Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-20T11:30:15.584Z Has data issue: false hasContentIssue false
  • English
  • Français

The Physical Environment as a Determinant of the Health Status of Older Populations

Published online by Cambridge University Press:  29 November 2010

Kathy M. Shipp  and
Laurence G. Branch
Kathy M. Shipp
Affiliation:
Duke University
Laurence G. Branch
Affiliation:
Duke University and VA National Center for Health Promotion*
Get access Rights & Permissions [Opens in a new window]

Abstract

Although the physical environment as a co-determinant of health could be approached in many ways, we chose to focus on an understudied area: how the immediate living environment can act as a persuasive force affecting physical activity level in older people, with physical activity in turn affecting health status. To explore this topic, the methods and findings of a literature search are described, the theoretical underpinnings of our thesis are presented, and an example is given of how a planned environment, which upon first glance seems supportive, may have unexpected and negative consequences on the activity level, and ultimately the health status, of the residents. Theory related to changes with aging in homeostatic capacity and reserve capacity of organ systems as well as Lawton's environmental press-competence model are applied to environmental characteristics (e.g., staircases) of continuing care retirement communities. We argue that physically challenging aspects of the environment, such as stairs, should be included in the design of living spaces for the elderly with the goal of encouraging greater daily physical activity and improved health status.

Résumé

Il y a diverses façons d'aborder le sujet de l'environnement physique vu comme co-déterminant de l'état de santé. Nous avons choisi de nous attarder à un domaine peu étudié, soit l'impact de l'aménagement de l'espace domicilaire sur le niveau d'activité physique des personnes âgées, et conséquemment sur l'état de santé des individus. À cette fin, nous décrivrons la méthode et les résultats de notre revue de littérature et les hypothèses qui sous-tendent notre étude. Nous citons l'exemple d' un environnement de toute apparence bien aménagé, et semble-t-il acceuillant, qui malgré tout exerce subtilemment un impact négatif sur le niveau d'activité physique, et éventuellement sur l'état de santé des résidents. La théorie du changement de la capacité homéostatitique et des forces de réserve du corps avec l'avancement en âge, ainsi que le modèle de Lawton environmental press-competence, ont été appliqués aux caractéristiquers environnementales (tels les escaliers) des résidences destinées aux personnes âgées. Il en ressort que l'aménagement de l'espace devrait offrir un certain nombre de défis physiques (tels les escaliers) afin de stimuler davantage d'activités physiques dans la vie quotidienne des résidents, et par conséquent, améliorer leur état de santé.

