Relations of the neighbourhood socio-economic and physical environment with 3-year changes in health-related quality of life among community-dwelling older adults in Belgium

Current evidence on the relations between neighbourhood environments and older adults' health-related quality of life (HRQoL) relies mainly on cross-sectional studies. This longitudinal study aimed to examine the relations of neighbourhood socio-economic status (SES) and objective and perceived physical environmental factors with 3-year changes in physical and mental HRQoL. Baseline and three-year follow-up data were collected in 503 Belgian older adults. Generalized linear mixed models were applied. Participants living in low compared to high SES neighbourhoods experienced stronger decreases in physical and mental HRQoL. Shorter objective distances to the nearest private recreational facility and park and better perceived aesthetics were associated with weaker decreases in physical HRQoL. Independent of time, higher perceived safety from crime was related to better physical and mental HRQoL. Unexpectedly, higher levels of perceived access to recreational facilities, land use mix diversity, connectivity and traffic safety were associated with stronger decreases in HRQoL. To prevent decreases in HRQoL, policies should prioritize older adults living in low SES neighbourhoods and provide aesthetically pleasing and safe neighbourhoods with nearby parks and private recreational facilities. Future research is needed to clarify the observed unanticipated effects and mediating pathways in the relations between neighbourhood environments and HRQoL.