Neighbourhood physical environment, intrinsic capacity, and 4-year late-life functional ability trajectories of low-income Chinese older population: A longitudinal study with the parallel process of latent growth curve modelling

Abstract

Background: Knowledge of how intrinsic capacity (IC) and neighbourhood physical environment shape functional ability (FA) trajectories in later life remains understudied. We investigated four-year trajectories of IC and their impact on FA trajectories and the association between neighbourhood physical environment and FA trajectories among community-dwelling older adults in Hong Kong, China. Methods: We conducted a four-wave longitudinal study from 2014 to 2017 in Hong Kong with 2,081 adults aged 65 and above. FA was assessed by The Chinese Lawton Instrumental Activities of Daily Living Scale. We used cognition, affect, locomotion, sensory capacity, and vitality to capture the multiple domains of IC. Neighbourhood physical environment attributes included green space, land use diversity, and availability of facilities, assessed within 200-and 500-meter buffers of respondents' homes. We used the parallel process of latent growth curve model. Findings: IC (Unstandardized coefficient, b = À0.02, p<0.001) and FA (b = À0.20, p<0.001) each decreased significantly over time. Individuals with declines in IC experienced a faster decline in FA over time. Green space within a 200-meter buffer (b = 1.15, p = 0.023), the number of leisure (b = 0.03, p = .0.043) and public transport (b = 0.08, p = .0.003) facilities within a 500-meter buffer slowed the rate of FA decline. Interpretation: The level of FA decreased over time in later life. Changes in IC shaped FA trajectories. Increased residential green space and the number of leisure and public transport facilities in the neighbourhood may help slow FA decline over time. Funding: The Hong Kong Housing Society.

INtrinsic Capacity and its RElAtionship With Life-SpacE Mobility (INCREASE): a cross-sectional study of community-dwelling older adults in Singapore

“…However, notwithstanding the positive association between IC and LSM, it is important to consider that the ability of older adults to age well and correspondingly their life-space can be influenced by the physical environment serving as a barrier or facilitator and its interaction with IC. 47 In addition, even in this cohort of relatively well and functionally independent older adults, as reflected by the overall high ADL and IADL scores, and only 1.2% being overtly frail, we have observed a significant positive association between IC and LSM. This further supports the concept of IC in monitoring overall health status of older people before they experience significant losses in functional ability and LSM.…”

“…However, notwithstanding the positive association between IC and LSM, it is important to consider that the ability of older adults to age well and correspondingly their life-space can be influenced by the physical environment serving as a barrier or facilitator and its interaction with IC. 47 …”

The Effects of Public Open Space on Older People’s Well-Being: From Neighborhood Social Cohesion to Place Dependence

“…Although aging is associated with significant losses and decline, people’s life experience has become more positive due to better emotion regulation as they age [ 65 ]. Studies also show that the old-old group tends to rely more on their immediate environment (like POS) to acquire a good quality of life, as the geographic range of their daily routines is narrower compared with other age groups [ 66 , 67 ].…”

Stakeholders’ Perspective on Working Towards a Healthy Ageing Society: Evidence from a Rapidly Ageing Context

“…Available evidence from the literature accounted for these factors for measuring healthy ageing (Irshad et al, 2021 ; Rivadeneira et al, 2021 ). It was also found that the intrinsic capacity of individuals largely represents the functional ability that enables wellbeing in old age (Beard et al, 2022 ; Lu et al, 2021 ). On the other hand, the extrinsic factors are outside the individuals’ internal mechanism but could have a significant direct or indirect role in determining healthy ageing.…”