Residential greenness, activities of daily living, and instrumental activities of daily living: A longitudinal cohort study of older adults in China

Anna Zhu, Lijing L. Yan, Chih Da Wu, Peter James, Yi Zeng, John S. Ji

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17 Citations (Scopus)

Abstract

Background: We aimed to explore whether higher levels of residential greenness were related to lower odds of disabilities in activities of daily living (ADL) and instrumental activities of daily living (IADL). Methods: We included older adults 65 years of age or older from the Chinese Longitudinal Healthy Longevity Survey. Our exposure was Normalized Difference Vegetation Index in 500 m radius around residence. Our outcome was ADL and IADL. We used binary logistic regression and mixed-effects logistic regression to estimate the odds of ADL and IADL disabilities. Results: A total of 36,803 and 32,316 participants were included for the analysis of ADL and IADL, with 71.6% free of ADL disability and 47.3% free of IADL disability. In the logistic regression model, compared with the participants living in the lowest quartile of residential greenness, those in the highest quartile had a 28% (odds ratio [OR] = 0.72; 95% confidence interval [CI] = 0.65, 0.79) lower odds of ADL disability and a 14% (OR = 0.86; 95% CI = 0.77, 0.95) lower odds of IADL disability. A similar association was found in the mixed-effects logistic regression models. During the follow-up period, 5,004 and 4,880 healthy participants developed ADL and IADL disabilities. Per 0.1-unit increase in baseline annual average Normalized Difference Vegetation Index (NDVI) was related to an OR of 0.95 of developing ADL disability (95% CI = 0.93, 0.98) and IADL disability (95% CI = 0.91, 0.98). Conclusions: Our study suggests that increasing green space is associated with lower odds of ADL and IADL disabilities, which may reduce caregiver burden of long-term care for Chinese older adults.

Original languageEnglish
Article numbere065
JournalEnvironmental Epidemiology
Volume3
Issue number5
DOIs
Publication statusPublished - 2019

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Global and Planetary Change
  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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