The influence of the built environment and perceived neighborhood on physical frailty and sarcopenia in older adults: A systematic review

Abstract

Objective

To examine the scientific evidence on the relationship between the built environment, perceived neighborhood, and physical frailty and sarcopenia in older adults.

Methods

The search used PUBMED, SCOPUS, EMBASE, Web of Science, Scielo databases, and Google Scholar as gray literature. Studies with non-institutionalized older adults aged 60 years or older that tested the relationship with the perceived neighborhood and built environment and with physical frailty or sarcopenia, as well as observational studies published in English, Portuguese, and Spanish, were included.

Results

18 studies were included in the qualitative synthesis (n = 102.789 older adults). Three studies evaluated the relationship between the built environment and perceived neighborhood and sarcopenia, and 15 studies with physical frailty. Regarding the study design, five studies were cohort, and 13 were cross-sectional. The results found that lack of access to public transportation, poor access to recreational facilities, absence of destination, hazard hills, and absence of traffic safety were risk factors for sarcopenia. Walkability, safety from crime, recreational facilities/walking and cycling facilities/exercise facilities and neighborhood aesthetics, were environmental characteristics that showed associations with physical frailty. After sensitivity analysis, walkability was shown to be inconclusive.

Conclusion

Evidence indicates that older adults who live in built environments with higher walkability, access to recreational facilities/walking and cycling facilities/exercise facilities and neighborhood aesthetics are less likely to develop physical frailty. Current evidence regarding sarcopenia remains limited and inconclusive.