Keywords

EnvironmentDesignHousingPhysical ActivityOlder PersonsHealth.Environnementdessinaménagementactivité physiquepersonnes âgéessanté.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 18 , Issue 3 , Automne/Fall 1999 , pp. 313 - 327
Copyright
Copyright © Canadian Association on Gerontology 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Kahana, E. A congruence model of person-environment interaction. In: MP, Lawton, PG, Windley, TO, Byerts, eds. Aging and the environment: theoretical approaches. New York: Springer Publishing Company, 1982.Google Scholar
2.Forbes, WF, Lessard, S, Gentleman, JF. Geochemical risk factors for mental functioning, based on the Ontario Longitudinal Study of Aging (LSA) V. Comparison of the results, relevant to aluminum water concentrations obtained from the LSA and from death certificates mentioning dementia. Can J Aging. 1995; 14:642–56.Google Scholar
3.Brown, V. The effects of poverty environments on elders' subjective well-being: a conceptual model. The Gerontologist. 1995; 35:541–48.CrossRefGoogle ScholarPubMed
4.Lawton, MP. Planning and managing housing for the elderly. New York: John Wiley and Sons, Inc., 1975.Google Scholar
5.Anderson, RT, Longino, CF. Concepts and measurement of the housing quality of older adults: Developing a public-health approach. In: WE, Folts, DE, Yeatts, eds., Housing and the aging population: Options for the new century. New York: Garland Publishing, Inc., 1994.Google Scholar
6.Thompson, I. Woldenberg Village: An illustration of supportive design for older persons. Exp Aging Res 1994; 20:239–44.Google Scholar
7.Connell, BR. Role of the environment in falls prevention. Clinics Geriatr Med 1996; 12:859–80.CrossRefGoogle ScholarPubMed
8.Speechley, M, Tinetti, M. Falls and injuriein frail and vigorous community elderly persons. J Amer Geriatr Soc 1991; 39:46–52.CrossRefGoogle ScholarPubMed
9.Connell, BR, Wolf, SL. Environmental and behavioral circumstances associated with falls at home among healthy elderly individuals. Arch Phys Med Rehabil 1997; 78:179–86.Google Scholar
10.Allander, E, Gullberg, B, Johnell, O, Kanis, JA, Ranstam, J, Elffors, L. Circumstances around the fall in a multinational hip fracture risk study: a diverse pattern for prevention. Accid Anal Prev 1998; 30:607–16.CrossRefGoogle Scholar
11.Tinetti, ME, Doucette, JT, Claus, EB. The contribution of predisposing and situational risk factors to serious fall injuries. J Amer Geriatr Soc 1995; 43:1207–13.Google Scholar
12.Northridge, ME, Nevitt, MC, Kelsey, JL. Non-syncopal falls in the elderly in relation to home environments. Osteoporosis Int. 1996; 6:249–55.CrossRefGoogle ScholarPubMed
13.Sattin, RW, Rodriquez, JG, De Vito, CA, Wingo, PA. Home environmental hazards and the risk of fall injury events among community-dwelling older persons. J Amer Geriatr Soc 1998; 46:669–76.Google Scholar
14.Blautz, B, Beck, DE, Selmar, C, Radetsky, M. Modifying the environment: a community-based injury-reduction program for elderly residents. Am J Prev Med 1996; 12(suppl 1): 33–8.Google Scholar
15.Thompson, PG. Preventing falls in the elderly at home: a community-based program. Med J Austr 1996; 164:530–32.CrossRefGoogle Scholar
16.Lilja, M, Borell, L. Elderly people's daily activities and need for mobility support. Scand J Caring Sci 1997; 11:73–80.CrossRefGoogle ScholarPubMed
17.Fox, PL. Environmental modifications in the homes of elderly Canadians with disabilities. Disability Rehabil 1995; 17:43–9.Google Scholar
18.Trickey, F, Maltais, D, Gosselin, C, Robitaille, Y. Adapting older persons' homes to promote independence. Phys Occup Therapy Geriatr 1993; 12:1–14.Google Scholar
19.Gosselin, C, Robitaille, Y, Trickey, F, Maltais, D. Factors predicting the implementation of home modifications among elderly people with loss of independence. Phys Occup Therapy Geriatr 1993; 12:15–27.CrossRefGoogle Scholar
20.Mann, WC, Hurren, D, Tornita, M, Bengali, M, Steinfeld, E. Environmental problems in homes of elders with disabilities. Occup Therapy J Res 1994; 14:191–211.Google Scholar
21.Gill, TM, Robison, JR, Williams, CS, Tinetti, ME. Mismatches between the home environment and physical capabilities among community-living older persons. J Amer Geriatr Soc 1999; 47:88–92.CrossRefGoogle ScholarPubMed
22.Van Den Hombergh, CEJ, Schouten, EG, Van Staveren, WA, Van Amelsvoort, LGPM, Kok, FJ. Physical activities of noninstitutionalized Dutch elderly and characteristics of inactive elderly. Med Sci Sports Exerc 1995; 27:334–39.Google Scholar
23.Sallis, JF, Bauman, A, Pratt, M. Environmental and policy interventions to promote physical activity. Amer J Prev Med 1998; 15:379–97.CrossRefGoogle ScholarPubMed
24.Fries, JF, Crapo, LM. Vitality and aging: implications of the rectangular curve. San Francisco: WH Freeman and Company, 1981.Google Scholar
25.Leaf, A. Dehydration in the elderly. N Engl J Med 1984; 34:791–92.CrossRefGoogle Scholar
