Factors Influencing Older Adults' Perception of the Age-Friendliness of Their Environment and the Impact of Loneliness, Technology Use, and Mobility: Quantitative Analysis.

Abstract

Background: The World Health Organization's (WHO) publication on age-friendly environments (AFEs) imagines future cities to become more age-friendly to harness the latent potential of older adults, especially those who have restricted mobility. AFE has important implications for older adults in maintaining social connections, independence, and successful aging-in-place. However, technology is notably absent in the 8 intersecting domains of AFEs that the WHO imagines improve older adult well-being, and we investigated whether technology should form a ninth domain. While mobility was severely restricted, the COVID-19 pandemic provided an opportunity to test how older adults' perceptions of their AFE changed and what role technology was playing.

Objective: This study examined how life-space mobility (LSM), a concept for assessing patterns of functional mobility over time, and loneliness impacted perceived AFEs and the moderating effect of technology. It also explores whether technology should play a greater role as the ninth domain of the WHO's imagination of the AFE of the future.

Methods: In this cross-sectional quantitative observation study, data from 92 older adults aged 65-89 years were collected in England from March 2020 to June 2021 during the COVID-19 pandemic. The Life-space Questionnaire, Technology Experience Questionnaire, UCLA (University of California, Los Angeles) Loneliness Scale, and age-friendly environment assessment tool were used. Correlation and moderation analyses were used to investigate relationships between variables.

Results: Most participants (86/92, 93%) had not left their immediate town in the previous 4 weeks before the interview. Restricted LSM was positively correlated to the age-friendly environment assessment tool, that is, rising physical isolation was linked to a better perception of AFEs; however, we discovered this result was due to the moderating impact of increased use of technology, and that restricted LSM actually had a negative effect on AFEs. Loneliness was correlated negatively with the perception of AFEs, but technology use was found to moderate the impact of loneliness.

Conclusions: Pandemic-related LSM restrictions impacted perceived AFEs and loneliness negatively, but technology played a moderating role. The findings demonstrate that technology could be considered as a ninth domain in the WHO's assessment of AFEs for older adults and that there is a need for its explicit acknowledgment.