Age-friendly Communities Research Articles

Perceived Gap of Age-Friendliness among Community-Dwelling Older Adults: Findings from Malaysia, a Middle-Income Country.

Background: The United Nations predicts that the global population aged 65 years or above will double from 703 million in 2019 to 1.5 billion by 2050. In Malaysia, the older population has reached 2.4 million, accounting for nearly 8% of the population. This study aimed to evaluate the perceptions of the elderly on the importance and availability of the age-friendly features in eight domains specified by the Global Network of Age-Friendly City and Communities. Methods: This was a cross-sectional study conducted by structured face-to-face and or telephone interviews. Gap score analysis was performed for 32 items of the 8 age-friendly domains. The gap scores were categorized as follows: 0 = not important OR important and element available; 1 = important but unsure whether the element is available; 2 = important but element not available. The gap scores were then dichotomized into “yes” and “no”, and multivariate logistic regression analysis was subsequently performed. Results: From the 1061 respondents, the housing (55.4%) and transportation (50.7%) domains reported the highest mean perceived gap scores. Out of the 32 elements, the highest mean gap percent scores were observed in elderly priority parking bays (83.8%), home visits by healthcare professionals (78.9%), financial assistance for home modification and purchase (66.3%), and affordable housing options (63.6%). Respondents in the city center reported higher gap scores for modified restrooms, parks, volunteer activities, and the internet; respondents in the non-city center reported higher gap scores for nursing homes, healthcare professionals, and cultural celebrations. Age, location, marital status, income, duration of stay, physical exercise, internet access, and intention to continue working were found to be associated with a higher perceived gap in specific domains. Conclusion: The most significant unmet needs were detected in the housing, transportation, and employment opportunities domains. Considerable disparities in the perceived gap were detected between the older population in the city center and non-city center. To address shortcomings in the local age-friendly setting, coordinated municipal policies, political commitment, and benchmarking of existing age-friendly cities are warranted.

Social cohesion and an age-friendly environment determine the life satisfaction of elderly people in rural areas: an integrative review of the literature

Abstract Introduction. As the global population is ageing and life expectancy is gradually increasing, we wanted to use a literature review to study what determines the life satisfaction of older people in rural areas. In doing so, we focused on age-friendly communities that enable older people to live as actively and independently as possible and allow quality ageing. Methods. The integrative literature review method in accordance with PRISMA guidelines was used. The selection of articles in English was made according to the following inclusion criteria: scientificity, content relevance and topicality. The literature search covered the bibliographic-catalogue databases Web of Science and PubMed, from 2010 to 2020. After selection, a qualitative content analysis was applied to the data. Results. From the initial twenty-one articles, we gained an insight into the life satisfaction of the elderly in rural areas through a substantive analysis of nine scientific articles. Two content categories were identified: social cohesion of the elderly and age-friendly environment. Discussion and conclusion. Social cohesion and an age-friendly environment are important for ensuring the life satisfaction of elderly people in rural areas. Based on a review of the literature, we found out that literature focusing on ageing in urban areas predominates. In the future, it will be necessary to study the factors that affect the life satisfaction in geographical locations that are similar in size and cultural and social characteristics.

Responding to Local Needs by Mobilizing Community Assets: Age-Friendly Community Initiatives During the COVID-19 Pandemic.

Background and ObjectivesAge-friendly community initiatives (AFCIs) strive to make localities better for long and healthy lives by fostering improvements across social, physical, and service environments. Despite the heightened need for community supports during the coronavirus disease 2019 pandemic, very little research has addressed the work of AFCIs in the context of this crisis. We aimed to develop theory on how AFCI core teams have contributed to community responses during the pandemic, as well as what contexts have influenced the initiatives’ ability to contribute.Research Design and MethodsAs part of a multiyear, community-partnered study on the development of philanthropically supported initiatives in northern New Jersey, we conducted qualitative interviews with 8 AFCI core teams during the winter of 2020–2021. The interviews focused on the leaders’ efforts at that time, with probing questions concerning enabling factors for their community responses. We analyzed the data using an inductive coding process encompassing open, axial, and subcoding.ResultsThe analysis indicated four distinct roles of AFC core groups: good community partner, creator, advocate, and communications broker. We further found that AFC leaders primarily drew on three types of capital—human, social, and tangible—to enact these roles, oftentimes in cumulative ways.Discussion and ImplicationsWe interpret our study’s findings and their implications by integrating insights from theories of social impact. We further highlight the importance of continued research on community-centered approaches to promote aging in community during times of societal crisis, and otherwise.

