Date Presented 04/04/19
This study investigated the relationships of home layout and the ADL, physical, cognitive, and psychosocial functions in community-dwelling older adults. The findings support the idea that the spatial layout of a home affects the ability to live in one's own home independently.
Primary Author and Speaker: Yoonjeong Lim
Additional Authors and Speakers: Kinsuk Maitra, Sang-Heon Lee, Sonit Bafna
Contributing Authors: Audrey Reiner, Veronica Betancourt, Ben Allen, Marianna Thomas, Eric Minter, Wei Wang, Amanda Pitts, Hayat Akmel, Jonathan Cam, Mary Alvarez
PURPOSE: Aging in place is defined as "the ability to live in one's own home and community safely, independently, and comfortably, regardless of age, income, or ability level". It is imperative that older adults aging at home should be mobile, socially engaged, and independent in performing ADLs and IADLs. In occupational therapy, very little attention has been given to the influence of the spatial layout of a home on the behavior of those interacting with that space. Therefore, this study investigated the relationships of home layout and the ADL, physical, cognitive, and psychosocial functions in community-dwelling older adults.
DESIGN: This study used a cross-sectional design. Twenty-six community-dwelling older adults participated in this study. Inclusion criteria specified individuals who are 60 years or older and live in their own homes. They must be able to sit and complete the questionnaires for one hour. Participants who have neurological disorders and are not ambulatory were excluded from this study.
METHOD: Data collection consisted of two parts: a home visit and online surveys. Researchers visited the participants’ homes and measured the spatial layout of the homes. Physical and cognitive functions were examined using the Modified Physical Performance Test (MPPT), grip strength, the Montreal Cognitive Assessment (MoCA), and the CANTAB cognitive test. Participants also completed the online surveys that measure self-reported ADL, IADL, and psychosocial function. The Barthel Index, Lawton IADL Scale, and Loneliness Scale were included in the survey. Spatial layout was analyzed by the spatial syntax software, Depthmap X, to calculate connectivity and depth. Connectivity measures the number of rooms directly connected to a space. The mean depth of a room is the average number of steps that separate it from all the rooms of the house. In addition, association between home layout and ADL, physical, cognitive, and psychosocial functions were analyzed using the Spearman correlation coefficient. The IBM SPSS version 24 was used, and the alpha level was set at .05.
RESULTS: The mean depth showed a trend of positive correlation with the Barthel Index (p=.069). Both average connectivity (p=.007) and mean depth (p=.005) were positively correlated with the MPPT. The average connectivity showed positive correlation with the MoCA (p=.026), and the mean depth was negatively correlated with the CANTAB Cognitive Test (p=.014). In addition, the average connectivity (p=.012) and mean depth (p=.014) showed a negative correlation with the Loneliness Scale.
CONCLUSION: This study is the first trial to identify whether a home layout influences independence in ADL, physical functioning, and Psychosocial engagements. This study found several correlations between home layout variables and ADL, physical, cognitive, and psychosocial functions. The findings of this study support the idea that the spatial layout of a home affects the ability to live in one's own home independently. To stay and grow old within their current homes and community, older adults will need environments that encourage mobility and psychosocial well-being.
IMPACT STATEMENT: Occupational therapy practitioners have the knowledge and expertise to develop solutions to barriers that environments pose to occupational performance, including the home environment. Based on the finding of this study, practitioners should understand the influence of home layout on occupational performance to promote productive aging.
References
Eid, Y., & Shehayeb, D. (2004). Determinants of activity patterns in Egyptian homes: A space syntax analysis of use. University of Cambridge. 1-14.
Marquardt, G., Johnston, D., Black, B. S., Morrison, A., Rosenblatt, A., Lyketsos, C. G., & Samus, Q. M. (2011). Association of the spatial layout of the home and ADL abilities among older adults with dementia. American Journal of Alzheimer’s Disease and Other Dementias, 26(1), 51-57. doi:10.1177/1533317510387584
