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The Home Environment and Disability-Related Outcomes in Aging Individuals: What Is the Empirical Evidence?
Open accessAbstract
PURPOSE: Building on the disablement process model and the concept of person-environment fit (p-e fit), this review article examines 2 critical questions concerning the role of home environments: (a) What is the recent evidence supporting a relationship between home environments and disability-related outcomes? and (b) What is the recent evidence regarding the effects of home modifications on disability-related outcomes? DESIGN AND METHODS: Using computerized and manual search, we identified relevant peer-reviewed original publications and review articles published between January 1, 1997, and August 31, 2006. For Research Question 1, 25 original investigations and for Research Question 2, 29 original investigations and 10 review articles were identified. RESULTS: For Research Question 1, evidence for a relationship between home environments and disability-related outcomes for older adults exists but is limited by cross-sectional designs and poor research quality. For Research Question 2, evidence based on randomized controlled trials shows that improving home environments enhances functional ability outcomes but not so much falls-related outcomes. Some evidence also exists that studies using a p-e fit perspective result in more supportive findings than studies that do not use this framework. IMPLICATIONS: Considerable evidence exists that supports the role of home environments in the disablement process, but there are also inconsistencies in findings across studies. Future research should optimize psychometric properties of home environment assessment tools and explore the role of both objective characteristics and perceived attributions of home environments to understand person-environment dynamics and their impact on disability-related outcomes in old age.
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“Proposition 5: Environmental strategies and resources for coping with care needs consist of the use of compensatory and optimizing devices to maintain autonomy and well-being (e.g., adequate housing, mobility and other technology).”
From Toward a More Comprehensive Concept of Successful Aging: Disability and Care Needs: Table 1. (2016) · cites this paper as Wahl et al., 2009
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“Successful aging with disability and care needs depends, to a large extent, on environmental factors: Housing, technological equipment, provision of services as well as infrastructure of the neighborhood.”
From Toward a More Comprehensive Concept of Successful Aging: Disability and Care Needs: Table 1. (2016) · cites this paper as Wahl et al., 2009
Experimental — accuracy not yet measuredIn the citing paper
“Domotics is another important field of research, because nearly three quarters of older adults with dementia are cared for in their own homes (298), and there is a strong correlation between home environment and disability-related outcomes (299).”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [299]
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Tsuchiya‐Ito, R., Slaug, B., & Ishibashi, T. (2019) · Journal of Housing for the Elderly · doi:10.1080/02763893.2019.1597803 · Cited by 24
Benzinger, P., Iwarsson, S., Kroog, A., Beische, D., Lindemann, U., Klenk, J., & Becker, C. (2014) · Aging Clinical and Experimental Research · doi:10.1007/s40520-014-0196-0 · Cited by 23
Functional Goals and Predictors of Their Attainment in Low-Income Community-Dwelling Older Adults
Waldersen, B. W., Wolff, J. L., Roberts, L., Bridges, A. E., Gitlin, L. N., & Szanton, S. L. (2016) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2016.11.017 · Cited by 27
Validation of Housing Standards Addressing Accessibility
Helle, T., Iwarsson, S., & Brandt, Å. (2013) · Journal of Applied Gerontology · doi:10.1177/0733464813503042 · Cited by 23
Seplaki, C. L., Agree, E. M., Weiss, C. O., Szanton, S. L., Bandeen‐Roche, K., & Fried, L. P. (2013) · The Gerontologist · doi:10.1093/geront/gnt030 · Cited by 23
Oswald, F., & Wahl, H. (2016) · Springer eBooks · doi:10.1007/978-3-658-12484-7_6 · Cited by 23
Metadata
- Authors
- Wahl, H.-W., Fange, A., Oswald, F., Gitlin, L. N., & Iwarsson, S.
- Affiliations
- Heidelberg University (DE)
- Thomas Jefferson University (US)
- Lund University (SE)
- Venue
- The Gerontologist
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-05-06
- Volume
- 49
- Issue
- 3
- Pages
- 355-367
- ISSN
- 0016-9013 (ISSN-L)
- 1758-5341
- PMC
- PMC4854361
- OpenAlex
- W2153217064
- Cited by
- 315
- References
- 90
- Citations by year
- 2026: 12 · 2025: 11 · 2024: 12 · 2023: 16 · 2022: 13 · 2021: 15 · 2020: 10 · 2019: 30 · 2018: 24 · 2017: 14 · 2016: 29 · 2015: 28 · 2014: 19 · 2013: 28 · 2012: 17
- FWCI
- 2.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Gerontologist (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- National Institute on Aging (R01AG013687)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Health Sciences › Health Professions › Occupational Therapy › Assistive Technology in Communication and Mobility
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Keywords
- family environment, home modification, older adults, aging, person-environment fit, functional capacity, falls
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Aging, Persons with Disabilities, Housing, Humans, Interior Design and Furnishings, Middle Aged
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