Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands; Zonnehuisgroep Amstelland, Amstelveen, the Netherlands; Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Arch Gerontol Geriatr. 2019 Nov-Dec;85:103901. doi: 10.1016/j.archger.2019.103901. Epub 2019 Jul 16.
To determine cross-sectional and longitudinal associations of environmental factors with frailty and disability.
This study was conducted in a sample of Dutch citizens. At baseline the sample consisted of 429 subjects (aged ≥ 65 years); a subset of this sample participated again two and half years later (N = 355). The participants completed a web-based questionnaire, "the Senioren Barometer", comprising seven scales for assessing environmental factors, and the Tilburg Frailty Indicator (TFI) and the Groningen Activity Restriction Scale (GARS), for assessing frailty and disability, respectively. Environmental factors of interest were: nuisance; housing; facilities; residents; neighborhood; stench/noise; and traffic.
Sequential regression analyses demonstrated that all environmental factors together explained a significant part of the variance of physical and social frailty and disability in performing activities of daily living (ADL) and instrumental activities of daily living (IADL), measured at Time 1 (T1) and Time 2 (T2). These analyses also showed that four of the environmental factors were associated with at least one of the outcome measures: housing, nuisance, residents, and neighborhood. Housing was the only environmental factor associated with three different outcome measures (social frailty, ADL disability, IADL disability), assessed at T1 and T2.
The findings offer health-care and welfare professionals and also policymakers starting points for interventions. These interventions should focus, in particular, on housing, nuisance, residents, and neighborhood, because their impact on frailty and/or disability was the largest.
确定环境因素与虚弱和残疾的横断面和纵向关联。
本研究在荷兰公民样本中进行。在基线时，样本由 429 名受试者（年龄≥65 岁）组成；该样本的一部分在两年半后再次参加（N=355）。参与者完成了一个基于网络的问卷，“老年人晴雨表”，包括七个评估环境因素的量表，以及蒂尔堡虚弱指标（TFI）和格罗宁根活动限制量表（GARS），分别评估虚弱和残疾。感兴趣的环境因素包括：滋扰；住房；设施；居民；邻里；恶臭/噪音；以及交通。
顺序回归分析表明，所有环境因素共同解释了在 T1 和 T2 测量的日常生活活动（ADL）和工具性日常生活活动（IADL）中的身体和社会虚弱和残疾的部分方差。这些分析还表明，有四个环境因素与至少一个结果测量指标有关：住房、滋扰、居民和邻里。住房是唯一一个与三个不同的结果测量指标（社会虚弱、ADL 残疾、IADL 残疾）相关的环境因素，这些指标在 T1 和 T2 进行了评估。
这些发现为医疗保健和福利专业人员以及政策制定者提供了干预的起点。这些干预措施应特别侧重于住房、滋扰、居民和邻里，因为它们对虚弱和/或残疾的影响最大。
