Savage Rachel D, Huynh Tai, Hahn-Goldberg Shoshana, Matai Lavina, Boblitz Alexa, Altaf Azmina, Bronskill Susan E, Brown Kevin A, Feng Patrick, Lewis-Fung Samantha E, Sheth Maya S, Yu Christina, Recknagel Jen, Rochon Paula A
Women's Age Lab, Women's College Hospital, Toronto, Ontario, Canada.
Women's College Research and Innovation Institute, Women's College Hospital, Toronto, Ontario, Canada.
J Am Geriatr Soc. 2025 Jan;73(1):74-87. doi: 10.1111/jgs.19278. Epub 2024 Dec 1.
Naturally occurring retirement communities (NORCs) are geographical areas that have naturally become home to a large concentration of older adults. This density means that NORCs have the potential to become a pillar for aging in place strategies, but at present, there is limited data on residents and their health needs. Our objective was to describe and compare the health and healthcare use of older adults living in high-rise NORC buildings to those in all other housing types in the community.
We conducted a population-based descriptive study of community-dwelling older adults aged ≥65 years by linking a provincial NORC registry in Ontario, Canada with health administrative records. Individuals were classified as NORC residents if their residential postal code on January 1, 2020 matched the NORC registry. Sociodemographic, clinical, and healthcare use characteristics were compared by NORC status using standardized differences (STD) and stratified by rurality, and further by age and sex in urban settings.
Overall, 219,995 (7.7%) of 2,869,706 older adults were NORC residents. Compared to community-dwelling older adults, NORC residents were older (mean 77.4 vs 74.6 years; STD 0.34), and more were female (61.8% vs 52.2%; STD 0.19) and had low income (16.0% vs 9.3%; STD 0.11). NORC residents also had more active chronic conditions (mean 1.9 vs 1.5; STD 0.27), medications (mean 3.4 vs 2.8; STD 0.21), home care use (15.3% vs 9.8%; STD 0.17), and primary care visits (mean 9.7 vs 7.6 visits in prior 2 years; STD 0.22). Findings were robust across rurality, age, and sex.
Our findings suggest that NORC residents have greater health needs than other older adults living in the community and underscore NORCs as important targets for equity-focused strategies to support aging in place.
自然形成的退休社区（NORC）是指那些自然地成为大量老年人聚居地的地理区域。这种人口密度意味着NORC有潜力成为就地养老策略的支柱，但目前，关于居民及其健康需求的数据有限。我们的目标是描述和比较居住在高层NORC建筑中的老年人与社区中其他所有住房类型的老年人的健康状况和医疗保健使用情况。
我们通过将加拿大安大略省的省级NORC登记册与健康管理记录相链接，对年龄≥65岁的社区居住老年人进行了一项基于人群的描述性研究。如果个体在2020年1月1日的居住邮政编码与NORC登记册匹配，则被归类为NORC居民。使用标准化差异（STD）按NORC状态比较社会人口学、临床和医疗保健使用特征，并按农村地区进行分层，在城市环境中进一步按年龄和性别分层。
总体而言，2869706名老年人中有219995名（7.7%）是NORC居民。与社区居住的老年人相比，NORC居民年龄更大（平均77.4岁对74.6岁；STD 0.34），女性更多（61.8%对52.2%；STD 0.19），且低收入者更多（16.0%对9.3%；STD 0.11）。NORC居民也有更多活跃的慢性病（平均1.9种对1.5种；STD 0.27）、药物（平均3.4种对2.8种；STD 0.21）、家庭护理使用（15.3%对9.8%；STD 0.17）以及初级保健就诊（前两年平均9.7次对7.6次就诊；STD 0.22）。这些发现在农村地区、年龄和性别方面都很稳健。
我们的研究结果表明，NORC居民比社区中其他老年人有更大的健康需求，并强调NORC是支持就地养老的以公平为重点策略的重要目标。
