Department of Geography, National Distance Education University (UNED), 28040 Madrid, Spain.
Research Group on Ageing (GIE-CSIC), Institute of Economics, Geography and Demography (IEGD), Spanish National Research Council (CSIC), 28037 Madrid, Spain.
Int J Environ Res Public Health. 2020 Nov 10;17(22):8305. doi: 10.3390/ijerph17228305.
The academic literature contains little information regarding the interventions that create age-friendly cities and communities in order to promote active ageing. A systematic review was carried out to determine the available empirical evidence in relation to the characteristics, content and effectiveness of interventions aimed at improving environmental and psychosocial risk factors for older people, from the perspective of age-friendly communities and the promotion of active ageing. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the studies retained in this review were identified through a systematic search of the academic literature in selected electronic databases including Web of Science and Scopus. Independent critical appraisal and data extraction were conducted by two reviewers. The checklist was used to assess the quality of the articles. : The search identified 1020 potentially eligible documents, of which 11 satisfied the established criteria. Non-exhaustive practices prevailed over rigorous investigations, with a high proportion of studies observed to be of low methodological quality and at high risk of bias. This reflected the predominance of uncontrolled interventions. Environmental interventions were focused on reducing risk and adapting the everyday environmental setting, while psychosocial interventions prioritised social strategies (behavioural changes, promotion of participation) and training. Interventions were more effective in certain domains of age-friendly cities and communities such as transportation and housing, followed by increased participation as a lifestyle-related behavioural change. The inferred changes were associated with providing information and enhancing skills; modifying access, barriers, exposures, and opportunities; enhancing services and support; continuity and effectiveness of changes over time; and modifying policies based on the bottom-up approach of age-friendly cities and communities (AFCC). Interventions focused on personal and organisational aspects might have positive effects in the longer term. However, fewer changes would be observed in interventions revolving around changing lifestyles owing to the impact of complex multi-causal factors. The relative effectiveness in terms of health calls into question the design of interventions and the supposed "friendliness" of certain communities. There is a need to encourage sound longitudinal research aimed at providing key knowledge for the implementation and evaluation of public policies, and to encourage age-friendly community programmes to promote active ageing.
学术文献中关于创建有利于老年人的城市和社区的干预措施的信息很少，这些干预措施旨在促进积极老龄化。进行了系统评价，以确定从有利于老年人的社区和促进积极老龄化的角度出发，改善老年人环境和心理社会风险因素的干预措施的特征、内容和有效性的现有经验证据。根据系统评价和荟萃分析的首选报告项目 (PRISMA) 指南，通过在选定的电子数据库（包括 Web of Science 和 Scopus）中系统搜索学术文献，确定了本综述中保留的研究。两名评审员独立进行批判性评估和数据提取。使用清单评估文章的质量。：搜索确定了 1020 篇潜在合格文献，其中 11 篇符合既定标准。非穷尽性实践普遍存在于严格调查之上，很大一部分研究被观察到方法质量低且存在高度偏倚风险。这反映了无控制干预的主导地位。环境干预侧重于降低风险和适应日常环境设置，而心理社会干预则优先考虑社会策略（行为改变、促进参与）和培训。干预措施在有利于老年人的城市和社区的某些领域（如交通和住房）更有效，其次是增加作为与生活方式相关的行为改变的参与度。推断的变化与提供信息和增强技能有关；修改访问权限、障碍、暴露和机会；增强服务和支持；随着时间的推移，改变的连续性和有效性；以及根据有利于老年人的城市和社区的自下而上方法修改政策 (AFCC)。 专注于个人和组织方面的干预措施可能会在长期内产生积极影响。然而，由于复杂多因果因素的影响，围绕改变生活方式的干预措施观察到的变化较少。在健康方面的相对有效性引起了对干预措施设计和某些社区所谓的“友好性”的质疑。有必要鼓励进行良好的纵向研究，为公共政策的实施和评估提供关键知识，并鼓励有利于老年人的社区计划促进积极老龄化。
