Centre for Urban Transitions, Swinburne University of Technology, Hawthorn, VIC, Australia.
Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia.
PLoS One. 2021 Jun 3;16(6):e0252017. doi: 10.1371/journal.pone.0252017. eCollection 2021.
Cross-sectional studies have found some built environmental attributes to be associated with residents' lower levels of mobility (functional capacity to walk outside the home). However, less is known about what environmental attributes are related to mobility decline. This longitudinal study examined area-level associations of specific environmental attributes with mid-to-older aged adults' changes in walking mobility.
Data collected from 4,088 adults (aged 46-71 years at baseline) who participated in a cohort study in Brisbane, Australia were used. The outcome was the change in self-reported mobility score (SF-36) from 2013 to 2016, which were aggregated at the neighborhood (N = 156) and suburb (N = 99) levels, due to the known lack of sensitivity in SF-36 subscales to individual changes. Linear regression analysis examined associations of mobility change with seven environmental attributes measured at baseline (residential density, intersection density, land use mix, density of walking/bike paths, park density, bus stop density, density of social incivilities), adjusting for confounding variables.
Participants on average reported 4% of mobility decline during the 3-year study period. It was found that greater land use diversity was consistently associated with less decline in walking mobility, while greater density of social incivilities was associated with more decline in walking mobility. The latter finding was significant only at the neighborhood level. No consistent associations were observed for residential density, intersection density, density of walking/bike paths, park density, and bus stop density.
Our findings suggest that mid-to-older aged adults who live in areas with lower land use diversity and more social incivilities may be at risk of developing mobility limitations. Recommended policies to slow residents' mobility decline and to achieve aging in place include improving these environmental attributes where needed and advising older adults to relocate to safer, mixed-use neighborhoods.
横断面研究发现，一些建成环境属性与居民较低的流动性（户外行走的功能能力）有关。然而，对于哪些环境属性与流动性下降有关，人们知之甚少。本纵向研究调查了特定环境属性与中老年人步行能力变化的区域水平关联。
本研究使用了来自澳大利亚布里斯班一项队列研究中 4088 名成年人（基线时年龄为 46-71 岁）的数据。结果是 2013 年至 2016 年自我报告的移动能力评分（SF-36）的变化，由于 SF-36 子量表对个体变化的敏感性不足，因此将其汇总到邻里（N=156）和郊区（N=99）水平。线性回归分析考察了在基线时测量的七个环境属性（居住密度、交叉口密度、土地利用混合、步行/自行车道密度、公园密度、公共汽车站密度、社会不文明密度）与移动能力变化的关联，调整了混杂变量。
参与者在 3 年的研究期间平均报告了 4%的移动能力下降。研究发现，土地利用多样性越大，步行能力下降的幅度越小，而社会不文明密度越大，步行能力下降的幅度越大。后一种发现仅在邻里层面上有统计学意义。居住密度、交叉口密度、步行/自行车道密度、公园密度和公共汽车站密度与移动能力下降均无一致关联。
我们的研究结果表明，居住在土地利用多样性较低和社会不文明程度较高地区的中老年人可能面临行动能力受限的风险。建议采取政策来减缓居民的移动能力下降，并实现就地老龄化，包括在必要时改善这些环境属性，并建议老年人迁往更安全、混合用途的社区。
