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The Association of Perceived Neighborhood Walkability and Environmental Pollution With Frailty Among Community-dwelling Older Adults in Korean Rural Areas: A Cross-sectional Study

  • Kim, Mi-Ji (Department of Preventive Medicine and Institute of Health Science, Gyeongsang National University College of Medicine) ;
  • Seo, Sung-Hyo (Department of Preventive Medicine and Institute of Health Science, Gyeongsang National University College of Medicine) ;
  • Seo, Ae-Rim (Department of Preventive Medicine and Institute of Health Science, Gyeongsang National University College of Medicine) ;
  • Kim, Bo-Kyoung (Department of Preventive Medicine and Institute of Health Science, Gyeongsang National University College of Medicine) ;
  • Lee, Gyeong-Ye (Center for Farmer's Safety and Health, Gyeongsang National University Hospital) ;
  • Choi, Yeun-Soon (Department of Preventive Medicine and Institute of Health Science, Gyeongsang National University College of Medicine) ;
  • Kim, Jin-Hwan (Department of Health Policy and Management, Seoul National University College of Medicine) ;
  • Kim, Jang-Rak (Department of Preventive Medicine and Institute of Health Science, Gyeongsang National University College of Medicine) ;
  • Kang, Yune-Sik (Department of Preventive Medicine and Institute of Health Science, Gyeongsang National University College of Medicine) ;
  • Jeong, Baek-Geun (Department of Preventive Medicine and Institute of Health Science, Gyeongsang National University College of Medicine) ;
  • Park, Ki-Soo (Department of Preventive Medicine and Institute of Health Science, Gyeongsang National University College of Medicine)
  • Received : 2019.06.26
  • Accepted : 2019.10.24
  • Published : 2019.11.29

Abstract

Objectives: The aim of this study was to evaluate the associations of frailty with perceived neighborhood walkability and environmental pollution among community-dwelling older adults in rural areas. Methods: The participants were 808 community-dwelling men and women aged 65 years and older in 2 rural towns. Comprehensive information, including demographics, socioeconomic status, grip strength, polypharmacy, perceived neighborhood environment (specifically, walkability and environmental pollution), and frailty, was collected from participants using face-to-face interviews conducted between June and August 2018. Perceived neighborhood walkability was measured using 20 items that were selected and revised from the Neighborhood Environment Walkability Scale, the Neighborhood Walkability Checklist from the National Heart Foundation of Australia, and the Physical Activity Neighborhood Environment Survey. The Kaigo-Yobo Checklist was used to assess participants' frailty. Results: The overall prevalence of frailty in this community-dwelling population was 35.5%. Sex, age, cohabitation status, educational attainment, employment status, grip strength, and polypharmacy were significantly associated with frailty. In the logistic regression analysis, frailty was associated with low perceived neighborhood walkability (adjusted odds ratio [aOR], 0.881; 95% confidence interval [CI], 0.833 to 0.932; p<0.001) and severe perceived neighborhood environmental pollution (aOR, 1.052; 95% CI, 1.017 to 1.087; p=0.003) after adjusting for sex, age, cohabitation status, educational attainment, employment status, monthly income, grip strength, and polypharmacy. Conclusions: More studies are warranted to establish causal relationships between walkability and environmental pollution and frailty.

