Association of Age-Friendly Communities With Health and Well-Being Among Older Adults: An Ecological and Multilevel Analysis From the Japan Gerontological Evaluation Study

This cross-sectional study examined the association of age-friendly communities (AFC) with health and well-being among older adults, using the Japan Gerontological Evaluation Study 2016 data. Ecological and multilevel analyses of 71,824 older adults across 145 communities revealed that the community’s age-friendliness consistently showed associations with health and well-being. Age-friendly physical environments (accessibility to barrier-free outdoor spaces, buildings, and transportation resources) exhibited an inverse association with functional health deficits. Social engagement and communication (participation in community groups, volunteer engagement, and information use) were inversely associated with depressive symptoms. Social inclusion and dementia-friendliness (respect and inclusion for older adults and positive attitudes toward people with dementia) were positively associated with happiness. Community’s age-friendliness is well-linked to the multiple aspects of older adults’ health and well-being, underscoring the AFC promotion for healthy aging.