Department of Rehabilitation, Hananooka Hospital, Mie, Japan; Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.
Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Institute of Health and Sport Sciences, University of Tsukuba, Tokyo, Japan.
J Am Med Dir Assoc. 2023 Nov;24(11):1677-1682. doi: 10.1016/j.jamda.2023.06.023. Epub 2023 Aug 1.
The purpose of this study was to investigate the association between subjective built environment and the onset of frailty in older adults living in the community. In addition, we examined whether daily walking time, depressive symptoms, and social support from neighbors and friends are mediating factors.
This was a longitudinal study using prospective cohort data from the 2013 Japan Gerontological Evaluation Study.
Participants included 38,829 older adults who were not frail recruited from 22 cities and towns.
The dependent variable, frailty, was assessed using the Kihon checklist. The explanatory variables were 5 items for the subjective built environment. The mediating variables were walking time of at least 30 minutes per day, a Geriatric Depression Scale (GDS) score of at least 5 points, and social support from neighbors and friends. We performed a causal mediation analysis of mediating effects between each built environment and frailty onset. Furthermore, the proportion of mediation was estimated.
After 3 years of follow-up, frailty emerged in 2232 adults (6.7%) in 2016. Access to parks and sidewalks, access to fresh food stores, houses or facilities where people feel free to drop in, and fascinating views, or buildings reduced the onset of frailty. Mediators significantly associated with the built environment and onset of frailty were access to parks and sidewalks (walking time: 5.9%, GDS: 22.9%, social support: 5.9%), access to fresh food stores (GDS: 31.9%, social support: 4.0%), hills and steps (GDS: 20.6%), houses or facilities where people feel free to drop in (walking time: 4.0%, GDS 28.0%, social support: 10.4%), and fascinating views, or buildings (walking time: 7.8%, GDS: 42.1%, social support: 12.0%).
We found that walking time, depression, and social support were mediating factors in the relationship between built environment and the onset of frailty.
本研究旨在探讨社区居住的老年人主观居住环境与虚弱发生之间的关联。此外，我们还研究了每日行走时间、抑郁症状以及邻里和朋友的社会支持是否为中介因素。
这是一项使用 2013 年日本老年评估研究的前瞻性队列数据的纵向研究。
参与者包括从 22 个城市和城镇招募的 38829 名未虚弱的老年人。
因变量为虚弱，使用 Kihon 清单进行评估。解释变量为 5 项主观居住环境项目。中介变量为每天至少行走 30 分钟、老年抑郁量表（GDS）评分至少 5 分以及邻里和朋友的社会支持。我们对每个居住环境与虚弱发生之间的中介效应进行了因果中介分析，并估计了中介效应的比例。
在 2016 年 3 年的随访后，2232 名成年人（6.7%）出现了虚弱。能够到达公园和人行道、新鲜食品店、人们可以自由出入的房屋或设施、迷人的景观或建筑，可以降低虚弱的发生。与居住环境和虚弱发生显著相关的中介因素是能够到达公园和人行道（行走时间：5.9%，GDS：22.9%，社会支持：5.9%）、到达新鲜食品店（GDS：31.9%，社会支持：4.0%）、山丘和台阶（GDS：20.6%）、人们可以自由出入的房屋或设施（行走时间：4.0%，GDS：28.0%，社会支持：10.4%）以及迷人的景观或建筑（行走时间：7.8%，GDS：42.1%，社会支持：12.0%）。
我们发现行走时间、抑郁和社会支持是居住环境与虚弱发生之间关系的中介因素。