Successful Aging

The number of older adults in our society is increasing rapidly. Aging is complex and may occur at varying rates across multiple domains, including biological aging, cognitive aging, and emotional aging. Age-related medical conditions are now among the leading causes of morbidity and mortality among older adults, making healthy aging a major public health priority. Successful aging encompasses more than longevity, medical health, or freedom from disability. It can be viewed as a multidimensional construct including minimization of disability and medical illness combined with maximization of physical, cognitive, emotional, and social functioning. We review the current literature regarding successful aging. We also discuss strategies to improve the likelihood of successful aging and several key advances, such as definitions of successful aging in different populations, neuroplasticity of aging, wisdom as an empirical construct, the concept of a good (or successful) death, and the development of age-friendly communities. This review contains 3 figures, 5 tables, and 53 references. Key words: aging, elderly, older adult, successful aging, successful aging interventions

Social exclusion and health outcomes among empty nest and non-empty nest older people in China

AbstractMany existing studies lack a comprehensive picture of the social exclusion statuses and health outcomes of empty nesters and those empty nesters living alone or with a spouse only. Cross-sectional analysis was conducted on representative national data from the 2014 China Longitudinal Aging Social Survey, focusing on respondents aged 60 and above (N = 7,923). Four dimensions of social exclusion (social relationships, subjective feeling of being excluded, social activities and financial products) and three health outcomes (self-reported health (SRH), activities of daily living (ADLs) and depression), were considered. Results show that ‘empty nest’ older people were more likely to be excluded from social relationships and to experience subjective feelings of being excluded, and were less likely to participate in social activities than non-empty nesters. Empty nesters were significantly less likely to report fair SRH and ADL difficulties than non-empty nesters, but they were more likely to report having depression than non-empty nesters. Among ‘empty nest’ older people, empty nesters who were living alone were associated with higher levels of being excluded from social relationships and to experience subjective feelings of being excluded than those who were living with a spouse only. Future research could focus on the development of age-friendly communities which act as health interventions to address relevant situations of social exclusion and depression among empty nesters.

Perceived neighborhood environment, social capital and life satisfaction among older adults in Shanghai, China

This study examined the mediator role of social capital on the association between perceived neighborhood environment and life satisfaction among older adults in urban China, and further tested the moderating effect of gender in the above paths (i.e., from neighborhood environment to life satisfaction; from neighborhood environment to social capital; from social capital to life satisfaction). We used quota sampling approach to recruit 472 respondents aged 60 years old or older in Shanghai in 2020. From the perspective of structural equation modeling, multiple group analysis was conducted to examine the proposed hypotheses. The measurement model of social capital was well established in urban Chinese community contexts. Based on the whole sample, the results of the mediation model showed that social capital played a mediation role in the association between neighborhood environment and life satisfaction. Furthermore, the results of multiple group analysis showed that the association between neighborhood environment and cognitive social capital was only significant among older women. The findings highlight the role of neighborhood environment and social capital in building age-friendly communities.

The Age-Friendly Community Policy Movement and the Residential Location of U.S. Older Adults: The Case of Hamilton County, Ohio.

This study maps and discusses the status of the age-friendly community movement in a United States (U.S.) residential-geographic context using the AARP Livability Index and Hamilton County, Ohio, as a case study. The framework for the construction of this index shares multiple commonalities with the World Health Organization's widely adopted Age-Friendly Cities and Communities framework. Via visual inspection of maps and spatial analytics, this study compares geographic locations and spatial patterns of census tracts in terms of their residence desirability for older adults based on the Livability Index and actual residence locations of adults aged 65+ in Hamilton County. The comparison reveals that the actual residence locations of older adults differ from those that are most desirable. Given this difference between actual location choices and ideal or age-friendly residential environments, the age-friendly movement needs to discuss the gap between its framework, exemplified here by the AARP Livability Index, and reality to promote and implement its policies more effectively, especially in the U.S.

