Optimizing Mobility in Later Life: The Role of the Urban Built Environment for Older Adults Aging in Place
Optimizing Mobility in Later Life: The Role of the Urban Built Environment for Older Adults Aging in Place
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DOI：
10.1007/s11524-013-9800-4
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发表时间：
2013-12-01
影响因子：
6.6
通讯作者：
Gallagher, Nancy Ambrose
中科院分区：
文献类型：
--
作者：
Clarke, Philippa;Gallagher, Nancy Ambrose
城市建筑环境中的危险可能会对就地养老的老年人的出行造成障碍。我们以居住在密歇根州底特律市的 1,188 名老年人为样本，调查了城市建筑环境特征与 15 个月行动障碍轨迹之间的关系，该城市经历了快速的经济和结构衰退。数据来自密歇根州家庭护理最低数据集（2001-2008），这是密歇根州老年人的枚举数据库，这些老年人有资格通过医疗补助豁免计划获得联邦或州资助的家庭和社区长期护理。个案经理在入院时和每 90 天进行标准化评估。使用 Google 地球的“街景”功能通过虚拟审核对建筑环境进行了评估。根据无障碍设施的数量（例如，连续的无障碍人行道和公共交通的邻近性），为每个街区创建了一个汇总的无障碍得分。使用增长混合模型，确定了户外活动的两种潜在轨迹：一种捕捉到偶尔的户外活动（占样本的 83%），另一种捕捉到几乎没有家庭以外的活动。控制社会人口统计学和健康风险因素后，生活在交通便利的环境中的个人属于流动性较高的群体的几率要高出 18%（OR=1.18，95% CI=1.01，1.41）。这些发现强调了建筑环境对于城市老年人出行的重要性。
Hazards in the urban built environment can create barriers to mobility among older adults aging in place. We investigated the relationship between urban built environment characteristics and 15-month trajectories of mobility disability in a sample of 1,188 older adults living in Detroit, MI, a city that has undergone rapid economic and structural decline. Data come from the Michigan Minimum Data Set for Home Care (2001-2008), an enumerative database of older adults in Michigan who qualify for federal or state-funded home and community-based long-term care through a Medicaid waiver program. Standardized assessments are made at intake and every 90 days by case managers. Built environments were assessed with a virtual audit using the "Street View" feature of Google Earth. A summary accessibility score was created for each block based on a count of the number of accessible features (e. g., continuous barrier-free sidewalks and proximity of public transportation). Using growth mixture models, two latent trajectories of outdoor mobility were identified: one capturing occasional outdoor mobility (representing 83 % of the sample) and one capturing almost no mobility outside the home. Controlling for sociodemographic and health risk factors, individuals living in more accessible environments had a 18 % higher odds of being in the more mobile group (OR=1.18, 95 % CI=1.01, 1.41). These findings emphasize the importance of the built environment for mobility among urban-dwelling older adults.