Abstract
Objective
We examined the difference in the relationship between perceived neighborhood environments
and physical frailty between urban and rural older adults.
Design
Cross-sectional study.
Setting and Participants
Urban and rural community in South Korea; a total of 2593 community-dwelling older
adults aged 70-84 years (mean age: 76.0 years, 51.0% women) in the Korean Frailty
and Aging Cohort Study (KFACS).
Methods
The neighborhood environment was assessed using the 17-item Environmental Module of
the International Physical Activity Questionnaire (IPAQ-E). The IPAQ-E had 7 environmental
factors (residential density, access to destinations, neighborhood infrastructure,
neighborhood safety, social environment, aesthetic qualities, and street connectivity).
Physical frailty was defined using the Fried frailty criteria with modified cutoffs.
Results
The number of participants residing in urban and rural areas was 1902 and 691, respectively.
The prevalence of frailty was 5.3% and 12.0% in urban and rural areas, respectively.
In urban areas, frailty was associated with the total IPAQ-E score (β = −0.007, P = .009) after adjusting for confounding factors. There was no association in the
rural areas (β = −0.003, P = .535). In urban older adults, logistic regression showed that absence of destination
[odds ratio (OR) 2.58, 95% confidence interval (CI) 1.36-4.90] and no crime safety
at night (OR 2.00, 95% CI 1.12-3.57) were associated with a higher risk of frailty.
In rural older adults, poor access to recreational facilities (OR 2.17, 95% CI 1.07-4.40)
and no aesthetics (OR 2.49, 95% CI 1.22-5.10) were associated with frailty.
Conclusions and Implications
Our study indicated that the presence of destination and crime safety at night was
significantly associated with physical frailty among older adults living in urban
areas, whereas aesthetics and recreational facilities were significantly associated
with physical frailty in rural older adults.
Keywords
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Article info
Publication history
Published online: November 18, 2020
Footnotes
This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (grant number: HI15C3153).
The authors declare no conflict of interest.
Identification
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© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