Age-friendly communities and well-being realization among older native and immigrant populations in the Netherlands: a theory-guided study protocol

BackgroundWith rapid population aging, policy makers and service providers are becoming increasingly aware of the importance of building and maintaining age-friendly communities. Clearly, “age-friendly” relates to the impact of context on people’s well-being. But how? What is an age-friendly community, and does that differ for native and immigrant older people? Up until now, how native and immigrant older people in the Netherlands perceive community age-friendliness, and whether and how age-friendly communities help them realize well-being, remains unknown which limits opportunities to develop appropriate interventions. This article presents a study protocol to identify, theoretically and empirically, how and under what conditions age-friendly communities help native and immigrant older people in the Netherlands realize well-being.We present a theory-guided approach to elucidate differences in neighborhood age-friendliness and requirements for age-friendly community development between native Dutch and immigrant older people. Good interventions are built on good theory. The proposed research will add to theory building by systematically examining what older people get from their neighborhoods and the conditions that influence well-being realization, including the role of individual and neighborhood resources. We posit that physical and social well-being realization will be enhanced in age-friendly communities that support realization of multiple well-being needs and development of solidarity within and between groups in the neighborhood via cross-cutting sharing arrangements.MethodsWe present a mixed-methods design among native and immigrant older people (Turkish, Surinamese and Moroccan) consisting of: (i) Q-studies (combining in-depth interview-based and quantitative analyses); (ii) a pilot survey study; (iii) a main survey study in Rotterdam, the Hague, Utrecht, and Amsterdam; and (iv) focus groups.DiscussionBy exploring truly new ground in the field of age-friendly communities, the results of the proposed research will provide new empirical evidence, advance theory, and be helpful for the development of interventions aimed at improving age-friendliness and well-being for native and immigrant older populations, thereby contributing to resolving the societal challenges of caring for and supporting older people in the community.

도시 노인의 걷기실천과 건강증진에 관한 근거이론 연구

Objectives: This study aimed to conceptualize the walking experience of urban older adults from the perspective of health promotion. Methods: The research design applied a grounded theory approach. Theoretical sampling was implemented until theoretical saturation was reached, and 33 older adults living in a pedestrian-friendly community in Seoul were recruited for the study. Data were collected only at the first stage of social distancing between July and December 2020. This study employed qualitative multi-methods that combined in-depth interviews and field observation. The collected data were analyzed through open, axial, and selective coding, while text and spatial information were integrated during axial coding. Results: The open coding resulted in 83 concepts, 35 subcategories, and 14 categories, which were reconstructed according to the coding paradigm structure for axial coding. The walking experience phenomenon among urban older adults was reflected through the following: “subjectivity as a healthy older adult,” “autonomy of movement,” and “diverse range of daily experiences in terms of walking.” This phenomenon was linked to multidimensional health promotion by facilitating interactions between older adults and the environment in the context of urban old adults. Conclusion: A healthy and age-friendly community should move toward promoting the interaction between older adults and the environment by increasing the frequency of walking for various purposes.

Assessing Age-Friendliness: Individualistic vs. Collectivistic Cultures

ABSTRACT A major task ahead for South Korea is to create age-friendly communities and environments that can support older residents’ health, well-being, and quality of life. To that end, international partnerships have emerged to share information, assess need, and develop response strategies. In this study, the transferability of a US-developed age-friendly community resident survey, based on the WHO framework, was tested in two South Korean cities by comparing results to the same survey conducted in a US city. Descriptive, relational, and predictive analyses revealed the survey items were a better fit for the US city than the South Korean cities. Limited response variances collected in the Korean cities challenged the comparison of data between the Korean sites. Thus, a cultural lens was used to explain response patterns that reflect their understanding of social norms including avoiding disagreement and conflict in order to maintain social equilibrium and five cultural dimensions found in Western and Eastern societies (Individualism vs. collectivism, universalism vs. particularism, low vs. high power distance, low vs. high context, and inner vs, outer control). Recommendations for future assessments in South Korea include shifting focus away from the individual to the individual’s social network and community to improve understanding of need.

Engaged Scholarship in Gerontology: Frank Caro’s Lifetime Contributions

ABSTRACT Dr. Francis G. Caro, retired Professor of Gerontology at the University of Massachusetts Boston, Co-editor (1996–2005) and Editor-in-Chief (2005–2016) of the Journal of Aging and Social Policy, passed away on October 2, 2020. Caro dedicated most of his nearly 60 years of academic and professional activity to gerontology and services for older adults. This article offers a review of his contributions in four central areas of gerontology: the strengthening of long-term services and supports through integration of home care services with other domains, the expansion of how productive aging was socially understood and economically valued, the importance of rigorous program evaluation and ongoing methodological innovation, and the significance of age-friendly cities and communities, both in the United States and internationally. This review of Caro’s work highlights his integral role in helping to place several topics on the gerontological agenda that are still relevant today, establishing him as an important contributor to the field. He also exemplified productive aging and how scholarship can be theoretically rigorous but also applied in meaningful ways to make a difference in individual lives and within communities.

