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The Association of Perceived Neighborhood Walkability and Environmental Pollution with Frailty among Community-Dwelling Older Adults in Rural Areas: A Cross-Sectional Study
Mi-Ji Kim1 , Sung-Hyo Seo1 , Ae-Rim Seo1 , Bo-Kyoung Kim1 , Kyoung-Ye Lee2 , Yeun-Soon Choi1 , Jin-Hwan Kim3 , Jang-Rak Kim1 , Yune-Sik Kang1 , Baek-Geun Jeong1 , Ki-Soo Park1,2
1Department of Preventive Medicine and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Korea
2Center for Farmers Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
3Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
Corresponding Author: Ki-Soo Park ,Tel: 82-55-772-8095, Fax: 82-55-772-8099, Email: parkks@gnu.ac.kr
Received: June 26, 2019;  Accepted: October 24, 2019.
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.
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 2018 and August 2018. Perceived neighborhood walkability was measured using 20 items that were selected and revised from the Neighborhood Environment Walkability Scale (NEWS), the Neighborhood Walkability Checklist from the National Heart Foundation of Australia, and the Physical Activity Neighborhood Environment Survey (PANES). The Kaigo-Yobo Checklist was used to assess participants??frailty.
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% CI, 0.833-0.932; p<0.001) and severe perceived neighborhood environmental pollution (aOR, 1.052; 95% CI, 1.017-1.087; p=0.003) after adjusting for sex, age, cohabitation status, educational attainment, employment status, monthly income, grip strength, and polypharmacy.
More studies are warranted to establish causal relationships between walkability and environmental pollution and frailty.
Key words: Frailty; Built Environment; Walkability; Environmental Pollution; Rural Population; Frail Elderly
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