This study aimed to investigate the association between neighborhood walkability (using the Walk Score®), social participation, and incidence of disability over a three-year period among older adults living in a suburban area of Japan.This study aimed to investigate the association between neighborhood walkability (using the Walk Score®), social participation, and incidence of disability over a three-year period among older adults living in a suburban area of Japan.
A prospective cohort study used baseline data from the Keeping Active Across Generations Uniting the Youth and Aged (KAGUYA) study. The study included 2,610 community-dwelling adults aged 65 years and older (mean age 72.4 ± 6.0 years) residing in Koryo, Japan. The baseline survey, conducted in March 2016, excluded individuals who already required long-term care or were living in nursing homes. Data were collected via self-administered questionnaires that covered socioeconomic status, self-rated health, medical history, fall history, depressive symptoms, physical activity, and social participation. Walkability was assessed using the Walk Score®, categorizing areas as "car-dependent" (score 50) or "walkable" (score ≥50). Social participation was assessed by engagement in activities such as sports, hobbies, and recreation. The primary outcome was the onset of disability, as determined by new long-term care certifications over three years. Logistic regression analysis was used to explore the associations among neighborhood walkability, social participation, and disability incidence, with stratified analyses conducted based on social participation levels.
During the three-year follow-up, 169 participants (6.5%) were newly certified as having a disability. The analysis revealed that no engagement in social activities (odds ratio [OR] = 2.33, 95% confidence interval [CI] = 1.49–3.66) and lower neighborhood walkability (OR = 1.57, 95% CI = 1.01–2.45) were significantly associated with the onset of disability. Stratified analyses indicated that for participants not engaged in social participation at baseline, lower walkability was significantly associated with a higher incidence of disability, while this association was not observed among those participating in social activities.
The findings suggest that lower neighborhood walkability has a greater negative impact on the risk of disability among older adults who are not engaged in social participation. Enhancing walkability and promoting social engagement could play critical roles in reducing disability rates in older populations.
This study provides valuable insights into public health intervention and urban planning. Community-based approaches should be designed to prevent disability in older adults.
Social participation
Disability incidence
