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. 2021 May 27;62(1):46–55. doi: 10.1093/geront/gnab070

Understanding Aging in Place: Home and Community Features, Perceived Age-Friendliness of Community, and Intention Toward Aging in Place

Yeon Jin Choi 1,✉
Editor: Suzanne Meeks
PMCID: PMC8759482  PMID: 34043782

Abstract

Background and Objectives

Promoting age-friendliness of communities and supporting aging in place (AIP) are of great importance. Based on processes of belonging and agency, which suggest that person–environment interactions influence residents’ evaluations and behaviors related to the environment, this study aims to examine the interrelationship between the availability of age-friendly features, perceived age-friendliness of community, and intention toward AIP.

Research Design and Methods

This study used the 2015 AARP Age-Friendly Community Survey, which includes 66 home and neighborhood features under the 8 domains specified by the World Health Organization’s Age-Friendly Cities Guidelines. A series of regression and mediational analyses were conducted to test hypotheses.

Results

Overall, a greater availability of age-friendly features was positively associated with perceived age-friendliness of community and AIP intention. The relationship between age-friendly features and AIP intention was mediated by perceived age-friendliness of community (50.3%–96% of the total effects). When perceived age-friendliness of community was introduced to models, the direct effects of housing, outdoor spaces and buildings, and transportation domains remained significant.

Discussion and Implications

Findings suggest that a greater availability of age-friendly features influences older adults’ perception on their community, leading to the development of a desire to age in place, supporting processes of belonging and agency. Domains of housing, outdoor spaces and buildings, and transportation may be the most important features in promoting age-friendliness of community and the key determinants of AIP. Policymakers and practitioners may need to prioritize promoting an age-friendly built environment before the social environment in building age-friendly communities.

Keywords: Age-friendly community, Built environment, Ecology of aging, Mediation, Person–environment interaction

One of the concerns related to population aging is the issue of aging in place (AIP), remaining living in “[…] one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level” (Centers for Disease Control and Prevention, 2017). Older adults’ preference for AIP, which comes with various benefits, such as a comfortable environment, familiarity with the neighborhood, and feelings of independence and autonomy, has been reported in previous research (Center for Disease Control and Prevention, 2013; Golant, 2011). Accordingly, an increasing number of studies have investigated which aspects of environments can support AIP. Findings of these studies suggest that supportive services and features, such as high walkability, home modification, and home- and community-based services, can improve older adults’ ability to remain at home and promote AIP, while housing problems and adverse neighborhood environments (e.g., noise, traffic, crime) discourage AIP and lower residential stability (Aneshensel et al., 2016; Chippendale & Bear-Lehman, 2010; Choi, 2004; Hwang et al., 2011; Newman & Duncan, 1979; Pynoos et al., 2008; Safran-Norton, 2010; Szanton et al., 2016; Wang et al., 2012). However, little is known about how home and neighborhood environments influence AIP decisions despite the importance in developing policies and interventions. To bridge the gap, this study aims to investigate the mechanism linking home and neighborhood environments and AIP intention.

Theoretical and Empirical Framework

The ecological model of aging (Lawton, 1982; Lawton & Nahemow, 1973) provided an early framework for the person–environment (P–E) interaction in older age, which suggests that unique combinations of personal needs and environments (or P–E fit) determine an individual’s adaptation and the level of functioning (Wahl et al., 2012; Wahl & Oswald, 2010). More recently, two P–E processes, experience-driven belonging and behavioral-driven agency, have been introduced to better explain the P–E interchange (Wahl et al., 2012; Wahl & Oswald, 2010).

Processes of belonging refer to “subjective evaluations and interpretations of place” (Chaudhury & Oswald, 2019) based on the relationship between a person and an environment, such as residential satisfaction, place attachment, and meaning of home. For instance, a person who lives in a neighborhood with more community facilities and services available may have higher neighborhood satisfaction and perceive that the neighborhood is age-friendly (Fernández-Carro et al., 2015; Mouratidis, 2020; Novek & Menec, 2014; Rioux & Werner, 2011). On the other hand, negative experiences (e.g., maintenance issues) and the presence of undesirable features (e.g., garbage, insects, abandoned buildings, dark streets, and sidewalks) in one’s home or geographic location may lower residential satisfaction and perception of age-friendliness of the community (Byrnes et al., 2006; Chui et al., 2019; Fernández-Carro et al., 2015; Hillcoat-Nallétamby & Ogg, 2014; James III, 2008; Kahana et al., 2003; Mouratidis, 2020).

