BackgroundThere is renewed interest in the role of the built environment in public health. Relatively little research to date investigates its impact on healthy ageing. Ageing in place has been adopted as a key strategy for coping with the challenges of longevity. What is needed is a better understanding of how individual characteristics of older people's residential environments (from front door to wider neighbourhood) contribute to their wellbeing, in order to provide the basis for evidence-based housing/urban design and development of interventions. This research aimed to develop a tool to objectively measure a large range of built environment characteristics, as the basis for a preliminary study of potential relationships with a number of 'place-related' functional, emotional and social wellbeing constructs.MethodsThrough a review of urban design literature, design documents, and existing measures, a new tool, the NeDeCC (Neighbourhood Design Characteristics Checklist) was developed. It was piloted, refined, and its reliability validated through inter-rater tests. A range of place-related wellbeing constructs were identified and measured through interviews with 200 older people living in a wide variety of rural-urban environments and different types of housing in England. The NeDeCC was used to measure the residential environment of each participant, and significant bivariate relationships with wellbeing variables were identified.ResultsThe NeDeCC was found to have convincing face and construct validity and good inter-rater and test/retest reliability, though it would benefit from use of digital data sources such as Google Earth to eliminate the need for on-site survey. The significant relationships found in the study suggest that there may be characteristics of residential environments of potential relevance for older people's lives that have been overlooked in research to date, and that it may be worthwhile to question some of the assumptions about where and how older people want to live (e.g. villages seem to be positive). They also point to the importance of considering non-linear relationships.ConclusionsThe NeDeCC provides the basis for generation of evidence-based design guidance if it is used in prospective controlled studies or 'natural experiments' in the future. Ultimately, this will facilitate the creation of better places for ageing in place.
J Places and buildings are long established with any change being small-scale and incremental J The functions of places and buildings are obvious J Architectural features and street furniture are in designs familiar to or easily understood by older people A legible environment J There is a hierarchy of street types, such as main streets, side streets, alleyways and passages J Blocks are small and laid out on an irregular grid based on an adapted perimeter block pattern J Streets are short and fairly narrow J Streets are well connected and gently winding with open ended bends to enable visual continuity J Forked and t-junctions are more common than crossroads J Latent cues are positioned where visual access ends, especially at decision points, such as junctions and turnings J Entrances to places and buildings are clearly visible and obvious J Signs are minimal, giving simple, essential information at decision points J Signs have large graphics with realistic symbols in clear colour contrast to the background, preferably dark lettering on a light background J Directional signs are on single pointers J Signs locating important places and buildings are perpendicular to the wall J Signs have non-glare lighting and non-reflective coverings A distinctive environment J Urban and building form is varied J There is a variety of landmarks including historic and civic buildings, distinctive structures and places of activity J There is a variety of welcoming open spaces, including squares, parks and playgrounds J Architectural features are in a variety of styles, colours and materials J There is a variety of aesthetic and practical features, such as trees and street furniture Checklist of characteristics of dementia-friendly neighbourhoods Neighbourhoods for Life Designing dementia-friendly outdoor environments An accessible environment J Land uses are mixed J Services and facilities are within 5-10 minutes walking distance of housing J Footpaths are wide and flat J Pedestrian crossings and public toilets are at ground level J Unavoidable level changes have gentle slopes with a maximum gradient of 1 in 20 J Entrances to places and buildings are obvious and easy to use J Gates/doors have no more than 2kg of pressure to open and have lever handles A comfortable environment J The outdoor environment is welcoming and unintimidating J Urban areas have small, well-defined open spaces with toilets, seating, shelter and lighting J There are quiet side roads as alternative routes away from crowds/traffic J Some footpaths are tree-lined or pedestrianised to offer protection from heavy traffic J Acoustic barriers, such as planting and fencing, reduce background noise J Street clutter, such as a plethora of signs, advertising hoardings and bollards is minimal J Telephone boxes are enclosed J Bus shelters are enclosed and have seating J Seating is sturdy with arm and back rests and in materials that do not conduct heat or cold A safe environment J Footways are wide, well maintained and clean J Bicycle lanes are separate from footways J Pe...
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