How Safe is Your Neighborhood? Perceived Neighborhood Safety and Functional Decline in Older Adults

BACKGROUND Neighborhood characteristics are associated with health and the perception of safety is particularly important to exercise and health among older adults. Little is known about the relationship between perception of neighborhood safety and functional decline in older adults. OBJECTIVE To d...

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Bibliographic Details
Published in:Journal of general internal medicine : JGIM 2012-05, Vol.27 (5), p.541-547
Main Authors: Sun, Vivien K., Stijacic Cenzer, Irena, Kao, Helen, Ahalt, Cyrus, Williams, Brie A.
Format: Article
Language:English
Subjects:
Activities of Daily Living
Aged
Aged, 80 and over
Biological and medical sciences
General aspects
Health Status Disparities
Humans
Internal Medicine
Longitudinal Studies
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Neighborhoods
Older people
Original Research
Perception
Perceptions
Residence Characteristics - statistics & numerical data
Safety
Surveys and Questionnaires
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Summary:BACKGROUND Neighborhood characteristics are associated with health and the perception of safety is particularly important to exercise and health among older adults. Little is known about the relationship between perception of neighborhood safety and functional decline in older adults. OBJECTIVE To determine the relationship between perceived neighborhood safety and functional decline in older adults. DESIGN/SETTING Longitudinal, community-based. PARTICIPANTS 18,043 persons, 50 years or older, who participated in the 1998 and 2008 Health and Retirement Study. MAIN MEASURES The primary outcome was 10-year functional decline (new difficulty or dependence in any Activity of Daily Living, new mobility difficulty, and/or death). The primary predictor was perceived neighborhood safety categorized into three groups: “very safe”, “moderately safe”, and “unsafe.” We evaluated the association between perceived neighborhood safety and 10-year functional decline using a modified Poisson regression to generate unadjusted and adjusted relative risks (ARR). KEY RESULTS At baseline 11,742 (68.0%) participants perceived their neighborhood to be very safe, 4,477 (23.3%) moderately safe, and 1,824 (8.7%) unsafe. Over 10 years, 10,338 (53.9%) participants experienced functional decline, including 6,266 (50.2%) who had perceived their neighborhood to be very safe, 2,839 (61.2%) moderately safe, and 1,233 (63.6%) unsafe, P 
ISSN:0884-8734
1525-1497
DOI:10.1007/s11606-011-1943-y