Built environments and frailty in older adults: A three-year longitudinal JAGES study

Yuta Mori; Taishi Tsuji; Ryota Watanabe; Masamichi Hanazato; Takuto Miyazawa; Katsunori Kondo

doi:10.1016/j.archger.2022.104773

Built environments and frailty in older adults: A three-year longitudinal JAGES study

Arch Gerontol Geriatr. 2022 Nov-Dec:103:104773. doi: 10.1016/j.archger.2022.104773. Epub 2022 Jul 8.

Authors

Yuta Mori¹, Taishi Tsuji², Ryota Watanabe³, Masamichi Hanazato⁴, Takuto Miyazawa⁵, Katsunori Kondo⁶

Affiliations

¹ 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. Electronic address: yuta.mori.89@gmail.com.
² 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.
³ Center for Preventive Medical Sciences, University of Chiba, 1-33, Yayoicho, Inage-ku, Chiba, Chiba 263-8522, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan.
⁴ Center for Preventive Medical Sciences, University of Chiba, 1-33, Yayoicho, Inage-ku, Chiba, Chiba 263-8522, Japan.
⁵ Chiba Rehabilitation Center, 1-45-2, Hondacho, Midori-ku, Chiba, Chiba 266-0005, Japan.
⁶ Department of Public Health, Graduate School of Medicine, University of Chiba, 1-8-1, Inohana, Chuo-ku, Chiba, Chiba 260-8670, Japan; Center for Preventive Medical Sciences, University of Chiba, 1-33, Yayoicho, Inage-ku, Chiba, Chiba 263-8522, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan.

PMID: 35849975
DOI: 10.1016/j.archger.2022.104773

Abstract

Background: This study investigated the relationship between built environments and the onset of frailty after 3 years.

Methods: 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.

Results: 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).

Conclusions: 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.

Keywords: Built environment; Frailty; Multilevel regression; Neighborhood environment.