title: Are features of the neighborhood environment associated with disability in older adults?
abstract: OBJECTIVE
  To explore the association of features of a person's neighborhood environment with disability in daily activities.
  
  
  METHODS
  We recruited 436 people aged 65 years and over (mean 70.4 years (SD = 3.9)) with functional limitations from the Multicenter Osteoarthritis Study (MOST). Features of the neighborhood environment were assessed using the Home and Community Environment (HACE) survey. The Late-Life Disability Instrument (LLDI) was used to assess disability in daily activities. We used logistic regression to examine the association of individual environmental features with disability. RESULTS. Older adults whose neighborhoods did not have parks and walking areas less frequently engaged in a regular fitness program (OR = 0.4, 95% CI (0.2, 0.7)), and in social activities (OR = 0.5, 95% CI (0.3, 1.0)). Those whose neighborhoods had adequate handicap parking had 1.5-1.8 higher odds of engagement in several social and work role activities. The presence of public transportation was associated with 1.5-2.9 higher odds of not feeling limited in social, leisure, and work role activities, and instrumental activities of daily living.
  
  
  CONCLUSIONS
  Our exploratory study suggests that parks and walking areas, adequate handicap parking, and public transportation are associated with disability in older adults.
authors.affiliation: Clinical Epidemiology Research and Training Unit, Boston University Medical Center, Boston, Massachusetts, USA. white.daniel@gmail.com
authors.forename: Daniel K
authors.initials: DK
authors.lastname: White
authors.forename: Alan M
authors.initials: AM
authors.lastname: Jette
authors.forename: David T
authors.initials: DT
authors.lastname: Felson
authors.forename: Michael P
authors.initials: MP
authors.lastname: Lavalley
authors.forename: Cora E
authors.initials: CE
authors.lastname: Lewis
authors.forename: James C
authors.initials: JC
authors.lastname: Torner
authors.forename: Michael C
authors.initials: MC
authors.lastname: Nevitt
authors.forename: Julie J
authors.initials: JJ
authors.lastname: Keysor
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000407:Alabama; D001107:Architectural Accessibility; D002958:City Planning; D006233:Persons with Disabilities / Q000534:rehabilitation*; D004779:Environment Design; D005260:Female; D006801:Humans; D007484:Iowa; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D020380:Needs Assessment; D020370:Osteoarthritis, Knee / Q000517:prevention & control / Q000534:rehabilitation*; D012111:Residence Characteristics; D014186:Transportation