Influence of environmental barriers and facilitators on functioning: Analytical observational study in community-dwelling older adults.

INTRODUCTION

Environmental factors are critical determinants of healthy aging, directly impacting social participation and independence.

PURPOSE: To analyze the influence of environmental barriers and facilitators on the functioning of community-dwelling older adults, using standardized instruments that allow for a quantitative and multidimensional evaluation.

METHODS

This cross-sectional study included 100 older adults (age > 60 years). Instruments included the Measure of the Quality of the Environment (MQE), Vulnerable Elders Survey-13 (VES-13), World Health Organization Disability Assessment Schedule 2.0 - Brazilian Older Adult version (WHODAS-B.O), and the ICF Core Set for Physical Health in Older Adults.

RESULTS

Physical environments were identified as the primary barriers, while technology and political systems were major facilitators. Individuals with moderate/severe disability (90th percentile WHODAS-B.O) demonstrated significantly higher limitations (median 17.2 vs. 9.4). Significant associations were found between social networks as facilitators and lower disability (Spearman's correlation (rho) = -0.75; p < .001) and between political barriers and activity restrictions (rho = 0.78; p = .008).

CONCLUSION

Physical environmental barriers and political obstacles are key drivers of activity restrictions, whereas strong social networks act as a significant facilitator against disability in older adults. Physiotherapy practice must transition toward a biopsychosocial approach that incorporates systematic environmental and social assessments within home-based and community rehabilitation. Interventions should prioritize the mitigation of physical barriers and the integration of social support systems and assistive technology to effectively reduce disability levels and optimize community participation in this population.