Yang Jennifer Marie J, Stone Louise
Department of Rehabilitation Medicine, Philippine General Hospital, University of the Philippines Manila.
College of Health and Medicine, School of Medicine and Psychology, Australian National University.
Acta Med Philipp. 2024 Nov 15;58(20):77-89. doi: 10.47895/amp.v58i20.8512. eCollection 2024.
The built environment or physical environment consists of surroundings and conditions constructed by human activity. It includes urban design, neighborhoods, transportation, and smaller scale structures like the design and layout of rooms within buildings. The built environment can affect the physical, social, and functional wellbeing of older adults, both within their own homes and in the neighborhoods in which they live, and additionally plays a part in promoting healthy aging. This narrative review of the literature aims to present the ways in which the built environment can influence the functional ability of community-dwelling older adults, and affect their ability to live independently and age in place.
Narrative literature review and inductive thematic analysis.
Forty-five full-text, English language publications from peer-reviewed sources were selected for this review, with the majority (35) presenting quantitative research findings and originating from North America (28). Older adults in rural and developing countries were underrepresented in the literature, despite acknowledgement that health of the aging population is a worldwide problem. Three major themes emerged. First, the built environment affects older adults in the most fundamental way at home through design considerations, modifications, and technological advances promoting aging in place and accessibility. Secondly, built environments outside the home can affect older adults' physical activity and overall function with regard to mobility, transportation, and activities of daily living. The majority (22 of 45 publications) focused on this theme. Finally, the built environment in neighborhoods can affect older adults' perception of social support, their social participation, and quality of life.
As the built environment is created by humans and can be substantially modified, it possesses considerable potential for enhancing functional ability, social participation, and overall quality of life in community-dwelling older adults. It is possible to design a better person-environment fit, promoting safety, independence, optimal health, and quality of life. In order to support healthy aging, improvements in the built environment need to be accompanied by appropriate health and social policies, systems, and services. These changes require political will, as well as material resources that may not be readily available especially in the global South. A socioecological approach with adequate resources directed to older adults' health and healthcare is necessary in order to achieve the ultimate goal of healthy aging in this population.
建成环境或物理环境由人类活动构建的周边环境和条件组成。它包括城市设计、社区、交通，以及较小规模的建筑结构，如建筑物内房间的设计和布局。建成环境会影响老年人在自家以及居住社区内的身体、社会和功能健康，此外还在促进健康老龄化方面发挥作用。本叙述性文献综述旨在阐述建成环境影响社区居住老年人功能能力的方式，以及影响他们独立生活和原地养老能力的方式。
叙述性文献综述和归纳主题分析。
本综述从同行评审来源中选取了45篇英文全文出版物，其中大多数（35篇）呈现了定量研究结果，且大多来自北美（28篇）。尽管认识到老龄化人口的健康是一个全球性问题，但农村和发展中国家的老年人在文献中的代表性不足。出现了三个主要主题。第一，建成环境通过设计考量、改造和促进原地养老及无障碍通行的技术进步，在家中以最基本的方式影响老年人。第二，家外的建成环境会影响老年人在移动性、交通和日常生活活动方面的身体活动和整体功能。大多数（45篇出版物中的22篇）关注这一主题。最后，社区的建成环境会影响老年人对社会支持的感知、他们的社会参与和生活质量。
由于建成环境是由人类创造的，并且可以进行大幅改造，因此它在增强社区居住老年人的功能能力、社会参与和整体生活质量方面具有巨大潜力。有可能设计出更优的人与环境匹配，促进安全、独立、最佳健康和生活质量。为了支持健康老龄化，建成环境的改善需要辅以适当的健康和社会政策、系统及服务。这些变革需要政治意愿，以及可能并不容易获取的物质资源，尤其是在全球南方地区。为了实现这一人群健康老龄化的最终目标，采用社会生态方法并将充足资源用于老年人的健康和医疗保健是必要的。
