Associations among housing accessibility, housing-related control beliefs and independence in activities of daily living: a cross-sectional study among younger old in Sweden

Abstract

There is some evidence that housing accessibility, external housing-related control beliefs (HCB) and activities of daily living (ADL) are associated in complex ways; however, these pathways have not been explored in younger old. The aim was to assess the role of external HCB in the relationship between housing accessibility and ADL by applying moderation and mediation models. This was a cross-sectional study involving 366 community-living 67-70 years old participants from the Skåne part of the Swedish National Study of Aging and Care. We assessed moderation by including an interaction term in a logistic regression analysis (significant if p value < 0.05). We assessed mediation with a series of regression analyses with effect size measures expressed as proportion mediated and its 95% confidence interval (CI). In the absence of statistically significant interaction there was no support for external HCB as a moderator. There was evidence for partial mediation as external HCB was associated with ADL when controlled for housing accessibility, while housing accessibility remained associated with independence in ADL when adjusted for external HCB. The proportion mediated was 6% (95% CI 1; 14). While the results did not support external HCB as a moderator, external HCB mediated the association between housing accessibility and ADL. These results were different from previous findings suggesting that external HCB plays a marginally significant moderating and mediating role among very old. Such differences call for further studies that would allow further exploration and validation of the findings at different stages of the ageing process, preferably utilizing longitudinal study designs.

Longitudinal association between housing accessibility and activities of daily living: the role of self-efficacy and control in people ageing with Parkinson’s disease

“…In previous studies, HCQ showed comparable satisfactory internal consistency of the subscales in 66 -69 and 65 -91 year olds, and good test-retest reliability in 65 -91 year olds in Germany (30); internal consistency in the HHPD baseline sample was acceptable (31). For the current study, the total score combining two scales was dichotomised at 50% cut-off into low (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) and high (34-80) external HCB. GSE was assessed by the self-administered 10-item General self-efficacy Scale (32) at T1.…”

“…In the Swedish younger old, no moderating effect of external HCB was found in relation to the ADL Staircase (19). In very old people from Germany and Sweden those with a higher magnitude of accessibility problems and higher external HCB were more dependent in ADL according to ADL Staircase (p-value = 0.10) (18).…”

“…The GSE Scale has demonstrated satisfactory internal consistency, test-retest reliability and construct validity in people with PD in Sweden (33). For the current study, the total score was dichotomised at a 50% cut-off into low (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) and high (26-40) GSE.…”

“…More specifically, lower self-efficacy was found to be a barrier for exercising (15), while higher general and balance self-efficacy were associated with more life satisfaction (16) and better walking capacity (17). There is some evidence that assigning control over one's housing plays a moderating role in the association between housing accessibility problems and ADL in adults 80-89 years old (18), but not in those 67-70 years old (19), which suggests age related differences. Previous studies were cross-sectional and conducted in the general population limiting causal inference and generalizability to vulnerable populations, such as those ageing with specific chronic diseases.…”

Longitudinal association between housing accessibility and activities of daily living: the role of self-efficacy and control in people ageing with Parkinson’s disease

“…More specifically, lower self-efficacy was found to be a barrier for exercising [15], while higher general and balance self-efficacy were associated with more life satisfaction [16] and better walking capacity [17]. There is some evidence that assigning control over one's housing plays a moderating role in the association between housing accessibility problems and ADL in adults 80-89 years old [18], but not in those 67-70 years old [19], which suggests age related differences. Previous studies were cross-sectional and conducted in the general population limiting causal inference and generalizability to vulnerable populations, such as those ageing with specific chronic diseases.…”