Processes of agency represent “the full range of goal-directed behaviors related to the environment,” which include adaptive behaviors to maintain autonomy and stay independent, such as home modification and relocation (Chaudhury & Oswald, 2019; Wahl et al., 2012). Previous studies have reported that low residential/community satisfaction and dislikes about current home and/or neighborhood acted as push factors for moving and were associated with residents’ wish to move and actual move to another place (Ahn et al., 2020; Erickson et al., 2006; Hillcoat-Nallétamby & Ogg, 2014; Weeks et al., 2012). Using and sustaining places can also be considered as goal-directed behaviors that make use of one’s environment for well-being and autonomy (Chaudhury & Oswald, 2019; Wahl & Oswald, 2010). For example, older residents may decide to age in place because their community provides high-quality health care and social supports, which are valuable resources in later life. Processes of P–E agency are especially important in old age due to age-related changes, such as the decrease in functional and cognitive capacity (Chaudhury & Oswald, 2019; Satariano, 2006; Wahl et al., 2012; Wahl & Oswald, 2010).

The Current Study

Processes of belonging and agency can contribute to a better understanding of P–E interaction and AIP decisions. For example, older adults may perceive their community is not age-friendly (belonging) because of limited availability of features and services for them (a poor P–E fit), and the perception influences their decisions whether to stay in their current residence or to relocate to a more suitable place that matches their needs (agency). However, there has been no attempt to explore the possible interrelationship between home and neighborhood environments, residents’ evaluation of community, and AIP intention. Therefore, this study tested the following hypotheses developed (Figure 1):

Figure 1.

Figure 1.

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Path analysis model.

Hypothesis 1: A greater availability of age-friendly features in home and community is positively associated with perceived age-friendliness of community and AIP intention.

Hypothesis 2: The availability of age-friendly features in home and community indirectly affects AIP intention through its effect on the perceived age-friendliness of community.

Research Design and Methods

Data

This study involved secondary data analyses using the AARP Age-Friendly Community (AFC) Survey, which was developed to assess the World Health Organization (WHO)’s eight domains of “age-friendliness”: housing, outdoor spaces and buildings, transportation, community and health services, social participation, respect and social inclusion, civic participation and employment, and communication and information (WHO, 2007). The AARP AFC was previously used to examine an association between a P–E interaction with the health of older adults (Choi, 2020). This study further extends our knowledge on P–E exchange processes in later life by investigating how a P–E fit, an availability of age-friendly features in this study, influences older residents’ evaluation (perceived age-friendliness of community) and behaviors (AIP intention) related to the environment.

Sampling

This study used a two-stage cluster sampling approach. In the first stage, AARP identified 14 communities across the United States that range in size and demographic make-up: Atlanta, GA, Bangor, ME, Brownsville, TX, Dallas, TX, Fort Worth, TX, Houston, TX, Lansing, MI, Charlotte, NC, Philadelphia, PA, Phoenix, AZ, San Antonio, TX, Tallahassee, FL, Washington County, OR, and West Sacramento, CA. In Atlanta, GA, Dallas, TX, Fort Worth, TX, and Houston, TX, a random sample of 2,000 AARP members for each community was selected from AARP’s membership database. In Bangor, ME, Brownsville, TX, Lansing, MI, Charlotte, NC, Philadelphia, PA, Phoenix, AZ, San Antonio, TX, Tallahassee, FL, Washington County, OR, and West Sacramento, CA, a 3,000-person sample was recruited from each community from a listed-address database of Survey Sampling International, a well-respected provider of data solutions for survey research.

