JMIR Publications

ABSTRACT

Background:

Frailty syndrome increases the vulnerability of older people. The growing proportion of older adults emphasizes the need to enhance the understanding of the factors contributing to the prevalence of frailty. Current evidence indicates that the use of geomatic tools that integrate geolocation can provide key information for the implementation of preventive measures by improving the urban physical environment

Objective:

The main objective of this study was to analyze the relationship between various elements of the urban physical environment and the level of frailty syndrome in older people.

Methods:

A cohort of 300 adults aged 65 years and above from Talca City, Chile, underwent comprehensive medical assessments and were geographically mapped within a Geographic Information Systems (GIS) database. Frailty was determined by Fried Frailty Criteria. The spatial analysis of the frailty condition was conducted in conjunction with layers depicting urban physical facilities within the city, including vegetables and fruit shops, senior centers or communities, pharmacies, emergency health centers, main squares and parks, family or community health centers, and stadiums and sports fields.

Results:

The study analyzed 300 older adults, 74.5% women and 25.2% men, with no significant age and BMI differences between genders. Frailty prevalence varied significantly across clusters, with Cluster 3 showing the highest prevalence (34.1%, p=0.0059). Frail individuals resided significantly closer to emergency health centers (960±904m vs. 1352±936m, p=0.004), main squares/parks (1550±130m vs. 2048±105m, p=0.003), and sports fields (3040±236m vs. 4457±322m, p=0.004) compared to non-frail individuals. There were no significant differences in urban quality index across frailty groups (p>0.05), but frail individuals lived in areas with higher population density (0.013±0.001 vs. 0.01±0.0007, p=0.003).

Conclusions:

Frail individuals exhibit geospatial patterns suggesting intentional proximity to health facilities, sports venues, and urban facilities, unveiling associations with adaptive responses to frailty features and socioeconomic factors, highlighting the crucial intersection of urban environments and frailty for geriatric medicine and public health initiatives.