This study aimed to explore the prevalence of and risk factors for self-neglect among older adults who live alone. Data were obtained through face-to-face interview responses of 1,023 older adults living alone in a metropolitan area in South Korea, selected via stratified random sampling, which considered the population variables gender, age group, and district. Descriptive statistics were used to characterize the prevalence of self-neglect, and hierarchical multiple regression analysis was conducted to identify significant risk factors of self-neglect. At least 22.8% of the participants could be considered to have one form of elder self-neglect. Consistent with previous research, self-neglect was more prevalent in the older people living alone who had higher levels of depressive symptoms or a lack of family social support. Unexpectedly, self-neglect was more prevalent among respondents with higher levels of education and cognitive abilities, lower levels of medical comorbidities, and more children. Additionally, social networks of friends and use of social services (formal social support) did not affect the frequency of self-neglect. The findings have implications for gerontological practice and policy, especially for older people living alone in South Korea.
Findings call attention to the complexity of gentrification, and the need for more research examining how the intersection of neighborhood and individual characteristics influences older adults' health. Results reinforce the need for neighborhood-level interventions as well as relocation support to promote health in later life and caution against an overemphasis on aging in place.
Background and Objectives
Cities and counties worldwide have adopted the concept of “age-friendly communities.” These communities aspire to promote older adults’ well-being by providing a safe, affordable built environment and a social environment that encourages their participation. A major limitation in this field is the lack of valid and reliable measures that capture the complex dimensionality and dynamic nature of the aging-environment interface.
Research Design and Methods
This study uses data from the AARP 2016 Age-Friendly Community Surveys (N=3,652 adults ages 65 and older). The survey includes 62 indicators of age-friendliness, e g., outdoor spaces, transportation, housing, social participation, and community and health services. We randomly split the sample into two equal subsamples for confirmatory factor analysis (CFA) and structural equation modeling (SEM).
Results
CFA results indicated that both the five-factor model and the second-order factor model adequately fit the data. In the SEM five-factor model, outdoor space (β=.134; p=.017), social participation (β=.307; p<.001), and community and health services (β=-.149; p=.008) were associated with self-rated health, the outcome of interest. The path coefficients of housing and transportation were not significant. In the second-order factor model, people who lived in more age-friendly communities reported better self-rated health (β=.295; p<.001).
Discussion and Implications
Our findings show that the Age-Friendly Community Survey measures demonstrate reliability and concurrent validity. To promote older adults’ well-being, practitioners, policymakers, and researchers should focus on improving their built and social environments. They can use these measures for short- and long-term planning, monitoring, and evaluating age-friendly community initiatives.
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