The survey was conducted by mail between June and October 2015. Respondents received the following pieces of mail from AARP: (a) prenotification postcard, (b) survey, (c) reminder postcard, and (d) second survey copy. The collected data were weighted by age, gender, and AARP membership to reflect the actual age and gender distributions as well as AARP membership in each community. The 2015 AARP membership database and the 2015 Nielsen Pop Facts Advanced demographic data were used for the weighting.

Among 5,999 respondents in the 2015 AARP AFC survey, 43 were younger than the age 50 and 491 did not provide age (N = 5,465). Approximately one third of the respondents had missing information on the following variables: AIP intention (N = 660), race/ethnicity (N = 538), job opportunities (N = 125), education (N = 102), volunteering and civic engagement (N = 70), perceived age-friendliness of community (N = 53), social interaction (N = 49), health (N = 29), community information (N = 26), housing (N = 23), social participation and inclusion (N = 20), marital status (N = 16), length (N = 13), health and wellness (N = 12), transportation and female (N = 7), and outdoor (N = 3). Respondents with missing data were more likely to be older, female, not married or partnered, non-White, and have lower educational attainment and poor health. Missing data can cause problems, such as reduced statistical power and the representativeness of the sample as well as bias in the results (Satine, 2019). To remove the potential bias and get accurate and reliable results, 20 complete data sets were created using multiple imputation by chained equations. Cases with imputed values on the dependent variables were excluded from analyses (von Hippel, 2007).

Measures

AIP intention

AIP intention was assessed using a question, “How likely is it that you will move to a different home outside of your community?” with the following response options: 0 = not at all likely, 1 = not very likely, 2 = somewhat likely, 3 = very likely, and 4 = extremely likely. The variable was reverse-coded so that higher scores indicate a greater likelihood of AIP.

Home and community features

Adapting the WHO’s Age-Friendly Cities Guidelines (WHO, 2007), the AARP AFC Survey included 66 home and community features (or age-friendly features) under eight domains (Supplementary Material). Respondents were asked about the availability of each item and responses were coded as 0 = no/do not know and 1 = yes, so that an affirmative response reflects respondents’ perceived availability of the specified home and community feature. For each of the eight domains, an average score of the Yes responses was created, where higher scores indicate greater perceived availability of age-friendly features within the given home or community domain.

Perceived age-friendliness of community

Perceived age-friendliness of community was assessed using an item, “How would you rate your community as a place for people to live as they age?” Here, the community was specified as the geographic location where participants’ homes are located. Response options include 0 = poor, 1 = fair, 2 = good, 3 = very good, and 4 = excellent.

Covariates

Covariates include age (in years), gender (male [reference group]; female), marital status (married/partnered [reference group]; separated/divorced/widowed; never married), race/ethnicity (non-Hispanic White/other [reference group]; non-Hispanic Black; Hispanic), education (less than high school education [reference group]; high school education’ more than high school education), self-reported health (0 = poor to 4 = excellent), social interaction (0 = never to 7 = more than once a day), and the length at the current residence (0 = less than 5 years to 5 = 45 years or more).

Analysis Plan

Descriptive analyses were conducted to provide an overview of the sample. Pairwise correlation analyses were then conducted to assess the correlations between key variables. Multiple linear regression models were performed to estimate the direct effects of the availability of age-friendly features in home and community on AIP intention. Model 1 only included the availability of age-friendly features and Model 2 additionally includes the perceived age-friendliness of community. In addition, mediation analyses were performed to estimate the mediational role of perceived age-friendliness of community in the aforementioned associations. A series of linear regression models were performed as suggested by Baron and Kenny (1986): (a) the effect of the availability of age-friendly features on AIP intention, (b) the effect of the availability of age-friendly features on perceived age-friendliness of community, and (c) the effect of perceived age-friendliness of community and AIP intention. Then, the indirect effects of the availability of age-friendly features on AIP intention through perceived age-friendliness of community were calculated using the Sobel product of coefficients approach (Sobel, 1982). The intraclass correlation coefficient for perceived age-friendliness of community and AIP intention were 0.02 and 0.01, respectively, indicating that the extent of shared variance among respondents in a community is low. Therefore, multiple linear regression models instead of multilevel models were estimated. Due to multicollinearity issues, separate models were estimated for each domain: housing, outdoor spaces and buildings, transportation, community and health services, social participation, respect and social inclusion, civic participation and employment, and communication and information. Each analysis model includes sociodemographic controls: age, gender, marital status, race/ethnicity, education, self-reported health, social interaction, and the length spent in the current community. Finally, the proportion of the total effect that is mediated was calculated. All analyses were performed using Stata 15.

