Developing an indicator for community-level age-friendly communities: the Japan gerontological evaluation study
Abstract Background Age-friendly communities (AFCs) aim to create inclusive societies for older adults. The World Health Organization (WHO) highlights dementia considerations in AFC development; however, few community-level indicators include these elements. This study aimed to develop a community-l...
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BMC
2025-04-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-025-05919-4 |
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| author | Satoko Fujihara Taiji Noguchi Kazushige Ide Seungwon Jeong Katsunori Kondo Toshiyuki Ojima |
| author_facet | Satoko Fujihara Taiji Noguchi Kazushige Ide Seungwon Jeong Katsunori Kondo Toshiyuki Ojima |
| author_sort | Satoko Fujihara |
| collection | DOAJ |
| description | Abstract Background Age-friendly communities (AFCs) aim to create inclusive societies for older adults. The World Health Organization (WHO) highlights dementia considerations in AFC development; however, few community-level indicators include these elements. This study aimed to develop a community-level AFC indicator incorporating dementia-friendly elements based on WHO guidelines and to test its validity and reliability. Methods A repeated cross-sectional design used data from the 2016 and 2019 waves of the Japan Gerontological Evaluation Study (JAGES) covering 61 school districts in 16 municipalities (45,162 individuals aged 65 and older in 2016 and 39,313 in 2019). The 2016 and 2019 datasets served as the development and retest samples, respectively. The item selection process involved extracting indicators from the JAGES survey items that aligned with WHO guidelines as well as those based on prior research on dementia-friendly communities (DFCs). Following expert consultations, 23 candidate items were identified. Data were aggregated at the school district level. Exploratory factor analysis (EFA) was conducted on the 2016 data to derive the factor structure, and confirmatory factor analysis (CFA) was used to assess model fit. The reproducibility of the factor structure was evaluated using EFA on the 2019 retest sample. Internal consistency and test-retest reliability were assessed. Results The final 17-item indicator comprised three subscales: Social inclusion and dementia-friendliness (7 items, α = 0.86; e.g., Sense of belonging to the community), Social engagement and communication (5 items, α = 0.78; e.g., Participation in hobby groups), and Age-friendly physical environment (5 items, α = 0.82; e.g., Accessibility of barrier-free streets). The CFA showed an unsatisfactory model fit; however, test-retest reliability was adequate (r = 0.71–0.79; ICC = 0.67–0.78). Conclusions A valid and reliable 17-item community-level indicator was developed, aligning with the WHO framework and incorporating dementia-friendly elements. This indicator is a valuable tool for monitoring, evaluation, and inter-community comparisons, aiding the development of AFCs and DFCs in aging societies like Japan. Additionally, this indicator can be adapted for other high-income countries with similar socioeconomic backgrounds, healthcare systems, and community structures, providing a useful tool for age- and dementia-friendly initiatives. Clinical trial number Not applicable. |
| format | Article |
| id | doaj-art-fb4323ddea934018a801eab247472d80 |
| institution | OA Journals |
| issn | 1471-2318 |
| language | English |
| publishDate | 2025-04-01 |
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| series | BMC Geriatrics |
| spelling | doaj-art-fb4323ddea934018a801eab247472d802025-08-20T02:28:42ZengBMCBMC Geriatrics1471-23182025-04-0125111110.1186/s12877-025-05919-4Developing an indicator for community-level age-friendly communities: the Japan gerontological evaluation studySatoko Fujihara0Taiji Noguchi1Kazushige Ide2Seungwon Jeong3Katsunori Kondo4Toshiyuki Ojima5Research Department Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and WelfareDepartment of Community Health and Preventive Medicine, Hamamatsu University School of MedicineDepartment of Community Building for Well-being, Center for Preventive Medical Sciences, Chiba UniversityDepartment of Social Science, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Research InstituteResearch Department Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and WelfareDepartment of Community Health and Preventive Medicine, Hamamatsu University School of MedicineAbstract Background Age-friendly communities (AFCs) aim to create inclusive societies for older adults. The World Health Organization (WHO) highlights dementia considerations in AFC development; however, few community-level indicators include these elements. This study aimed to develop a community-level AFC indicator incorporating dementia-friendly elements based on WHO guidelines and to test its validity and reliability. Methods A repeated cross-sectional design used data from the 2016 and 2019 waves of the Japan Gerontological Evaluation Study (JAGES) covering 61 school districts in 16 municipalities (45,162 individuals aged 65 and older in 2016 and 39,313 in 2019). The 2016 and 2019 datasets served as the development and retest samples, respectively. The item selection process involved extracting indicators from the JAGES survey items that aligned with WHO guidelines as well as those based on prior research on dementia-friendly communities (DFCs). Following expert consultations, 23 candidate items were identified. Data were aggregated at the school district level. Exploratory factor analysis (EFA) was conducted on the 2016 data to derive the factor structure, and confirmatory factor analysis (CFA) was used to assess model fit. The reproducibility of the factor structure was evaluated using EFA on the 2019 retest sample. Internal consistency and test-retest reliability were assessed. Results The final 17-item indicator comprised three subscales: Social inclusion and dementia-friendliness (7 items, α = 0.86; e.g., Sense of belonging to the community), Social engagement and communication (5 items, α = 0.78; e.g., Participation in hobby groups), and Age-friendly physical environment (5 items, α = 0.82; e.g., Accessibility of barrier-free streets). The CFA showed an unsatisfactory model fit; however, test-retest reliability was adequate (r = 0.71–0.79; ICC = 0.67–0.78). Conclusions A valid and reliable 17-item community-level indicator was developed, aligning with the WHO framework and incorporating dementia-friendly elements. This indicator is a valuable tool for monitoring, evaluation, and inter-community comparisons, aiding the development of AFCs and DFCs in aging societies like Japan. Additionally, this indicator can be adapted for other high-income countries with similar socioeconomic backgrounds, healthcare systems, and community structures, providing a useful tool for age- and dementia-friendly initiatives. Clinical trial number Not applicable.https://doi.org/10.1186/s12877-025-05919-4Age-friendly communitiesDementia-friendly communitiesCommunity-level indicatorsHealthy aging |
| spellingShingle | Satoko Fujihara Taiji Noguchi Kazushige Ide Seungwon Jeong Katsunori Kondo Toshiyuki Ojima Developing an indicator for community-level age-friendly communities: the Japan gerontological evaluation study BMC Geriatrics Age-friendly communities Dementia-friendly communities Community-level indicators Healthy aging |
| title | Developing an indicator for community-level age-friendly communities: the Japan gerontological evaluation study |
| title_full | Developing an indicator for community-level age-friendly communities: the Japan gerontological evaluation study |
| title_fullStr | Developing an indicator for community-level age-friendly communities: the Japan gerontological evaluation study |
| title_full_unstemmed | Developing an indicator for community-level age-friendly communities: the Japan gerontological evaluation study |
| title_short | Developing an indicator for community-level age-friendly communities: the Japan gerontological evaluation study |
| title_sort | developing an indicator for community level age friendly communities the japan gerontological evaluation study |
| topic | Age-friendly communities Dementia-friendly communities Community-level indicators Healthy aging |
| url | https://doi.org/10.1186/s12877-025-05919-4 |
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