Mori Yuta, Tsuji Taishi, Watanabe Ryota, Hanazato Masamichi, Miyazawa Takuto, Kondo Katsunori
Department of Rehabilitation, Hananooka Hospital, 707-3, Yamamurocho, Matsusaka, Mie 515-0052, Japan; Department of Public Health, Graduate School of Medicine, University of Chiba, 1-8-1, Inohana, Chuo-ku, Chiba, Chiba 260-8670, Japan.
Faculty of Health and Sport Sciences, University of Tsukuba, 3-29-1, Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan; Center for Preventive Medical Sciences, University of Chiba, 1-33, Yayoicho, Inage-ku, Chiba, Chiba 263-8522, Japan.
Arch Gerontol Geriatr. 2022 Nov-Dec;103:104773. doi: 10.1016/j.archger.2022.104773. Epub 2022 Jul 8.
This study investigated the relationship between built environments and the onset of frailty after 3 years.
This was a longitudinal study using prospective cohort data from the 2013 Japan Gerontological Evaluation Study on 38,829 older adults nested in 562 comunnities who were not frail. The dependent variable, frailty, was assessed using the Kihon checklist. The explanatory variables were eight items for the built environment at the individual and community levels. To consider each level of built environment simultaneously, multilevel Poisson regression analysis was used to calculate risk ratios and 95% confidence intervals.
After 3 years of follow-up, the onset of frailty was 2740 (7.1%) in 2016. At the individual level, there was an increased risk of developing frailty in negative built environments, such as locations with graffiti or garbage (incidence rate ratio (IRR), 1.15; confidence interval (CI), 1.05-1.25). Positive built environments, such as areas with access to parks and sidewalks (IRR, 0.78; CI, 0.70-0.88), lowered the risk of developing frailty. At the community level, the risk of developing frailty was lower only in areas with locations difficult for walking (hills or steps) (IRR, 0.97; CI, 0.94-0.99).
At the individual level, frailty onset was associated with all built environments. However, irrespective of their answers, there was a lower risk of developing frailty among older adults living in areas where walking was difficult. It would be desirable to verify whether the risk of developing frailty can be reduced by changing the built environment.
本研究调查了建成环境与3年后衰弱发病之间的关系。
这是一项纵向研究，使用了2013年日本老年学评估研究中562个社区的38829名非衰弱老年人的前瞻性队列数据。使用基宏检查表评估因变量衰弱。解释变量是个体和社区层面建成环境的八个项目。为了同时考虑建成环境的每个层面，采用多水平泊松回归分析来计算风险比和95%置信区间。
经过3年的随访，2016年衰弱发病者为2740人（7.1%）。在个体层面，在负面建成环境中，如存在涂鸦或垃圾的地方，发生衰弱的风险增加（发病率比（IRR），1.15；置信区间（CI），1.05 - 1.25）。正面建成环境，如可使用公园和人行道的区域（IRR，0.78；CI，0.70 - 0.88），降低了发生衰弱的风险。在社区层面，仅在步行困难的区域（山丘或台阶），发生衰弱的风险较低（IRR，0.97；CI，0.94 - 0.99）。
在个体层面，衰弱发病与所有建成环境相关。然而，无论他们的回答如何，生活在步行困难区域的老年人发生衰弱的风险较低。通过改变建成环境是否可以降低发生衰弱的风险，这有待验证。