A Policy Framework for Producing Age-Friendly Communities from the Perspective of Production of Space.

Given various hindrances in the macro context, how to efficiently develop age-friendly community policies requires further research. Currently, such kinds of frameworks are lacking. This paper aims to develop a policy framework to minimise cost and resolve conflict of interest between different generations in age-friendly community development. The study adopted a scientometric method to review the theoretical development of age-friendly community studies. Firstly, with a search for the keywords “age-friendly” and “community” on Web of Science, 72 English academic papers were found containing explicit theories. Most of the studies were conducted in the Global North. Then, a mixed analytical method was used to find a suitable theory, “the production of space”, to develop the policy framework. Lastly, a policy framework was developed to overcome barriers to age-friendly community development strategically. Echoing previous studies, this paper proposes a way to counter financial austerity in age-friendly initiative investment and balance the consideration for older and younger populations in urban development. For practice, the policy framework can provide a reference for more efficient age-friendly community policymaking in different regions. For future research, the framework provides a model for more empirical studies considering the social dynamics in age-friendly community development.

Giving, Receiving, and Doing Together: Interorganizational Interactions in Age-Friendly Community Initiatives

ABSTRACT Multi-sectoral collaboration is widely considered essential for age-friendly community change; however, there has been little empirical research to describe the ways in which organizations interact as part of age-friendly community initiatives (AFCIs). We conducted a qualitative descriptive study using data from multiple waves of semi-structured interviews with core teams of eight grant-funded AFCIs in the north-eastern U.S. We employed iterative, inductive coding to systematically describe ways in which AFCI core teams described working with other organizational entities. Findings indicated two overarching themes: (a) helping each other (giving and receiving linking, informational, and instrumental assistance), and (b) doing something together (organizing community events, planning collaborative projects, participating in meetings). We discuss the implications of this characterization for guiding research, evaluation, and policy to optimize AFCI implementation and impact across diverse settings.

Right to the city and community facility planning for elderly: The case of urban renewal district in Hong Kong

The concept of right to the city has attracted increasing attention in urban planning area. However, many cities are far from providing equitable resources. The questions of what is, who has the right, and how it has been affected during urban renewal process have not been fully examined. Although access to public services is widely recognized as an important right, whether elderly’s right to community facilities in urban renewal district has been addressed sufficiently still remains questionable. This study builds a conceptual framework to understand the factors affecting elderly’s right to community facilities in an urban renewal district. Through focus group meetings held in three neighborhoods in Kwun Tong district and spatial analysis, elderly’s perception and the provision of community facilities were ascertained. The findings reveal how inequitable provision of community facilities, gentrification caused by transit-oriented development mode and insufficient mobility services have affected elderly’s right to access community facilities and deprived their rights. Urban renewal, as an important urban planning strategy, has not effectively remedied the inequality in access to public goods. The study recommends strategic planning policies to enhance equitable right to the city in the planning for building a more age-friendly community in urban renewal district.

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.

Developing Synergistic Relationships between Age-Friendly Universities and Age-Friendly Communities

The Age-Friendly University (AFU) initiative was designed to support the Global Network for Age-Friendly Cities and Communities (WHO, 2018) and offers a range of opportunities for institutions of higher education to help communities adapt to their new age-diverse social structures as a result of shifting age demographics. In turn, age-friendly community partnerships are helping to fuel campus efforts to advance age-inclusivity through education, research, and community engagement. At present over 70 institutions have joined the AFU global network, as more campuses prepare to become age-friendly partners. In this collaborative symposium (Directors of Aging Centers and AFU Interest Groups), campus leaders will describe synergistic relationships between their age-friendly campus efforts and the age-friendly efforts of their neighboring communities. Montepare (Lasell University) will provide an overview of the AFU initiative and its set of 10 principles, and make the case that campuses and communities are necessary partners for creating and developing age-friendly efforts. Demonstrating this assertion, Pastor and Rogers (University of Illinois Urbana-Champaign) will describe linkages between their community and campus initiatives, including developing a Panel of Elders, television programming for older adults, and hosting joint events. Black and Andel (University of South Florida) will discuss the intersection between the AFU principles and the processes undertaken by age-friendly communities. Revell and Viveiros (University of Massachusetts Dartmouth) will show how campus collaborations with nearby communities are instrumental in sustaining age-friendly efforts, especially during a pandemic.

