title: Relationships between frailty, neighborhood security, social cohesion and sense of belonging among community-dwelling older people.
abstract: OBJECTIVE
  The relationships between frailty and neighborhood social resources and neighborhood quality among community-dwelling older people are poorly understood. We therefore enquired into these associations while controlling for important individual characteristics.
  
  
  METHODS
  Our cross-sectional study included 945 out of 1440 (66% response rate) community-dwelling older people (aged ≥ 70 years) in Rotterdam. The sample included approximately 430 older adults per district and was proportional with respect to neighborhood and age. Potential participants were mailed questionnaires, non-respondents were first sent a reminder, then asked by telephone and finally visited at home to complete the questionnaire.
  
  
  RESULTS
  Age, sex, marital status and level of education varied between the frail and non-frail. A significantly larger proportion of the frail was female (64.4% vs 48.0%; P ≤ 0.001), fewer were married (22.1% vs 48.4%; P ≤ 0.001) and the frail were, on average, older than the non-frail (78.8 vs 76.0 years; P ≤ 0.001). A significantly larger proportion of the frail were poorly educated (25.9% vs 18.6%; P ≤ 0.01). Multilevel regression analyses showed that older age (P<0.001) was associated with higher likelihood of frailty and marital status (P<0.001) with lower likelihood of frailty. Feeling more secure (P<0.001) and having a stronger sense of social cohesion and neighborhood belonging (P<0.05) seemed to protect against frailty.
  
  
  CONCLUSIONS
  The results of this study support the importance of feeling safe, social cohesion and a sense of belonging within the neighborhood. These findings could have important implications for efforts to reduce frailty of older people within communities.
authors.affiliation: Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands. cramm@bmg.eur.nl
authors.forename: Jane M
authors.initials: JM
authors.lastname: Cramm
authors.forename: Anna P
authors.initials: AP
authors.lastname: Nieboer
mesh_terms: D000368:Aged; D000375:Aging / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000379:methods*; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008603:Mental Health; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires