Associations of neighborhood built and social environments with frailty among mid‐to‐older aged Australian adults

Abstract

Aim: Neighborhood environmental attributes are associated with physical activity and health status. We examined cross-sectional associations of built and social environmental attributes with frailty among community-dwelling mid-to-older aged adults in Australia.Methods: Data from 3419 adults aged 50-74 years living in 200 neighborhoods in Brisbane, Australia, were used. Frailty status was assessed by a frailty index comprising 32 items. The built environment attributes examined were residential density, street connectivity, land use mix, park area and bus stop density. Self-reported levels of safety and social cohesion were used as social environmental factors. Associations were examined using multilevel logistic regression.Results: The prevalence of frailty was 12%. One standard deviation increment in street connectivity in a 1-km network buffer around participants' homes and in a neighbourhood was associated with 23% and 13% higher odds of being frail, respectively. One standard deviation increment in land use mix at the neighborhood level was associated with 12% lower odds of being frail. Higher levels of safety and social cohesion were consistently associated with a lower odds of being frail. Conclusions: Consistent with previous studies, we found that social environmental attributes were relevant to residents' frailty status, whereas the relationships between built environmental attributes and frailty were not clear (frailty was associated with lower street connectivity but with higher land used mix). Community-level initiatives to enhance safety and social cohesion might be effective to reduce frailty. Further research is required to explain the equivocal findings obtained for built environmental attributes and frailty.

Frailty and Environmental Attributes in Older Adults: Insight from an Ecological Model

“…Recently, similar associations between built environmental attributes and frailty have been demonstrated in cross-sectional 34 , 35) and longitudinal studies 36 , 37) . Walking-friendly neighborhoods protect against frailty by promoting everyday physical activity; however, the findings warrant further investigation as a result of being inconsistent 38) .…”

Demographic data in the built environment and human health studies

“…Studies on children and adolescents often include the education level of parents as a controlling factor instead of the grade level of the participants, and there is generally no need to control marital status [31][32][33][34]. Some studies from Australia used the Index of Relative Socio-Economic Advantage and Disadvantage to control social economic status as this index is readily available and widely used in Australia [35][36][37].…”

Social capital, depressive symptomatology, and frailty among older adults in the western areas of China

“…It is a characteristic of social life, including interpersonal trust, norms of reciprocity, mutual aid, and social involvement [19][20][21]. Studies have found that both community-level SC and individual-level SC are negatively associated with the risk of frailty [22,23]. Living in a community with rich civic participation, such as engagement in social activities, was associated with a lower risk of frailty onset among older adults (OR = 0.94) [23].…”