Results

Descriptive

Table 1 presents the number of items and Cronbach’s alpha for each domain of the perceived availability of age-friendly features indices. Cronbach’s alpha to test reliability and internal consistency ranged from 0.75 to 0.91.

Table 1.

Reliability of the Perceived Availability of Age-Friendly Features Indices

Domains Number of items Cronbach’s α
Housing 7 0.78
Outdoor spaces and buildings 7 0.75
Transportation 14 0.86
Health and wellness 14 0.91
Social participation and inclusion 10 0.90
Volunteering and civic engagement 5 0.86
Job opportunities 3 0.85
Community information 6 0.80
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Table 2 presents the descriptive characteristics of the study sample. The mean global assessment of community score was 2.57 (SD = 1.01; skewness = −0.38), which falls between good and very good. The mean response for the likelihood of the AIP variable was 2.86 (SD = 1.22; skewness = −0.88), meaning respondents are, on average, somewhat or very likely to stay in their community.

Table 2.

Descriptive Information on the Analytic Sample

Variables M (SD) or %
Global assessment of community (range: 0–4) 2.57 (1.01)
Likelihood of aging in place (range: 0–4) 2.86 (1.22)
Perceived availability of age-friendly features (range: 0–1)
 Housing 0.41 (0.30)
 Outdoor spaces and buildings 0.44 (0.31)
 Transportation 0.58 (0.29)
 Health and wellness 0.51 (0.32)
 Social participation and inclusion 0.41 (0.35)
 Volunteering and civic engagement 0.27 (0.35)
 Job opportunities 0.15 (0.31)
 Community information 0.24 (0.28)
Age (in years; range: 50–101) 69.15 (0.14)
Gender
 Male 41.2%
 Female 58.8%
Marital status
 Married/partnered 48.1%
 Separated/divorced/widowed 42.8%
 Never married 9.1%
Race/ethnicity
 Non-Hispanic White/Other 70.1%
 Non-Hispanic Black 19.2%
 Hispanic 10.7%
Education
 Less than high school 7.5%
 High school 22.0%
 More than high school 70.5%
Health (range: 0–4) 2.64 (0.98)
Social interaction (range: 0–7) 5.51 (1.66)
Length of time spent in the current community (years)
 Less than 5 4.8
 5–15 10.8
 15–25 12.1
25–35 13.4
 35–45 14.1
 More than 45 44.8
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Note: Higher value indicates a greater perceived availability of age-friendly features, better self-reported health, social interaction, and longer length of time spent in the current community.

The average availability for the sample ranged from 0.15 to 0.58, meaning that, on average, respondents were aware of between 15% and 58% of the age-friendly features in the given domain being available in their community. The mean of volunteering and civic engagement, job opportunities, and community information was below 0.30. Of particular note, the average of job opportunities was 0.15 (SD = 0.31), which indicates low availability awareness. On the other hand, the mean of transportation and health and wellness was 0.58 (SD = 0.29) and 0.51 (0.32), respectively, suggesting relatively high availability awareness of the features.

With regard to sociodemographic characteristics, the majority of the sample were female (58.8%), married or partnered (48.1%), non-Hispanic White or other (70.1%), have more than high school education (70.5%), and lived in the current community for more than 45 years (44.8%). The average age of respondents was 69.15 years (SD = 10.10); self-reported health was 2.64 (SD = 0.98), which is between fair and good; and social interaction was 5.51 (SD = 1.66), which is between several times a week and about once a day.

