, in what ways, and for whom is essential to supporting the systematic development of community-wide approaches to promote the health and well-being of older adults.