Optimizing Mobility in Later Life: The Role of the Urban Built Environment for Older Adults Aging in Place

Abstract

Hazards in the urban built environment can create barriers to mobility among older adults aging in place. We investigated the relationship between urban built environment characteristics and 15-month trajectories of mobility disability in a sample of 1,188 older adults living in Detroit, MI, a city that has undergone rapid economic and structural decline. Data come from the Michigan Minimum Data Set for Home Care (2001Care ( -2008, an enumerative database of older adults in Michigan who qualify for federal or state-funded home and community-based long-term care through a Medicaid waiver program. Standardized assessments are made at intake and every 90 days by case managers. Built environments were assessed with a virtual audit using the "Street View" feature of Google Earth. A summary accessibility score was created for each block based on a count of the number of accessible features (e.g., continuous barrier-free sidewalks and proximity of public transportation). Using growth mixture models, two latent trajectories of outdoor mobility were identified: one capturing occasional outdoor mobility (representing 83 % of the sample) and one capturing almost no mobility outside the home. Controlling for sociodemographic and health risk factors, individuals living in more accessible environments had a 18 % higher odds of being in the more mobile group (OR01.18, 95 % CI01.01, 1.41). These findings emphasize the importance of the built environment for mobility among urban-dwelling older adults.

Associations Between Environmental Characteristics and Life-Space Mobility in Community-Dwelling Older People

“…The findings are in line with Clarke and Gallagher (Clarke & Gallagher, 2013), who, in their study of outdoor mobility trajectories among community-dwelling older people, reported that those with more objectively assessed barriers in their environment were more likely to be homebound than those living in accessible environments. Similarly, Hovbrandt and colleagues (2007) reported that people who experience barriers in the outdoor environment start to avoid moving in those areas, whereas positive features of the environment motivate people to go outdoors.…”

Perceived environmental barriers to outdoor mobility and changes in sense of autonomy in participation outdoors among older people: a prospective two-year cohort study

“…This finding is novel, yet in line with previous studies showing that perceived environmental barriers restrict community-dwelling older people's possibilities for outdoor mobility (Clarke & Gallagher, 2013) and physical activity participation (Adams et al, 2012;Dawson et al, 2007;Granner, Sharpe, Hutto, Wilcox, & Addy, 2007). This study adds knowledge on the influence of environmental factors on older people's satisfaction with their possibilities to live their life as would like and to make autonomous decisions related to daily life.…”

O idoso e a mobilidade urbana: uma abordagem reflexiva para a enfermagem

“…Design of visual orientation signs, barrier-free sidewalks, traffic signs and pedestrian signals and easy access to recreational activities have been shown to be positive for mobility in the elderly; already poor road conditions, heavy traffic, and excessive noise are being shown as the appearance of mobility deficits. 8 …”