交通、住房和城市发展干预措施对老年人流动性的影响：对实验和准实验研究的系统回顾

IF 3.2 3区工程技术 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Transport & Health Pub Date : 2024-07-01 DOI:10.1016/j.jth.2024.101859

Thiago Hérick de Sá , Daniele Sudsataya , Andra Fry , Nazak Salehi , Aishwarya Katiki , Megan Mcleod , Greg Rathmell , Jon Cylus , Louise Lafortune , Tine Buffel , Patty Doran , Alana Officer , Huseyin Naci

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引用次数: 0

摘要

背景对老年人友好的城市和社区旨在提高和保护老年人的功能能力。本系统综述评估了交通、住房和城市发展干预措施对老年人行动能力的影响。方法我们系统地检索了截至 2022 年 7 月的 MEDLINE、Embase、CINAHL、Scopus、PsycINFO 和 SocINDEX，以确定评估交通、住房和城市发展干预措施对老年人行动能力影响的研究。研究结果我们共纳入了 15 项研究，其中 6 项为随机对照试验。纳入的研究都是在高收入环境中进行的，并采用了不同的指标来评估流动性结果。在住房干预措施中，有三项研究考察了家庭环境中的辅助技术对体弱老年人的影响。其中两项干预措施维持了功能状态而没有改善，第三项干预措施的结果显示显著下降，对照组的情况更糟。公共交通干预措施的重点是通过教育举措和政策修订来提高流动性，这些措施始终产生积极的效果。与老年人驾驶培训有关的干预措施，包括课堂和道路评估，都显示出有益的效果。对城市设计干预措施进行评估的研究结果差异较大，一些研究通过使老年人更容易进入公共空间来提高流动性，而另一些研究则在改变基础设施后取得了好坏参半的结果。由于文献中对行动能力的概念不尽相同，加强对行动能力测量的协调将有助于我们了解社会和建筑环境如何有助于保持和提高老年人的行动能力。

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The impact of transport, housing, and urban development interventions on older adults’ mobility: A systematic review of experimental and quasi-experimental studies

Background

Age-friendly cities and communities aim to enhance and preserve the functional abilities of older adults. This systematic review assesses the impact of interventions in transportation, housing, and urban development on the mobility of older adults.

Methods

We systematically searched MEDLINE, Embase, CINAHL, Scopus, PsycINFO, and SocINDEX up to July 2022 to identify studies that evaluated the impact of transportation, housing, and urban development interventions on older adults' mobility. Only randomised controlled trials and quasi-experimental studies with control groups were included to establish a causal relationship between interventions and mobility outcomes.

Findings

We included a total of 15 studies, of which six were randomised controlled trials. Included studies were conducted in high-income settings and employed diverse metrics to assess mobility outcomes. Among housing interventions, three studies examined the impact of assistive technology within home environments for frail older adults. Two of these interventions maintained functional status without improvement, while the third showed a significant decline in outcomes, with the control group faring even worse. Public transport interventions, focused on enhancing mobility through educational initiatives and policy revisions, consistently produced positive outcomes. Interventions related to driving training for older adults, including in-class and on-road assessments, demonstrated beneficial effects. Results from studies evaluating urban design interventions were more varied, with some enhancing mobility by making public spaces more accessible for older adults and others yielding mixed results following infrastructure changes.

Interpretation

Interventions in the built environments of older adults, specifically targeting transportation, housing and urban development, have the potential to enhance mobility and related outcomes according to rigorously designed quantitative evaluations. Due to heterogeneity in how mobility is conceptualised in the literature, greater harmonisation in measurement of mobility would help us understand how the social and built environment contribute to maintaining and improving mobility in older adults.