Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, 474-8511, Aichi, Japan.
Japan Society for the Promotion of Science, Tokyo, Japan.
BMC Geriatr. 2023 Aug 10;23(1):483. doi: 10.1186/s12877-023-04170-z.
This study examined the effect of neighborhood amenities on disability risk among community-dwelling older adults in Japan, based on lifestyle activities.
This was an observational prospective cohort study. Participants comprised 13,258 older adults from the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes. We calculated participants' Walk Score using their home addresses and divided them into three groups: "car-dependent," "somewhat walkable," and "very walkable." We then calculated the average value of lifestyle activities. We divided the neighborhood amenity groups into two groups, "fewer lifestyle activities" and "more lifestyle activities," for a total of six groups. After identifying interactions between neighborhood amenities and lifestyle activities, Cox proportional hazard models to calculate hazard ratios for incident disability risk, based on neighborhood amenities and lifestyle activities.
An interaction occurred between neighborhood amenities and lifestyle activities (p < 0.05). Survival probabilities for incident disability based on lifestyle activities were estimated for each neighborhood amenity group: car-dependent, 1.62 (95% CI 1.07 to 2.46); somewhat walkable, 1.08 (95% CI 0.84 to 1.40); and very walkable, 1.05 (95% CI 0.87 to 1.27). Those with fewer lifestyle activities in the car-dependent group exhibited the highest risk of incident disability in the unadjusted and adjusted models.
Given that the aging population is increasing steadily, considering older adults' neighborhood amenities and lifestyle activities in their day-to-day lives can help clinicians to deliver more older adult-centered care. Incorporating the lifestyle activities and neighborhood amenities of older adults into care planning will lead to the design and development of integrated clinical and community screening programs.
本研究基于生活活动，考察了日本社区居住的老年人的邻里设施对残疾风险的影响。
这是一项观察性前瞻性队列研究。参与者包括来自日本老年医学与老年学国家中心的 13258 名老年人。我们使用他们的家庭住址计算参与者的步行分数，并将他们分为三组：“依赖汽车”、“有些可行走”和“非常可行走”。然后，我们计算了生活活动的平均值。我们将邻里设施组分为“较少的生活活动”和“较多的生活活动”两组，总共六组。在确定邻里设施和生活活动之间的相互作用后，使用 Cox 比例风险模型计算基于邻里设施和生活活动的残疾风险发生率的危险比。
邻里设施和生活活动之间存在交互作用（p<0.05）。根据生活活动，对每个邻里设施组的残疾发生率的生存概率进行了估计：依赖汽车，1.62（95%CI 1.07 至 2.46）；有些可行走，1.08（95%CI 0.84 至 1.40）；非常可行走，1.05（95%CI 0.87 至 1.27）。在未调整和调整模型中，在依赖汽车组中生活活动较少的人群发生残疾的风险最高。
鉴于人口老龄化稳步增加，考虑老年人的邻里设施和日常生活中的生活活动可以帮助临床医生为老年人提供更具针对性的护理。将老年人的生活活动和邻里设施纳入护理计划将导致综合临床和社区筛查计划的设计和开发。