26.Lawton, MP. Competence, environmental press, and the adaptation of older people. In P, Lawton, PG, Windley, TO, Byerts, eds. Aging and the environment: theoretical approaches. New York: Springer Publishing Company, 1982.Google Scholar
27.Lawton, MP. Competence, environmental press, and the adaptation of older people. In P, Lawton, PG, Windley, TO, Byerts, eds. Aging and the environment: theoretical approaches. New York: Springer Publishing Company, 1982, pg. 39.Google Scholar
28.Lawton, MP. Competence, environmental press, and the adaptation of older people. In P, Lawton, PG, Windley, TO, Byerts, eds. Aging and the environment: theoretical approaches. New York: Springer Publishing Company, 1982 pg. 46.Google Scholar
29.Lawton, MP. Competence, environmental press, and the adaptation of older people. In P, Lawton, PG, Windley, TO, Byerts, eds. Aging and the environment: theoretical approaches. New York: Springer Publishing Company, 1982Google Scholar
30.Bortz, WM IIThe physics of frailty. J Am Geriate Soc 1993; 41:1004–8.Google ScholarPubMed
31.Spirduso, WW, Gilliam-MacRae, P. Physical activity and quality of life in the frail elderly. In JE, Birren, JE, Lubben, JC, Rowe, DE, Deutchman, eds. The concept and measurement of quality of life in the frail elderly. New York: Academic Press, 1991.Google Scholar
32.Stewart, AL, Hays, RD, Wells, KB, et al. Long-term functioning and well-being outcomes associated with physical activity and exercise in patients with chronic conditions in the medical outcomes study. J Clin Epidemiol 1994; 47:719–30.CrossRefGoogle ScholarPubMed
33.Young, DR, Masaki, KH, Curb, D. Associations of physical activity with performance-based and self-reported physical functioning in older men: The Honolulu Heart Program. J Am Geriate Soc 1995; 43:845–54.CrossRefGoogle ScholarPubMed
34.Buchner, DM, Wagner, EH. Preventing frail health. Clin in Geriate Med 1992; 8:1–17.CrossRefGoogle ScholarPubMed
35.Buchner, DM, Beresford, SA, Larson, EB, LaCroix, AZ, & Wagner, EH. Effects of physical activity on health status in older adults II: Intervention studies. Ann Rev Public Health 1992; 9:9–88.Google Scholar
36.Wolinsky, FD, Stump, TE, Clark, DO. Antecedents and consequences of physical activity and exercise among older adults. The Gerontologist 1995; 35:451–62.CrossRefGoogle ScholarPubMed
37.Astrand, PO. Why exercise? Med Sci Sports Exerc 1992; 24(2):153–62.Google Scholar
38.Branch, LG. Continuing care retirement communities: Self-insuring for long-term care. The Gerontologist 1987; 27:4–8.CrossRefGoogle ScholarPubMed
39.Somers, AR, Spears, NL. The continuing care retirement community: A significant option for long-term care. New York: Springer Publishing Company, 1992.Google Scholar
40.Pynoos, J, Liebig, PS. Housing policy for frail elders: trends and implications for long-term care. In: J, Pynoos, PS, Liebig, eds. Housing frail elders: International policies, perspectives, and prospects. Baltimore: Johns Hopkins University Press, 1995.Google Scholar
41.Brink, S. Housing the frail elderly in Canada. In: J, Pynoos, PS, Liebig, eds. Housing frail elders: International policies, perspectives, and prospects. Baltimore: Johns Hopkins University Press, 1995.Google Scholar
42.Pynoos, J, Régnier, V. Improving residential environmental environments for the frail elderly: Bridging the gap between theory and application. In: JE, Birren, JE, Lubben, JC, Rowe, DE, Deutchman, eds. The concept and measurement of quality of life in the frail elderly. New York: Academic Press, 1991.Google Scholar
43.Régnier, V, Hamilton, J, Yatabe, S. Assisted living for the aged and frail. New York: Columbia University Press, 1995.Google Scholar
44.Smith, DW, Brett, AW, Straker, JK, Snell, J, Jackson, FW III,, Ulmer, ME. A study of stairs in the housing of independently-li ving elderly people. Int J Aging Human Develop 1994; 39:247–56.Google Scholar
45.Shroyer, JL. Recommendations for environmental design research correlating falls and the physical environment. Exp Aging Res 1994; 20:303–9.CrossRefGoogle ScholarPubMed
46.Nevitt, MC, Cummings, SR, Kidd, S, et.al. Risk factors for recurrent nonsyncopalfalls. J Amer Med Ass 1989; 261:2663–8.Google Scholar
47.Clemson, L, Cumming, RG, Roland, M. Case-control study of hazards in the home and risk of falls and hip fractures. Age Aging 1996: 25:97–101.CrossRefGoogle ScholarPubMed
48.Raphael, D, Cava, M, Brown, I, et.al. Frailty: A public health perspective. Can J Public Health 1995; 86:224–7.Google Scholar
49.Tempier, J, Mullet, GM, Archea, J. An analysis of the behavior of stair users. Washington DC, Center for Building Technology, National Bureau of Standards, Report No. NBSIR–78–1554, 1978.Google Scholar
50.Murray, DM. Design and analysis of group-randomized trials. New York: Oxford University Press, 1998.Google Scholar
51.Rose, G. Sick individuals and sick populations. Int J Epidemiol 1985; 14:32–8.CrossRefGoogle ScholarPubMed