Ageing well in the urban environment: meeting the health and social needs of older Adults - study protocol for a prospective, longitudinal mixed-methods study.

backgroundUrbanisation and ageing populations are global challenges for ageing well. This mixed-methods study examines the health and social needs of older adults in urban areas in Berlin, Germany and in Singapore, focusing on three key dimensions of healthy ageing and wellbeing: health, mobility, loneliness, and equity as a cross-cutting theme.

methodsThe design follows a mixed-methods approach combining a quantitative longitudinal cohort study with qualitative interviews. For the quantitative cohort study, a standardised survey is carried out via home visits with a random sample of n = 1,050 adults aged 65 + years each in selected neighbourhoods in Berlin (three neighbourhoods) and Singapore (five neighbourhoods). The questionnaire comprises questions on health and health care utilization, neighbourhood, loneliness and social contacts, mobility and sociodemographic characteristics. Additionally, three functional tests (cognitive functioning, hand grip strength, and walking speed) are carried out with participants. Participants are followed-up after 12 months with a second survey interview. The survey data is linked with openly available geospatial data to allow for more in-depth study of the built-up and social environment and physical barriers in the selected neighbourhoods. For the qualitative component, walking interviews are conducted with n=50 people each in Berlin and Singapore focusing on older adults' subjective perspective on health, mobility, green spaces and loneliness in their urban neighbourhood. The results of the different study components will be triangulated. DISCUSSION: The Ageing Well Study offers a valuable opportunity to assess the health and social needs of older adults in two distinct urban contexts. The mixed-methods design and utilization of multiple data sources enables an examination of the various dimensions of ageing well from disparate angles and perspectives. The extensive quantitative data set permits the examination of associations and interlinkages between the various dimensions of ageing well and the living environment, as well as the identification of changes over a 12-month period. By opting for home visits, participants with limited mobility are more likely to participate. Minor adaptations of the instruments and methods were implemented to best suit local context, administrative regulations, and feasibility at the study site.

trial registrationThe study has been registered prospectively at the German Register for Clinical Studies (DRKS) (DRKS00033043, registration date: 16th Nov 2023) which is part of the WHO International Clinical Trials Registry Platform (WHO ICTRP).