Universidad Industrial de Santander, Bucaramanga, Colombia.
Universidad del Norte, Barranquilla, Colombia.
Cad Saude Publica. 2020 Nov 23;36(11):e00206919. doi: 10.1590/0102-311X00206919. eCollection 2020.
Considering that the world population is rapidly aging and disability is a very frequent event in older adults, there is an increasing interest in studying their determinants, such as the neighborhood characteristics. Thus, this study aimed to explore the association between the social environment of the neighborhood and disability in older adults. A cohort study was assembled using waves 1 and 2 from the Study of Global Ageing and Adults Health (SAGE) in Mexico, which included adults with 55+ years old. Neighborhood characteristics - such as social participation, trust and safety - and individual covariates were measured only in wave 1 (baseline), while disability was measured in both waves to adjust for the score of wave 1. Multilevel negative binomial models with random intercepts at the municipality level were constructed for the disability score in wave 2, using each of the social environment variables as the main exposure and adjusting for the sociodemographic and health-related variables. Finally, interaction terms with sex, age, and socioeconomic quintiles were tested. Results showed that neighborhoods with a medium (IRR: 0.68; 95%CI: 0.53-0.87) or high (IRR: 0.67; 95%CI: 0.52-0.86) safety level were associated with a significant reduction in the disability score of adults older than 75 years, although there was no association between other characteristics of the social environment and disability in the general sample. Consequently, actions to improve safety in the neighborhoods should be carried out to help reduce the disability score in vulnerable older adults, especially in a context where safety is a critical issue, as in Mexico.
考虑到世界人口正在迅速老龄化，残疾在老年人中是一种非常常见的现象，因此人们越来越关注研究其决定因素，如邻里特征。因此，本研究旨在探讨邻里社会环境与老年人残疾之间的关系。该队列研究使用了来自墨西哥全球老龄化和成人健康研究（SAGE）的第 1 波和第 2 波数据，其中包括 55 岁以上的成年人。邻里特征 - 如社会参与度、信任和安全感 - 以及个体协变量仅在第 1 波（基线）中进行测量，而残疾则在两波中进行测量，以调整第 1 波的得分。使用每个社会环境变量作为主要暴露因素，调整社会人口统计学和健康相关变量后，为第 2 波的残疾评分构建了带有市县级随机截距的多层次负二项式模型。最后，测试了与性别、年龄和社会经济五分位数的交互项。结果表明，邻里安全水平中等（IRR：0.68；95%CI：0.53-0.87）或较高（IRR：0.67；95%CI：0.52-0.86）的社区与 75 岁以上成年人的残疾评分显著降低相关，尽管社会环境的其他特征与一般样本中的残疾没有关联。因此，应该采取行动改善邻里安全，以帮助减少弱势老年人的残疾评分，特别是在墨西哥这样的安全是一个关键问题的背景下。
