Neighborhood Characteristics and Frailty: A Scoping Review

Abstract

Background and Objectives Frailty is highly prevalent in later life and associated with early mortality and adverse health outcomes. The neighborhood has been identified as an important contributor to individual health, and neighborhood characteristics may contribute to frailty development. A scoping review was conducted of the peer-reviewed literature to better understand how physical and social neighborhood characteristics contribute to frailty. Research Design and Methods Following an established scoping review methodology, we searched four peer-reviewed databases for relevant studies published from January 1, 2008, to December 31, 2018. Data extracted from studies included study characteristics, operationalization of neighborhood, the conceptual model of the neighborhood–frailty relationship, operationalization of frailty, and study findings for associations among neighborhood variables and frailty indicators. Results A total of 522 articles were identified and 13 articles were included in the final data charting. Existing studies suggest that neighborhood characteristics are associated with frailty in later life. Few studies articulated a conceptual model identifying exact mechanisms through which neighborhood factors affected frailty. Studies designs were mostly cross-sectional. Longitudinal studies did not measure neighborhood characteristics over time. Studies varied considerably in how they operationalized the neighborhood. Frailty was most commonly assessed using a 5-point phenotype or a frailty index approach. Discussion and Implications Findings indicate that research on the relationship between neighborhood characteristics and frailty is an emerging area of inquiry. Additional studies are needed to more definitely explicate mechanisms through which neighborhoods contribute to, or protect older adults from, frailty.

Perceived Neighborhood Environment Associated with Sarcopenia in Urban-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study (KFACS)

“…The World Health Organization (WHO) emphasized the role of the physical and social neighborhood environment for “healthy and active aging” in older adults in its guidelines of global age-friendly cities [ 7 , 8 ]. Many studies have previously reported that a poor neighborhood environment is associated with adverse health outcomes, including falls [ 9 ], disability [ 10 ], frailty [ 11 , 12 ], and mortality [ 13 ] all of which are known to be related to sarcopenia. Previous studies have reported that the neighborhood environment promotes healthy lifestyle habits, such as increased physical and social activity [ 13 , 14 , 15 ] and better dietary choices in older adults [ 16 , 17 ].…”

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

“…built environment, social cohesion, socioeconomic status, racial composition) in relation to frailty. 6 That review found a potential role of some social factors in residents' frailty. 6 Neighborhood-level deprivation was commonly used as a measure of social environments, and higher levels of deprivation were found to be associated with higher rates of frailty.…”

Is life-course neighbourhood deprivation associated with frailty and frailty progression from age 70 to 82 in the Lothian Birth Cohort 1936?

“…2 Not everybody ages in the same way: age-related decline in physical and mental capacities and functional abilities are not homogenous. 3 Frailty is an age-related syndrome characterised as increased vulnerability, loss of resistance to stressors, and decreased reserves of capacity, which develops as a consequence of cumulative declines in several inter-related physiological systems. 4,5 Frailty among older people heightens the risk of falls, 6 morbidity 4 and mortality; 7 it is linked to increased healthand social-care costs.…”

“…However, the evidence relied heavily on cross-sectional data and none of the identified investigations utilised repeated neighbourhood assessments through time. 3 Similarly, little is known about how neighbourhood-level factors are associated with frailty progression. 3,11 Places evolve All rights reserved.…”

“…3 Similarly, little is known about how neighbourhood-level factors are associated with frailty progression. 3,11 Places evolve All rights reserved. No reuse allowed without permission.…”