Age-friendliness of living environments from the older person’s viewpoint: development of the Age-Friendly Environment Assessment Tool

Abstract

Background according to the World Health Organisation, the role of the environment for older adults is to maintain and facilitate independence and promote quality of life. However, measures that examine the environment in terms of its potential impact on older people are either oriented towards specific aspects of the environment, specifically designed for community-level assessment rather than individually oriented, or are unwieldy for everyday use. Objectives this article describes the development and validation of the Age-Friendly Environment Assessment Tool (AFEAT), assessing whether individual function and frailty impact on perceptions of environmental age-friendliness. The extent to which such perceptions may have moderate impacts of frailty on outcomes such as need for care support, quality of life and loneliness is examined. Methods a total of 132 participants aged 58–96 were recruited from retirement villages and local communities in the Midlands of the UK. Participants completed the AFEAT, and a series of measures designed to assess frailty and assessments of quality of life, loneliness and perceptions of functional limitations. Results internal reliability assessment indicated that the AFEAT possesses a Cronbach’s Alpha score of 0.745. The AFEAT significantly predicted quality of life and loneliness, accounting for 17.1% and 5.8% of variance respectively, indicating high concurrent and predictive validity. Furthermore, the AFEAT moderated the predictive strength of frailty in predicting the amount of formal care an individual receives, but not quality of life or loneliness. Discussion the AFEAT is a valid and reliable tool, and analyses highlight the need for an individual-oriented Age-Friendly environment tool.

How Older People Experience the Age-Friendliness of Their City: Development of the Age-Friendly Cities and Communities Questionnaire

“…Table 5 presents the correlations between the AFCCQ and the AFEAT [ 26 ]. The hypothesis that the sum scores of both scales are highly positively correlated (r = 0.75, p < 0.01) was confirmed ( Table 5 ).…”

“…In their words, the WHO’s age-friendly indicators are generalised and overarching and need modification by considering local needs. Garner and Holland [ 26 ] did similar important work from a British perspective. Their works show that a meticulous cross-cultural validation may be an important aspect in moving the AFCCQ further.…”

“…This applies not only to ethnic or cultural diversity, but also to other factors such as gender, age, socioeconomic position or health status, which influence what people consider important when it comes to the age-friendliness of their living environment. Garner and Holland [ 26 ], for example, point to the relation between individual functioning and frailty and perceptions of environmental age-friendliness. When exploring the older people’s perception of their neighbourhood, Scharf et al [ 56 ] found that older people’s ethnic background has an important influence on people’s perceptions.…”

“…During data collection, the items of the AFCCQ were supplemented by the ten core questions of the AFEAT (Age-Friendly Environment Assessment Tool) by Garner & Holland [ 26 ]. This is a validated questionnaire, and its questions needed to be answered using the same five-point Likert scale as with the AFCCQ (ranging from Strongly Disagree—Disagree—Neither Agree/Disagree—Agree—Strongly Agree).…”

“…The study identified 25 indicators as priority indicators for the City of Unley that need to be considered for the development of an age-friendly Unley. Garner and Holland [ 26 ] described the development and validation of the Age-Friendly Environment Assessment Tool (AFEAT), assessing whether individual function and frailty impact on perceptions of environmental age-friendliness. The AFEAT was developed using the WHO Age-Friendly Environment Checklist.…”