Neighborhood Social Environment and Lower Extremity Function in Older Adults
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Date
2020-01-01
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Department
Gerontology
Program
Gerontology
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This item may be protected under Title 17 of the U.S. Copyright Law. It is made available by UMBC for non-commercial research and education. For permission to publish or reproduce, please see http://aok.lib.umbc.edu/specoll/repro.php or contact Special Collections at speccoll(at)umbc.edu
This item may be protected under Title 17 of the U.S. Copyright Law. It is made available by UMBC for non-commercial research and education. For permission to publish or reproduce, please see http://aok.lib.umbc.edu/specoll/repro.php or contact Special Collections at speccoll(at)umbc.edu
Abstract
Background: Research examining the linkages between neighborhood social environments and physical function in older adults is scarce. In order to reduce functional health disparities in older adulthood, it is critical to understand the pathways by which neighborhood environments influence physical function, and whether there are differences in these pathways by race/ethnicity and economic status. Objective: The objectives of this research were to (1) examine the associations between the neighborhood social environment (i.e., social cohesion, disorder) and lower extremity function; (2) determine whether physical activity and depression symptoms were potential pathways linking the social environment to physical function; and (3) assess whether race/ethnicity and economic vulnerability moderated these potential pathways. Methods: Data came from wave seven (2017) of the National Health and Aging Trends Study (NHATS). The sample was composed of 3,934 community-dwelling Medicare beneficiaries (Non-Hispanic White (n =2,906), African American (n =781), and Hispanic (n =247)). The analysis for objective one was conducted using ordinary least squares (OLS) regression. Analyses for objectives two and three were conducted using the PROCESS macro, an OLS path analysis modeling tool for estimating mediation and moderated mediation. Results: There was a positive direct association between neighborhood social cohesion and function, while disorder was not directly associated with function. Social cohesion was also indirectly related to function through physical activity and depression symptoms; greater social cohesion was associated with higher levels of physical activity and with less depression symptoms, and both were linked to better function. Neighborhood disorder was only associated with function indirectly through physical activity; high disorder was associated with lower levels of physical activity. There was no evidence of significant differences in pathways by race/ethnicity. The indirect pathways between disorder and function differed by economic vulnerability; among older adults with high economic vulnerability, disorder was associated with poorer function via depressive symptoms, while for those with low economic vulnerability, disorder was associated with poorer function via physical activity. Conclusion: Findings highlight the associations between the neighborhood social environment and lower extremity function and bring attention to differences in the potential pathways linking the two. Policies and programs could strive towards optimizing neighborhood social environments in order to promote functional health in older adulthood.