Keywords

References

  1. Korean Statistical Information Service. Statistics on the aged in 2018 [cited 2018 Sep 27]. Available from: http://kosis.kr/publication/publicationWord.do (Korean).
  2. Gobbens RJ, Luijkx KG, Wijnen-Sponselee MT, Schols JM. Towards an integral conceptual model of frailty. J Nutr Health Aging 2010;14(3):175-181. https://doi.org/10.1007/s12603-010-0045-6
  3. Kim DH, Arai H. Social frailty. Korean J Clin Geriatr 2015;16(2):44-49 (Korean). https://doi.org/10.15656/kjcg.2015.16.2.44
  4. Gobbens RJ, van Assen MA, Luijkx KG, Wijnen-Sponselee MT, Schols JM. Determinants of frailty. J Am Med Dir Assoc 2010;11(5):356-364. https://doi.org/10.1016/j.jamda.2009.11.008
  5. Topinkova E. Aging, disability and frailty. Ann Nutr Metab 2008;52 Suppl 1:6-11. https://doi.org/10.1159/000115340
  6. Xue QL, Fried LP, Glass TA, Laffan A, Chaves PH. Life-space constriction, development of frailty, and the competing risk of mortality: the Women's Health And Aging Study I. Am J Epidemiol 2008;167(2):240-248. https://doi.org/10.1093/aje/kwm270
  7. Barnett DW, Barnett A, Nathan A, Van Cauwenberg J, Cerin E; Council on Environment and Physical Activity (CEPA) - Older Adults Working Group. Built environmental correlates of older adults' total physical activity and walking: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2017;14(1):103. https://doi.org/10.1186/s12966-017-0558-z
  8. Mahmood A, Chaudhury H, Michael YL, Campo M, Hay K, Sarte A. A photovoice documentation of the role of neighborhood physical and social environments in older adults' physical activity in two metropolitan areas in North America. Soc Sci Med 2012;74(8):1180-1192. https://doi.org/10.1016/j.socscimed.2011.12.039
  9. Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies. Health Info Libr J 2009;26(2):91-108. https://doi.org/10.1111/j.1471-1842.2009.00848.x
  10. Brunekreef B, Holgate ST. Air pollution and health. Lancet 2002;360(9341):1233-1242. https://doi.org/10.1016/S0140-6736(02)11274-8
  11. Gent JF, Triche EW, Holford TR, Belanger K, Bracken MB, Beckett WS, et al. Association of low-level ozone and fine particles with respiratory symptoms in children with asthma. JAMA 2003;290(14):1859-1867. https://doi.org/10.1001/jama.290.14.1859
  12. Hwang HS, Yoon JL, Park BJ, Choi HR, Kwon IS, Shinkai S, et al. The validity and reliability of the Kaigo-Yobo checklist in Korean elderly. J Korean Geriatr Soc 2012;16(3):121-132 (Korean). https://doi.org/10.4235/jkgs.2012.16.3.121
  13. Murayama H, Nishi M, Shimizu Y, Kim MJ, Yoshida H, Amano H, et al. The Hatoyama Cohort Study: design and profile of participants at baseline. J Epidemiol 2012;22(6):551-558. https://doi.org/10.2188/jea.JE20120015
  14. Saelens BE, Sallis JF, Black JB, Chen D. Neighborhood-based differences in physical activity: an environment scale evaluation. Am J Public Health 2003;93(9):1552-1558. https://doi.org/10.2105/AJPH.93.9.1552
  15. Heart Foundation. Neighbourhood walkability checklist. How walkable is your community? [cited 2019 Jun 1]. Available from: https://www.heartfoundation.org.au/images/uploads/main/Active_living/Neighbourhood-walkability-checklist.pdf.
  16. Sallis JF, Kerr J, Carlson JA, Norman GJ, Saelens BE, Durant N, et al. Evaluating a brief self-report measure of neighborhood environments for physical activity research and surveillance: Physical Activity Neighborhood Environment Scale (PANES). J Phys Act Health 2010;7(4):533-540. https://doi.org/10.1123/jpah.7.4.533
  17. Hanibuchi T, Nakaya T, Yonejima M, Honjo K. Perceived and objective measures of neighborhood walkability and physical activity among adults in Japan: a multilevel analysis of a nationally representative sample. Int J Environ Res Public Health 2015;12(10):13350-13364. https://doi.org/10.3390/ijerph121013350
  18. Ministry of Health and Welfare. 2018 median income and criteria for selection of medical benefit and national minimum [cited 2017 Aug 18]. Available from: http://www.mohw.go.kr/react/jb/sjb0406vw.jsp?PAR_MENU_ID=03&MENU_ID=030406&CONT_SEQ=341140 (Korean).
  19. Yoo JI, Choi H, Ha YC. Mean hand grip strength and cut-off value for sarcopenia in Korean adults using KNHANES VI. J Korean Med Sci 2017;32(5):868-872. https://doi.org/10.3346/jkms.2017.32.5.868
  20. Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc 2014;15(2):95-101. https://doi.org/10.1016/j.jamda.2013.11.025
