Understanding Needs of Older Adults with Different Physical Functioning

Background/Purpose: About eight in ten adults aged 45-plus feel strongly about staying in their current home and their community for as long as possible. Accordingly, the number of older adults who are living in their community has increased, even for those people with high levels of disability. Given this, provisions and interventions should be considered to ensure that older adults are able to remain in their community. Since older adults’ health status may affect their needs, this study aimed to understand differences in needs for community resources and services among older adults by both physical functioning and self-reported health.

Methods: In 2015, AARP conducted 14 age-friendly community studies using a standardized survey instrument.  The survey instrument was used to assess how communities are doing across the eight domains of age-friendliness, as established by the World Health Organization (WHO). The AARP survey encapsulates the WHO eight as: (1) Home & Community, (2) Home, Public Buildings, & Spaces, (3) Transportation, (4) Health & Wellness, (5) Social Participation, Inclusion, & Education Opportunities, (6) Volunteering & Civic Engagement, (7) Job Opportunities, and (8) Community Information. For this study, data were derived from six communities (i.e., Lansing, MI, San Antonio, TX, Phoenix, AZ, Charlotte, NC, Bangor, ME, Tallahassee, FL) that sampled residents age 50 and older. Among 2,344 survey respondents, 2,179 respondents who provided their age information comprised the subsample for this study.  The dependent variables of this study were the perceived importance of community features (0=Not at all important – 4=Extremely important) which were captured using 66 items under the eight domains. The independent variables were functional limitations (0=Yes; 1=No) and self-reported health (0=Poor – 4=Excellent). Five copies of datasets were created using multiple imputation. Hypotheses were tested using weighted OLS regression analysis.

Results: Having functional limitations was positively associated with perceived importance of Home & Community (b=.14, SE=.04; p<.001), Home, Public Buildings, & Spaces (b=.11, SE=04; p<.01), and Transportation (b=.07, SE=.03; p<.05). It was marginally associated with Health & Wellness (b=.05, SE=.05; p=.095) and Community Information (b=.07, SE=.04; p=.07). On the other hand, respondents who had better health were more likely to report higher needs for Social Participation, Inclusion, & Education Opportunities (b=.05, SE=.02; p<.01) and Volunteering & Civic Engagement (b=.05, SE=.02; p<.05). Health status was negatively associated with Home & Community (b=-.04, SE=.02; p<.05), and positively and marginally significantly associated with Job Opportunities (b=.04, SE=.02; p=.07).

Conclusions/Implications: The results suggest that older adults with different levels of physical functioning or health status have different needs. Therefore, different interventions and services should be considered and provided to older adults based on their physical health and their needs. For example, for older adults with functional limitations, services that can mitigate older adults’ limited physical/functional abilities, such as home repair and maintenance, better infrastructure, more transportation options, and health services, should be provided. For those with better health, providing more opportunities to participate in productive e.g., civic engagement, education) and/or recreational activities may enhance their well-being.