ArticleJournal of the American Medical Directors Association2020
Residential Greenness and Frailty Among Older Adults: A Longitudinal Cohort in China.
Article in Journal of the American Medical Directors Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Green Space and Health in Mainland China: A Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Relationship between Green and Blue Spaces with Mental and Physical Health: A Systematic Review of Longitudinal Observational Studies.International journal of environmental research and public health · 2021Pooled it
- The mediating role of cognitive function in the association between physical activity and frailty risk.Scientific reports · 2026Article
- The role of natural outdoor environment on COVID-19 mortality and hospitalisations among older community-dwellers in the pre-vaccination period: the Register RELOC-AGE cohort study in Sweden.BMC public health · 2025Article
- SANTANA Cohort: Study on Frailty in Institutionalised Older Adults and Its Relationship With Gordon's Functional Health Patterns.Journal of advanced nursing · 2025Article
- Association between physical activity and frailty transitions in middle-aged and older adults: a nationwide longitudinal study.The international journal of behavioral nutrition and physical activity · 2025Article
- Lead exposure and physical frailty in patients with type 2 diabetes mellitus: cross-sectional results from the METAL study.Endocrine · 2025Article
- Relationship between leisure activity and depression in Chinese older adults: chain mediating effect of diet and cognition.BMC geriatrics · 2025Article
- Association between indoor ventilation frequency and frailty among Chinese older adults.Frontiers in public health · 2025Article
- Enhancing the convenience of frailty index assessment for elderly Chinese people with machine learning methods.Scientific reports · 2024Article
- Association between dietary diversity changes and frailty among Chinese older adults: findings from a nationwide cohort study.Nutrition journal · 2024Article
- Dietary factors in relation to the risk of cognitive impairment and physical frailty in Chinese older adults: a prospective cohort study.European journal of nutrition · 2024Article
- Plant-Based Diet Indices and Their Association with Frailty in Older Adults: A CLHLS-Based Cohort Study.Nutrients · 2023Article
- China's public health initiatives for climate change adaptation.The Lancet regional health. Western Pacific · 2023Review
- Is waist-calf circumference ratio associated with frailty in older adults? Findings from a cohort study.BMC geriatrics · 2023Article
- Biomass fuel usage for cooking and frailty among older adults in China: a population-based cohort study.Frontiers in public health · 2023Article
- Associations between Frailty and Ambient Temperature in Winter: Findings from a Population-Based Study.International journal of environmental research and public health · 2022Article
- Calf circumference predicts frailty in older adults: the Chinese longitudinal healthy longevity survey.BMC geriatrics · 2022Article
- Sociodemographic Variations in the Availability of Urban Green Spaces in an Older Swedish Population.International journal of environmental research and public health · 2022Article
- Association between Age-Friendliness of Communities and Frailty among Older Adults: A Multilevel Analysis.International journal of environmental research and public health · 2022Article
Corrections and comments
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4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesFrailty is an accumulation of deficits characterized by reduced resilience to stressors and increased vulnerability to adverse outcomes. There is evolving evidence on the health benefits of residential greenness, but little is known about its impact on frailty.
designA longitudinal cohort study. SETTING AND
participantsWe included older adults aged ≥65 years from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) with a 12-year follow-up.
methodsWe assessed residential greenness by calculating the Normalized Difference Vegetation Index (NDVI) in the 500 m radius around participants' residence. We used 39 self-reported health items to construct a frailty index (FI) as a proportion of accumulated deficits. We defined an FI of ≤0.21 as nonfrail and prefrail, and an FI of >0.21 as frail. We used the mixed effects logistic regression models to examine the association between residential greenness and frailty, adjusted for a number of covariates.
resultsWe had 16,238 participants, with a mean age of 83.0 years (standard deviation: 11.5). The mean baseline NDVI and FI were 0.40, and 0.12, respectively. Compared to the participants living in the lowest quartile of residential greenness, those in the highest quartile had a 14% [odds ratio (OR): 0.86, 95% confidence interval (CI): 0.77, 0.97] lower odds of frailty. The association was stronger among urban vs rural residents. Additionally, each 0.1-unit increase in annual average NDVI was related to a 2% higher odds of improvement in the frailty status (OR: 1.02, 95% CI: 1.00, 1.04). CONCLUSIONS AND IMPLICATIONS: Our study suggests that higher levels of residential greenness are related to a lower likelihood of frailty, specifically in urban areas.
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