Bivariate

Table 3 displays pairwise correlation analysis results among key variables. Correlations are in the expected direction. The eight domains of home and community features were positively correlated with a global assessment of community and the likelihood of AIP although correlation coefficients were about or below 0.30 indicating a weak correlation. The correlation between global assessment of community and the likelihood of AIP was 0.24 (p < .001). Correlations among domains were stronger, correlation coefficients ranged from 0.32 (p < .001) for housing and transportation with job opportunities to 0.69 (p < .001) for social participation and inclusion and volunteering and civic engagement.

Table 3.

Pairwise Correlation (N = 3,722)

Variables 1 2 3 4 5 6 7 8 9
1. Perceived age-friendliness of community
2. AIP intention 0.24***
3. Housing 0.28*** 0.10***
4. Outdoor spaces and buildings 0.31*** 0.08*** 0.46***
5. Transportation 0.28*** 0.13*** 0.43*** 0.55***
6. Health and wellness 0.26*** 0.08*** 0.47*** 0.47*** 0.55***
7. Social participation and inclusion 0.29*** 0.15*** 0.46*** 0.49*** 0.47*** 0.66***
8. Volunteering and civic engagement 0.22*** 0.06*** 0.41*** 0.42*** 0.41*** 0.56*** 0.69***
9. Job opportunities 0.13*** 0.02*** 0.32*** 0.33*** 0.32*** 0.41*** 0.42*** 0.50***
10. Community information 0.12*** 0.06*** 0.35*** 0.37*** 0.38*** 0.46*** 0.46*** 0.53*** 0.49***
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Note: AIP = aging in place.

***p < .001.

Availability of Age-Friendly Features in Home and Community and AIP Intention

Table 4 presents the results of the regression models for the association between the availability of age-friendly features in home and community with perceived age-friendliness of community and AIP intention. The association between the availability of age-friendly features and AIP intention showed a similar pattern (Model 1). A greater availability of age-friendly features in all domains, except for job opportunities, was positively associated with AIP intention (housing [b = 0.36; p < .001]; outdoor spaces and buildings [b = 0.42; p < .001]; transportation [b = 0.51; p < .001]; health and wellness [b = 0.24; p < .001]; social participation and inclusion [b = 0.19; p < .001]; volunteering and civic engagement [b = 0.17; p < .01]; community information [b = 0.15; p < .05]).

Table 4.

Direct Effects of the Availability of Age-Friendly Features on AIP Intention

Variables Model 1 Model 2
b (SE) 95% CI p F b (SE) 95% CI p F
Lower Upper Lower Upper
Housing 0.36 (0.06) 0.25 0.47 *** 58.55*** 0.13 (0.06) 0.16 0.24 * 74.50***
Perceived age-friendliness of community 0.27 (0.02) 0.34 0.31 ***
Outdoor spaces and buildings 0.42 (0.05) 0.31 0.53 *** 60.27*** 0.18 (0.06) 0.23 0.30 ** 74.97***
Perceived age-friendliness of community 0.27 (0.02) 0.23 0.30 ***
Transportation 0.51 (0.06) 0.40 0.63 *** 61.92*** 0.28 (0.06) 0.16 0.39 *** 76.02***
Perceived age-friendliness of community 0.26 (0.02) 0.23 0.30 ***
Health and wellness 0.24 (0.05) 0.14 0.34 *** 56.96*** 0.05 (0.05) −0.06 0.15 74.18***
Perceived age-friendliness of community 0.28 (0.02) 0.25 0.31 ***
Social participation and inclusion 0.19 (0.05) 0.09 0.29 *** 56.49*** −0.05 (0.05) −0.10 0.09 74.13***
Perceived age-friendliness of community 0.29 (0.02) 0.25 0.32 ***
Volunteering and civic engagement 0.17 (0.05) 0.07 0.26 ** 56.20*** 0.03 (0.05) −0.07 0.12 74.16***
Perceived age-friendliness of community 0.28 (0.02) 0.25 0.32 ***
Job opportunities 0.08 (0.05) −0.02 0.19 55.34*** −0.03 (0.05) −0.13 0.07 74.10***
Perceived age-friendliness of community 0.28 (0.02) 0.25 0.32 ***
Community information 0.15 (0.06) 0.03 0.27 * 55.72*** 0.04 (0.06) −0.08 0.15 74.15***
Perceived age-friendliness of community 0.28 (0.02) 0.25 0.32 ***
Degrees of freedom 4,791 4,722
N 4,805 4,737
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Notes: AIP = aging in place. Due to multicollinearity issues, separate models were estimated for each domain. Each analysis model includes sociodemographic controls (age, gender, marital status, race/ethnicity, education, self-reported health, social interaction, and the length of time spent in the current community).

