How safe is your neighborhood? Perceived neighborhood safety and functional decline in older adults.
How safe is your neighborhood? Perceived neighborhood safety and functional decline in older adults.
复制标题
你的社区安全吗？
DOI：
10.1007/s11606-011-1943-y
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发表时间：
2012
影响因子：
5.7
通讯作者：
Williams,BrieA
中科院分区：
文献类型：
--
作者：
Sun,VivienK;StijacicCenzer,Irena;Kao,Helen;Ahalt,Cyrus;Williams,BrieA
背景邻里特征与健康相关，安全感对于老年人的锻炼和健康尤其重要。关于老年人邻里安全感与功能衰退之间的关系知之甚少。目的确定老年人邻里安全感与功能衰退之间的关系。设计/设置纵向、以社区为基础。参与者 18,043 名 50 岁或以上的人参加了 1998 年和 2008 年健康与退休研究。主要指标主要结果是 10 年功能衰退（新困难）或对任何日常生活活动的依赖、新的行动困难和/或死亡）。主要预测因素是对邻里安全的感知，分为三组：“非常安全”、“中等安全”和“不安全”。我们使用修正的泊松回归来评估邻里安全感与 10 年功能衰退之间的关联，以生成未调整和调整后的相对风险 (ARR)。 关键结果 在基线上，11,742 名参与者 (68.0%) 认为他们的邻里非常安全，4,477 名参与者 (23.3%) 认为他们的邻里安全，1,824 名参与者 (8.7%) 认为不安全。 10 年来，10,338 名参与者 (53.9%) 经历了功能衰退，其中 6,266 名参与者 (50.2%) 认为自己的社区非常安全，2,839 名参与者 (61.2%) 认为自己的社区比较安全，1,233 名参与者 (63.6%) 认为不安全，P < 0.001。对于基线时功能独立的 11,496 名 (63.3%) 参与者，感知的邻里安全与 10 年功能衰退相关（与非常安全组相比，中等安全 ARR 1.15 95% CI 1.09–1.20；不安全 ARR 1.21 95% CI：1.03–1.31）。对于基线功能障碍的参与者来说，感知的邻里安全与 10 年功能衰退之间的关系在统计上并不显着。结论询问老年人他们感知的邻里安全可能会提供有关他们未来功能衰退风险的重要信息。这些发现还表明，未来的研究可能会侧重于评估促进体育活动同时解决安全问题的干预措施是否有助于减少老年人的功能衰退。
BACKGROUNDNeighborhood characteristics are associated with health and the perception of safety is particularly important to exercise and health among older adults. Little is known about the relationship between perception of neighborhood safety and functional decline in older adults.OBJECTIVETo determine the relationship between perceived neighborhood safety and functional decline in older adults.DESIGN/SETTINGLongitudinal, community-based.PARTICIPANTS18,043 persons, 50 years or older, who participated in the 1998 and 2008 Health and Retirement Study.MAIN MEASURESThe primary outcome was 10-year functional decline (new difficulty or dependence in any Activity of Daily Living, new mobility difficulty, and/or death). The primary predictor was perceived neighborhood safety categorized into three groups: “very safe”, “moderately safe”, and “unsafe.” We evaluated the association between perceived neighborhood safety and 10-year functional decline using a modified Poisson regression to generate unadjusted and adjusted relative risks (ARR).KEY RESULTSAt baseline 11,742 (68.0%) participants perceived their neighborhood to be very safe, 4,477 (23.3%) moderately safe, and 1,824 (8.7%) unsafe. Over 10 years, 10,338 (53.9%) participants experienced functional decline, including 6,266 (50.2%) who had perceived their neighborhood to be very safe, 2,839 (61.2%) moderately safe, and 1,233 (63.6%) unsafe,P< 0.001. For the 11,496 (63.3%) of participants who were functionally independent at baseline, perceived neighborhood safety was associated with 10-year functional decline (moderately safe ARR 1.15 95% CI 1.09–1.20; unsafe ARR 1.21 95% CI: 1.03–1.31 compared to very safe group). The relationship between perceived neighborhood safety and 10-year functional decline was not statistically significant for participants who had baseline functional impairment.CONCLUSIONAsking older adults about their perceived neighborhood safety may provide important information about their risk of future functional decline. These findings also suggest that future studies might focus on assessing whether interventions that promote physical activity while addressing safety concerns help reduce functional decline in older adults.