Advanced

Environmental barriers, person-environment fit and mortality among community-dwelling very old people

Rantakokko, Merja; Tormakangas, Timo; Rantanen, Taina; Haak, Maria LU and Iwarsson, Susanne LU (2013) In BMC Public Health 13.
Abstract
Background: Environmental barriers are associated with disability-related outcomes in older people but little is known of the effect of environmental barriers on mortality. The aim of this study was to examine whether objectively measured barriers in the outdoor, entrance and indoor environments are associated with mortality among community-dwelling 80- to 89-year-old single-living people. Methods: This longitudinal study is based on a sample of 397 people who were single-living in ordinary housing in Sweden. Participants were interviewed during 2002-2003, and 393 were followed up for mortality until May 15, 2012. Environmental barriers and functional limitations were assessed with the Housing Enabler instrument, which is intended for... (More)
Background: Environmental barriers are associated with disability-related outcomes in older people but little is known of the effect of environmental barriers on mortality. The aim of this study was to examine whether objectively measured barriers in the outdoor, entrance and indoor environments are associated with mortality among community-dwelling 80- to 89-year-old single-living people. Methods: This longitudinal study is based on a sample of 397 people who were single-living in ordinary housing in Sweden. Participants were interviewed during 2002-2003, and 393 were followed up for mortality until May 15, 2012. Environmental barriers and functional limitations were assessed with the Housing Enabler instrument, which is intended for objective assessments of Person-Environment (P-E) fit problems in housing and the immediate outdoor environment. Mortality data were gathered from the public national register. Cox regression models were used for the analyses. Results: A total of 264 (67%) participants died during follow-up. Functional limitations increased mortality risk. Among the specific environmental barriers that generate the most P-E fit problems, lack of handrails in stairs at entrances was associated with the highest mortality risk (adjusted RR 1.55, 95% CI 1.14-2.10), whereas the total number of environmental barriers at entrances and outdoors was not associated with mortality. A higher number of environmental barriers indoors showed a slight protective effect against mortality even after adjustment for functional limitations (RR 0.98, 95% CI 0.96-1.00). Conclusion: Specific environmental problems may increase mortality risk among very-old single-living people. However, the association may be confounded by individuals' health status which is difficult to fully control for. Further studies are called for. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ENABLE AGE-project, Environment, Mortality, Older people, Housing, Enabler
in
BMC Public Health
volume
13
publisher
BioMed Central
external identifiers
  • wos:000323754900001
  • scopus:84883067441
ISSN
1471-2458
DOI
10.1186/1471-2458-13-783
language
English
LU publication?
yes
id
1912fb12-46a2-4b54-a3e5-e56e144f2873 (old id 4062907)
date added to LUP
2013-11-28 22:37:45
date last changed
2019-11-13 03:10:19
@article{1912fb12-46a2-4b54-a3e5-e56e144f2873,
  abstract     = {Background: Environmental barriers are associated with disability-related outcomes in older people but little is known of the effect of environmental barriers on mortality. The aim of this study was to examine whether objectively measured barriers in the outdoor, entrance and indoor environments are associated with mortality among community-dwelling 80- to 89-year-old single-living people. Methods: This longitudinal study is based on a sample of 397 people who were single-living in ordinary housing in Sweden. Participants were interviewed during 2002-2003, and 393 were followed up for mortality until May 15, 2012. Environmental barriers and functional limitations were assessed with the Housing Enabler instrument, which is intended for objective assessments of Person-Environment (P-E) fit problems in housing and the immediate outdoor environment. Mortality data were gathered from the public national register. Cox regression models were used for the analyses. Results: A total of 264 (67%) participants died during follow-up. Functional limitations increased mortality risk. Among the specific environmental barriers that generate the most P-E fit problems, lack of handrails in stairs at entrances was associated with the highest mortality risk (adjusted RR 1.55, 95% CI 1.14-2.10), whereas the total number of environmental barriers at entrances and outdoors was not associated with mortality. A higher number of environmental barriers indoors showed a slight protective effect against mortality even after adjustment for functional limitations (RR 0.98, 95% CI 0.96-1.00). Conclusion: Specific environmental problems may increase mortality risk among very-old single-living people. However, the association may be confounded by individuals' health status which is difficult to fully control for. Further studies are called for.},
  articleno    = {783},
  author       = {Rantakokko, Merja and Tormakangas, Timo and Rantanen, Taina and Haak, Maria and Iwarsson, Susanne},
  issn         = {1471-2458},
  keyword      = {ENABLE AGE-project,Environment,Mortality,Older people,Housing,Enabler},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {BMC Public Health},
  title        = {Environmental barriers, person-environment fit and mortality among community-dwelling very old people},
  url          = {http://dx.doi.org/10.1186/1471-2458-13-783},
  volume       = {13},
  year         = {2013},
}