*p < .05, **p < .01, ***p < .001.

When perceived age-friendliness of community was introduced (Model 2), housing (b = 0.13; p < .05), outdoor spaces and buildings (b = 0.18; p < .01), and transportation (b = 0.28; p < .001) remained significantly associated with a greater likelihood of AIP. However, health and wellness, social participation and inclusion, volunteering and civic engagement, and community information domain were no longer significant. Perceived age-friendliness of community was consistently associated with AIP intention (housing [b = 0.27; p < .001]; outdoor spaces and buildings [b = 0.27; p < .001]; transportation [b = 0.26; p < .001]; health and wellness [b = 0.28; p < .001]; social participation and inclusion [b = 0.29; p < .001]; volunteering and civic engagement [b = 0.28; p < .001]; job opportunities [b = 0.28; p < .001]; community information [b = 0.28; p < .001]; Path B; see Supplementary Material Table A for results with nonimputed data).

Mediation

Table 5 provides summary results of the mediation analyses. The results showed that a greater availability of age-friendly features in eight domains was all positively associated with perceived age-friendliness of community (housing [b = 0.83; p < .001]; outdoor spaces and buildings [b = 0.90; p < .001]; transportation [b = 0.89; p < .001]; health and wellness [b = 0.70; p < .001]; social participation and inclusion [b = 0.69; p < .001]; volunteering and civic engagement [b = 0.52; p < .001]; job opportunities [b = 0.40; p < .001]; community information [b = 0.43; p < .001]; Path A). Also, perceived age-friendliness of community was positively associated with AIP intention (Path B). Indirect effects computed using coefficients from Path A and Path B (Path A × Path B) were significant, suggesting perceived age-friendliness of community is a significant mediator (housing [b = 0.23; p < .001]; outdoor spaces and buildings [b = 0.23; p < .001]; transportation [b = 0.23; p < .001]; health and wellness [b = 0.19; SE = 0.05; p < .001]; social participation and inclusion [b = 0.19; p < .001]; volunteering and civic engagement [b = 0.15; p < .001]; job opportunities [b = 0.11; p < .001]; community information [b = 0.12; p < .001]). That is, the greater availability of age-friendly features in home and community was associated with higher perceived age-friendliness of community, which was ultimately associated with greater AIP intention. The indirect effect through perceived age-friendliness of community accounted for a low of 46.7% (for the transportation domain and AIP intention relationship) to a high of 97.6% (for the social participation and inclusion and AIP intention relationship) of the total effect of the availability of age-friendly features on AIP intention (see Supplementary Material Table B for results with nonimputed data).

Table 5.

Mediation Analysis: Perceived Age-Friendliness of Community as a Mediator Between Availability of Age-Friendly Features and AIP Intention (N = 4,737)