  21. Al Snih S, Graham JE, Ray LA, Samper-Ternent R, Markides KS, Ottenbacher KJ. Frailty and incidence of activities of daily living disability among older Mexican Americans. J Rehabil Med 2009;41(11):892-897. https://doi.org/10.2340/16501977-0424
  22. Aguilar-Navarro SG, Amieva H, Gutierrez-Robledo LM, Avila-Funes JA. Frailty among Mexican community-dwelling elderly: a story told 11 years later. The Mexican Health and Aging Study. Salud Publica Mex 2015;57 Suppl 1:S62-S69. https://doi.org/10.21149/spm.v57s1.7591
  23. Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc 2012;60(8):1487-1492. https://doi.org/10.1111/j.1532-5415.2012.04054.x
  24. Jang IY, Jung HW, Lee CK, Lee YS, Kim KI, Kim KW, et al. Rural and urban disparities in frailty and aging-related health conditions in Korea. J Am Geriatr Soc 2016;64(4):908-911. https://doi.org/10.1111/jgs.14074
  25. Jung HW, Jang IY, Lee YS, Lee CK, Cho EI, Kang WY, et al. Prevalence of frailty and aging-related health conditions in older Koreans in rural communities: a cross-sectional analysis of the aging study of Pyeongchang rural area. J Korean Med Sci 2016; 31(3):345-352. https://doi.org/10.3346/jkms.2016.31.3.345
  26. Chong BH, Yang CY, Oh GJ. The difference of subjective symptoms of musculoskeletal disorders and health related quality of life in vinylhouse and non-vinylhouse farmers. J Korean Soc Saf 2010;25(4):68-75 (Korean).
  27. Clarke P, George LK. Understanding and addressing the challenges of disability: the role of the built environment. Am J Epidemiol 2005;95(11):1933-1939.
  28. Renalds A, Smith TH, Hale PJ. A systematic review of built environment and health. Fam Community Health 2010;33(1):68-78. https://doi.org/10.1097/FCH.0b013e3181c4e2e5
  29. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56(3):M146-M156. https://doi.org/10.1093/gerona/56.3.M146
  30. Cesari M, Landi F, Vellas B, Bernabei R, Marzetti E. Sarcopenia and physical frailty: two sides of the same coin. Front Aging Neurosci 2014;6:192.
  31. Clarke P, Ailshire JA, Bader M, Morenoff JD, House JS. Mobility disability and the urban built environment. Am J Epidemiol 2008;168(5):506-513. https://doi.org/10.1093/aje/kwn185
  32. Mosallanezhad Z, Salavati M, Sotoudeh GR, Nilsson Wikmar L, Frandin K. Walking habits and health-related factors in 75-year-old Iranian women and men. Arch Gerontol Geriatr 2014;58(3):320-326. https://doi.org/10.1016/j.archger.2013.11.008
  33. Zhao Y, Chung PK. Neighborhood environment walkability and health-related quality of life among older adults in Hong Kong. Arch Gerontol Geriatr 2017;73:182-186. https://doi.org/10.1016/j.archger.2017.08.003
  34. Rautio N, Filatova S, Lehtiniemi H, Miettunen J. Living environment and its relationship to depressive mood: a systematic review. Int J Soc Psychiatry 2018;64(1):92-103. https://doi.org/10.1177/0020764017744582
  35. Galea S, Ahern J, Rudenstine S, Wallace Z, Vlahov D. Urban built environment and depression: a multilevel analysis. J Epidemiol Community Health 2005;59(10):822-827. https://doi.org/10.1136/jech.2005.033084
  36. Bernstein KT, Galea S, Ahern J, Tracy M, Vlahov D. The built environment and alcohol consumption in urban neighborhoods. Drug Alcohol Depend 2007;91(2-3):244-252. https://doi.org/10.1016/j.drugalcdep.2007.06.006
  37. Leyden KM. Social capital and the built environment: the importance of walkable neighborhoods. Am J Public Health 2003;93(9):1546-1551. https://doi.org/10.2105/AJPH.93.9.1546
  38. Wood L, Shannon T, Bulsara M, Pikora T, McCormack G, Giles- Corti B. The anatomy of the safe and social suburb: an exploratory study of the built environment, social capital and residents' perceptions of safety. Health Place 2008;14(1):15-31. https://doi.org/10.1016/j.healthplace.2007.04.004
  39. Araya R, Dunstan F, Playle R, Thomas H, Palmer S, Lewis G. Perceptions of social capital and the built environment and mental health. Soc Sci Med 2006;62(12):3072-3083. https://doi.org/10.1016/j.socscimed.2005.11.037
  40. Cerin E, Sit CH, Cheung MC, Ho SY, Lee LC, Chan WM. Reliable and valid NEWS for Chinese seniors: measuring perceived neighborhood attributes related to walking. Int J Behav Nutr Phys Act 2010;7:84. https://doi.org/10.1186/1479-5868-7-84

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