Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Finland.
Department of Health Sciences, Lund University, Sweden.
J Gerontol A Biol Sci Med Sci. 2014 Dec;69(12):1562-8. doi: 10.1093/gerona/glu069. Epub 2014 May 26.
We examined the association between perceived environmental barriers to outdoor mobility and loneliness among community-dwelling older people. In addition, we studied whether walking difficulties and autonomy in participation outdoors affected this association.
Cross-sectional analyses of face-to-face home interview data with 848 people aged 75-90 years (mean age: 80.1 years; 62% women) gathered within the "Life-Space Mobility in Old Age" (LISPE) project. Self-reports of loneliness, environmental barriers to outdoor mobility, and difficulties in walking 2 km were obtained with structured questionnaires. Autonomy in participation outdoors was assessed with the "Impact on Participation and Autonomy" questionnaire.
Altogether, 28% of participants reported experiencing loneliness sometimes or often. These participants also reported more difficulties in walking 2 km, restricted autonomy in participation outdoors, and more environmental barriers to outdoor mobility than people not experiencing loneliness. Snowy and icy winter conditions (odds ratio: 1.59 [95% confidence interval: 1.15-2.20]), long distances to services (odds ratio: 1.57 [1.00-2.46]), and hills in the nearby environment (odds ratio: 1.49 [1.05-2.12]) significantly increased the odds for loneliness, even after adjustments for walking difficulties, autonomy in participation outdoors, perceived financial situation, living alone, and health. Path modeling revealed that environmental barriers increased loneliness either through direct association or indirectly through restricted autonomy in participation outdoors.
Prospective studies should investigate whether removing environmental barriers to outdoor mobility improves autonomy in participation outdoors and alleviates loneliness among older people.
我们研究了社区居住的老年人感知到的户外移动环境障碍与孤独感之间的关系。此外，我们还研究了行走困难和户外活动自主性是否会影响这种关联。
这是一项横断面分析，使用“老年生活空间流动性”（LISPE）项目中的面对面家庭访谈数据，共纳入 848 名 75-90 岁（平均年龄：80.1 岁；62%为女性）的老年人。孤独感、户外移动环境障碍以及行走 2 公里的困难程度是通过结构化问卷来评估的。户外活动自主性是通过“参与和自主性的影响”问卷来评估的。
共有 28%的参与者报告有时或经常感到孤独。与不感到孤独的人相比，这些参与者还报告了更多的行走 2 公里的困难、户外活动自主性受限以及更多的户外移动环境障碍。多雪和多冰的冬季条件（优势比：1.59[95%置信区间：1.15-2.20]）、到服务设施的距离较远（优势比：1.57[1.00-2.46]）和附近环境中的丘陵（优势比：1.49[1.05-2.12]）显著增加了孤独感的可能性，即使在调整了行走困难、户外活动自主性、感知的财务状况、独居和健康状况后也是如此。路径建模显示，环境障碍通过直接关联或通过限制户外活动自主性间接地增加了孤独感。
前瞻性研究应调查消除户外移动环境障碍是否能提高老年人的户外活动自主性并减轻孤独感。