Path A: Predicting perceived age-friendliness of community Path B: Predicting AIP intention Path A × Path B: Indirect effects
95% CI 95% CI 95% CI
Variables b (SE) Lower Upper p b (SE) Lower Upper p b (SE) Lower Upper p % of total effect mediated Average degrees of freedom
Housing 0.83 (0.05) 0.74 0.92 *** 0.23 (0.02) 0.19 0.27 *** 58.3 280,169.54
Perceived age-friendliness of community 0.27 (0.02) 0.34 0.31 ***
Outdoor spaces and buildings 0.90 (0.04) 0.81 0.99 *** 0.23 (0.02) 0.19 0.28 *** 54.4 322,263.24
Perceived age-friendliness of community 0.27 (0.02) 0.23 0.30 ***
Transportation 0.89 (0.05) 0.79 0.98 *** 0.23 (0.02) 0.19 0.28 *** 46.7 299,521.21
Perceived age-friendliness of community 0.26 (0.02) 0.23 0.30 ***
Health and wellness 0.70 (0.04) 0.62 0.79 *** 0.19 (0.02) 0.16 0.23 *** 83.4 394,551.94
Perceived age-friendliness of community 0.28 (0.02) 0.25 0.31 ***
Social participation and inclusion 0.69 (0.04) 0.61 0.77 *** 0.19 (0.02) 0.15 0.23 *** 97.6 428,720.01
Perceived age-friendliness of community 0.29 (0.02) 0.25 0.32 ***
Volunteering and civic engagement 0.52 (0.04) 0.44 0.60 *** 0.15 (0.02) 0.11 0.18 *** 85.4 400,116.45
Perceived age-friendliness of community 0.28 (0.02) 0.25 0.32 ***
Job opportunities 0.40 (0.05) 0.31 0.49 *** 0.11 (0.02) 0.07 0.13 *** n/aa 296,945.17
Perceived age-friendliness of community 0.28 (0.02) 0.25 0.32 ***
Community information 0.43 (0.05) 0.33 0.53 *** 0.12 (0.02) 0.08 0.15 *** 58.2 316,177.50
Perceived age-friendliness of community 0.28 (0.02) 0.25 0.32 ***
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Notes: AIP = aging in place. Due to multicollinearity issues, separate models were estimated for each domain. Each analysis model includes sociodemographic controls (age, gender, marital status, race/ethnicity, education, self-reported health, social interaction, and the length of time spent in the current community).

aNot applicable; the total effect was not significant.

***p < .001.

Discussion

This study is the first to investigate how home and community environments influence residents’ evaluation of community and AIP intention and the mediational role of perceived age-friendliness of community within WHO’s Global Age-Friendly Cities framework (WHO, 2007).

A greater availability of age-friendly features in all domains was significantly associated with AIP intention, which is consistent with previous studies (Aneshensel et al., 2016; Chippendale & Bear-Lehman, 2010; Choi, 2004; Hwang et al., 2011; Newman & Duncan, 1979; Pynoos et al., 2008; Safran-Norton, 2010; Szanton et al., 2016; Wang et al., 2012). Based on the process of agency, this may be because older adults who lived in neighborhoods with age-friendly features consider AIP as an optimal option to stay independent, while it is not for those who lived in neighborhoods with limited availability of age-friendly features—they decide not to AIP and consider other places to regulate environmental press (Chaudhury & Oswald, 2019; Wahl et al., 2012). Among eight domains, housing, outdoor spaces and buildings, and transportation domains were consistently associated with AIP intention. The importance of the built environment in supporting AIP has been observed in previous studies. Dijk et al. (2015) conducted a study to investigate the importance of neighborhood characteristics that support successful AIP among community-dwelling older adults in Rotterdam, the Netherlands. Study participants were asked to rank 26 statements that were developed based on the eight domains of WHO’s Global Age-Friendly Cities’ framework (WHO, 2007). The housing, outdoor spaces and buildings, transportation, and community support and health services domains were more highly ranked than the social participation, respect and social approval, civic participation, and communication and information domains, suggesting greater needs for the former neighborhood characteristics and features than the latter. This may be because the built environment is closely related to health behaviors (e.g., healthy diet, physical activity, and health care utilization) and health (Arcury et al., 2005; Rahmanian & Gasevic, 2014; Sallis et al., 2012; Syed et al., 2013; Van Cauwenberg et al., 2015), which are linked with increased autonomy and independence. Among AARP AFC respondents, a greater availability of age-friendly features and a better P–E fit (congruence between personal needs [i.e., perceived importance of age-friendly features] and environments [i.e., availability of age-friendly features]) in outdoor spaces and buildings and transportation domains were associated with better self-rated health and a lower likelihood of having functional limitations (Choi, 2020).

