Disablement in context: neighborhood characteristics and their association with frailty onset among older adults

JT Caldwell, H Lee, KA Cagney - The Journals of Gerontology …, 2019 - academic.oup.com
The Journals of Gerontology: Series B, 2019academic.oup.com
Objectives Frailty, an aggregate expression of risk resulting from age-or disease-associated
physiologic accumulation, is responsible for large economic and societal costs. Little is
known about how the context in which older adult's live may contribute to differences in
frailty. This study clarifies the role of neighborhood structural characteristics and social
processes for understanding declines in health status. Method Data from two waves of the
National Social Life, Health and Aging Project were linked to tract-level information from the …
Objectives
Frailty, an aggregate expression of risk resulting from age- or disease-associated physiologic accumulation, is responsible for large economic and societal costs. Little is known about how the context in which older adults live may contribute to differences in frailty. This study clarifies the role of neighborhood structural characteristics and social processes for understanding declines in health status.
Method
Data from two waves of the National Social Life, Health and Aging Project were linked to tract-level information from the 2000 Census (n = 1,925). Frailty was measured with in-home assessments and self-report. Ordered logistic regressions were employed to estimate the role of tract-level structural and social process indicators at baseline on frailty at follow-up.
Results
Living in a neighborhood characterized with a higher density of African Americans and with more residential instability was associated with higher odds of frailty. Adults in neighborhoods with increasing levels of physical disorder had higher odds of frailty (adjusted odds ratio [AOR]: 1.20, 95% confidence interval [CI]: 1.03, 1.39), while those exposed to more social cohesion had lower odds (AOR: 0.87, CI: 0.78, 0.97).
Discussion
For older adults, both neighborhood structural and social process characteristics appear to be independently associated with frailty.
Oxford University Press
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