Association between residential greenspace structures and frailty in a cohort of older Chinese adults.

Abstract

Frailty is a late-life clinical syndrome resulting from the accumulation of aging-induced decline. Greenspaces measured with normalized difference vegetation index (NDVI) are protective of frailty. However, NDVI is not as informative as structure indices in describing greenspaces' constitution, shape, and connectivity measured by the largest patch index (LPI), shape index, and cohesion index representing larger, more complex, and more dense greenspaces through higher values. We aim to study the association between greenness structures and frailty in a cohort of Chinese older adults. We included older adults from 2008-2014 China Longitudinal Healthy Longevity Survey (CLHLS). We used greenspace indices from satellite to quantify structures (area-edge, shape, proximity) at county-level, and calculated frailty index (FI) as an outcome. We did cross-sectional analyses using linear and logistical regression, and longitudinal analyses using the generalized estimating equations (GEE). Among 8776 baseline participants, mean LPI, shape, cohesion, and FI are 7.93, 8.11, 97.6, and 0.17. In cross-sectional analyses, we find negative dose-response relationships for greenspace structures and frailty, especially in females, centenarians, illiterate people, city residents, unmarried people, and individuals with increased frailty. Participants living in the highest quartile of LPI, shape, and cohesion have 32% (95%CI: 21-42%), 35% (95%CI: 24-44%), and 37% (95%CI: 26%-46%) lower odds of frailty than the lowest quartile. However, we do not find a significant association in longitudinal analyses. Higher levels of greenness structures (area-edge, shape, and proximity) might be related to lower frailty, while a clear longitudinal benefit cannot be identified in this analysis. Areas dominated by vegetation (greenspaces) are associated with reduced frailty, an aging-related decline in physical function. Here, we aimed to look at the association between specific greenspace structures and frailty in a cohort of older Chinese adults. We use demographic and health data from a 6-year survey and greenspace structure data from satellites to conduct our statistical analysis. We find that a larger area, more complex shape, more concentrated greenspaces, and greater proximity might lower levels of frailty, especially in females, people aged 100 and above, illiterate people, city residents, unmarried people, and individuals with increased frailty. These findings help us to understand how the environment impacts our health and how we might mitigate frailty in older aged adults.