A greater availability of age-friendly features was also positively associated with perceived age-friendliness of community, which is consistent with the process of belonging, which suggests that environmental challenges and opportunities influence one’s evaluation of the environment (Chaudhury & Oswald, 2019; Wahl & Oswald, 2010), as well as existing literature. For instance, Novek and Menec (2014) conducted a qualitative participatory study in Canada to explore older adults’ perception of age-friendliness. This study involved interviews and focus groups, and participants were asked to take photographs “to illustrate community features that they considered ‘age-friendly’ or presented barriers” (Novek & Menec, 2014). The identified age-friendly features corresponded to the WHO’s domains of age-friendliness: housing (e.g., low-income housing, doorways, elevators, proxy to transportations, services, and amenities), physical environments (e.g., buildings, outdoor spaces), transportation (e.g., affordable and comfortable transportation options), community supports and health services (e.g., counseling, congregate meals, care services), social environment (e.g., recreational and social activities, relationship with family members), activities and volunteering (e.g., accessible and affordable activities), and businesses and services (e.g., grocery stores, shopping malls, restaurants). This finding suggests that older adults perceive that their community is age-friendly when home and community features that promote the ability to remain independent, increase access to essential services, and provide opportunities to develop social relationships are available.

Perceived age-friendliness of community was positively associated with AIP intention in all models, suggesting AIP intention is greatly influenced by respondents’ perception or assessment of community. Previous studies have identified unmet needs due to housing features or unavailability of community-based services as push factors increasing preferences for relocation and discouraging AIP (Erickson et al., 2006; Hillcoat-Nallétamby & Ogg, 2014; Tyvimaa & Kemp, 2011; Weeks et al., 2012). In this sense, moving or relocation can be understood as an adaptive behavior or compensatory process to optimize one’s environment and maintain a certain level of functioning when faced with losses (Baltes & Baltes, 1990; Baltes & Dickson, 2001).

Perceived age-friendliness of community significantly mediated the association between the availability of age-friendly features and AIP intention, suggesting that a greater availability of age-friendly features influences older adults’ perception or assessment of community, leading to the development of a desire to age in place. Based on processes of belonging and agency, moving or relocation can be understood as a proactive behavior to improve environments when residents’ needs are not satisfied.

Limitations

Although this study has important implications, it has several limitations worth noting. First, variables included in this study are self-reported, so there may be potential discrepancies. For instance, AIP intention may not predict actual AIP decisions. Although respondents reported that they are likely to remain in their current residence, it may not be feasible due to changes linked to aging, such as cognitive impairment, caregiving issues, and financial difficulties. Second, the cross-sectional design of the AARP AFC limits our ability to assess the causality of the association, which is critical for mediation analyses where a mediator is presumed to cause the outcome. For example, older adults who decided to age in place may pay more attention to their home and neighborhood environment, be more aware of the availability of age-friendly features, and perceive that their community is age-friendly compared to those who are not willing to age in place. Finally, although the study’s sample was randomly selected and the data were weighted to reflect demographic characteristics of the older population in 14 communities, they are not nationally representative. For that reason, these results cannot be generalized to the entire population of older adults in the United States. Therefore, additional research must be conducted to confirm if the findings can be applied to older adults in other communities.

Conclusion and Implications

While older adults’ desire to age in place becomes stronger, home and community environments are often not suitable to satisfy their needs. This study identified environmental aspects that should be considered when developing age-friendly communities. In this sample, domains of housing, outdoor spaces and buildings, and transportation were consistently positively associated with both perceived age-friendliness of community and AIP intention. Based on the findings, adopting age-friendly policies and city planning in those domains may be the most effective and efficient way to promote the age-friendliness of community and support AIP. Providing supports for home modification and maintenance, promoting neighborhood safety and walkability, and increasing transportation options for older adults will greatly improve the built environment.

The findings of this study also suggest that residents’ evaluation of community may be a key determinant of AIP. For older adults at the risk of relocation due to their unmet needs, identifying and providing needed services and helping them through the relocation process when their needs cannot be satisfied would be necessary.

Funding

This was supported by the National Institute on Aging (T32-AG000037).

Conflict of Interest

None declared.

Supplementary Material

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