Associations of neighborhood built and social environments with frailty among mid-to-older aged Australian adults

Aim
Neighborhood environmental attributes are associated with physical activity and health status. We examined cross-sectional associations of built and social environmental attributes with frailty among community-dwelling mid-to-older aged adults in Australia.

Methods
Data from 3419 adults aged 50–74 years living in 200 neighborhoods in Brisbane, Australia, were used. Frailty status was assessed by a frailty index comprising 32 items. The built environment attributes examined were residential density, street connectivity, land use mix, park area and bus stop density. Self-reported levels of safety and social cohesion were used as social environmental factors. Associations were examined using multilevel logistic regression.

Results
The prevalence of frailty was 12%. One standard deviation increment in street connectivity in a 1-km network buffer around participants' homes and in a neighbourhood was associated with 23% and 13% higher odds of being frail, respectively. One standard deviation increment in land use mix at the neighborhood level was associated with 12% lower odds of being frail. Higher levels of safety and social cohesion were consistently associated with a lower odds of being frail.

Conclusions
Consistent with previous studies, we found that social environmental attributes were relevant to residents' frailty status, whereas the relationships between built environmental attributes and frailty were not clear (frailty was associated with lower street connectivity but with higher land used mix). Community-level initiatives to enhance safety and social cohesion might be effective to reduce frailty. Further research is required to explain the equivocal findings obtained for built environmental attributes and frailty.