GWEP Successes and Lessons Learned From Making Communities Age Friendly

Geriatrics Workforce Enhancement Programs (GWEPs), funded by the Health Resources and Services Administration have a strong focus on age friendly care and community engagement. With a wide range of populations, locales, and health systems served, GWEPs have significant experience working with a wide variety of communities to implement age friendly care. In this symposium, we present successes and lessons learned from GWEP projects representing diverse populations and approaches to achieving age friendly communities. For instance, one GWEP is utilizing Patient Priorities Care to lay the framework for What Matters in clinical decision-making. Another GWEP is focusing on What Matters by uniquely embedding Area Agencies on Aging care coordinators within primary care settings to invite the participation of aging patients in advance care planning, among other health interventions. A third GWEP is using the 4Ms to educate patients and caregivers in geriatric psychiatry clinics in a population of veterans. Another GWEP is pairing Age Friendly Health System efforts within a health system with community-based efforts to become an age friendly and dementia friendly city. A final GWEP is using multiple educational modalities to create Age-Friendly Communities and assure that health systems, community-based organizations, and older adults and families are educated about the 4Ms. By exploring successes and lessons learned in making communities age friendly, we can improve existing and future programs centered on age friendly care for older adults.

Leveraging the Intersection between Age-friendly Universities and Age-Friendly Communities

Age-friendly Universities represent a growing contribution to the worldwide age-friendly movement. For universities, the international effort aims to highlight the role higher education plays in responding to the opportunities associated with an aging population. The initiative outlines ten principles to engage older adults via collegiate mission pertaining to research, education and service. Shared practices suggest diverse and unique application of the guiding tenets across participating colleges and universities. However Age-friendly Universities are also part of a broader ecosystem, situated in geographic locales reflecting actual or prospective age-friendly community status. The global Age-friendly Community movement is a decade-old effort to improve the environments in which we age via a cyclical process. This paper identifies the intersection between Age-friendly University principles and Age-Friendly Community processes and discusses reciprocal considerations for mutual advancement of the broader movement.

Age-Friendly as Tranquilo Ambiente: How Socio-Cultural Perspectives Shape Older Latinos’ Lived Environment

Researchers have increasingly considered the importance of age-friendly communities to improve the health and well-being of older adults. Studies have primarily focused on the built environment, such as community infrastructure, older adult behavior, and environmental expectations. Less attention, however, has been given to the role of cultural characteristics in shaping perceptions of age-friendly environments for Latinos. Using an ethnographic methodological approach, including participant observation in a Latino community near New York City and 72 semi-structured interviews, this study provides empirical insights into how older Latinos characterize age-friendly communities. Latino older adults described their community as age-friendly using Tranquilo Ambiente (TA), which translates to a calm or peaceful environment. According to older adults, a TA possesses the following: 1) a sense of personal safety, including protection of their body, 2) ethnic, social connectedness, including networks with other Latinos and important social and cultural events; and 3) a comparative understanding of their communities treatment of seniors versus other geographical and spatial locations. While much has been written on the role of the built and social environment in developing and implementing age-friendly communities, more research on the cultural significance and understanding of place among marginalized older adults is necessary. TA and its characteristics demonstrate that cultivating an age-friendly setting requires adapting structures and services to promote Latino older adults' social and cultural support and engagement.

Creating an Age-Friendly Model System Through a Community and University Partnership

The University of Massachusetts 5-campus system was the first university system to receive the Age-Friendly University designation in the AFU Global Network (Business West, 2019). Simultaneously, the town of Dartmouth and city of New Bedford became Age-Friendly Communities. This allowed for dynamic collaboration between our university and communities. This presentation highlights several examples. The Ora M. DeJesus Gerontology Center faculty and student researchers developed the original age-friendly survey items for New Bedford’s initial community assessment; and the College of Nursing and Health Sciences faculty and student researchers compiled data for Dartmouth’s survey. Community service during the pandemic has flourished. The Community Companions program, which matches students with community members in social need, went virtual. Nursing students and faculty have been on the frontline in the vaccination efforts in the town of Dartmouth. These partnerships will be presented as examples of potential opportunities for other age-friendly communities. Community-university partnerships are encouraged.