Environmental barriers, person-environment fit and mortality among community-dwelling very old people

Rantakokko, Merja, Törmäkangas, Timo, Rantanen, Taina, Haak, Maria and Iwarsson, Susanne (2013) Environmental barriers, person-environment fit and mortality among community-dwelling very old people. BMC Public Health, 13 1-8. doi:10.1186/1471-2458-13-783

Author Rantakokko, Merja
Törmäkangas, Timo
Rantanen, Taina
Haak, Maria
Iwarsson, Susanne
Title Environmental barriers, person-environment fit and mortality among community-dwelling very old people
Journal name BMC Public Health   Check publisher's open access policy
ISSN 1471-2458
Publication date 2013-08-28
Sub-type Article (original research)
DOI 10.1186/1471-2458-13-783
Open Access Status DOI
Volume 13
Start page 1
End page 8
Total pages 8
Place of publication London, United Kingdom
Publisher BioMed Central
Language eng
Formatted abstract
Background: Environmental barriers are associated with disability-related outcomes in older people but little is known of the effect of environmental barriers on mortality. The aim of this study was to examine whether objectively measured barriers in the outdoor, entrance and indoor environments are associated with mortality among community-dwelling 80- to 89-year-old single-living people.
Methods: This longitudinal study is based on a sample of 397 people who were single-living in ordinary housing in Sweden. Participants were interviewed during 2002–2003, and 393 were followed up for mortality until May 15, 2012. Environmental barriers and functional limitations were assessed with the Housing Enabler instrument, which is intended for objective assessments of Person-Environment (P-E) fit problems in housing and the immediate outdoor environment. Mortality data were gathered from the public national register. Cox regression models were used for the analyses.
Results: A total of 264 (67%) participants died during follow-up. Functional limitations increased mortality risk. Among the specific environmental barriers that generate the most P-E fit problems, lack of handrails in stairs at entrances was associated with the highest mortality risk (adjusted RR 1.55, 95% CI 1.14-2.10), whereas the total number of environmental barriers at entrances and outdoors was not associated with mortality. A higher number of environmental barriers indoors showed a slight protective effect against mortality even after adjustment for functional limitations (RR 0.98, 95% CI 0.96-1.00).
Conclusion: Specific environmental problems may increase mortality risk among very-old single-living people. However, the association may be confounded by individuals’ health status which is difficult to fully control for. Further studies are called for.
Keyword ENABLE AGE-project
Older people
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes Article # 783

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Nursing, Midwifery and Social Work Publications
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Citation counts: TR Web of Science Citation Count  Cited 5 times in Thomson Reuters Web of Science Article | Citations
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Created: Mon, 30 Jun 2014, 23:47:38 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work