Longitudinal Associations Between Neighborhood Environments and Functional Disabilities Among Community-Dwelling Older Adults in China

OBJECTIVES: This study aims to investigate the longitudinal associations between neighborhood environments and functional disabilities over time among older adults in China. Urban-rural disparities in these associations were examined in this study. METHODS: Data from 4 waves of the China Health and Retirement Longitudinal Study (2011-2018) were analyzed, including a sample of 5,379 older adults aged 60 and over. Multilevel linear probability modeling was fitted to estimate the effects of neighborhood environments on functional disabilities, encompassing both incidence and rate of change over a 7-year period. RESULTS: Older adults residing in neighborhoods with superior infrastructure experienced a lower incidence of functional disabilities in both rural and urban areas. In urban communities, increased handicapped access was associated with a reduced risk of IADL disability onset among older adults (B = -0.013, SE = 0.006, p < .05). In rural villages, the presence of 2 or more bus lines was associated with a slower rate of IADL disablement over the 7-year period (B = -0.019, SE = 0.009, p < .05). DISCUSSION: This research reveals the prominent roles of neighborhood environments in protecting functional abilities among older adults. The findings highlight the importance of incorporating community policies and infrastructure development into public health considerations. Empirical evidence is provided for policymakers and urban planners aimed at enhancing functional abilities in older adults and mitigating urban-rural disparities in health outcomes.