Exploring the Determinants of Age-Friendly Cities and Communities Perceptions Among Turkish Older Adults

Exploring the Determinants of Age-Friendly Cities and Communities Perceptions Among Turkish Older Adults | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Exploring the Determinants of Age-Friendly Cities and Communities Perceptions Among Turkish Older Adults Sevinç Sütlü, Özge Kutlu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7920642/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract The ageing population and rapid urbanisation highlight the need for inclusive and sustainable cities that support the well-being of older adults. Drawing on the framework of environmental gerontology, this study explores the determinants of perceptions of age-friendly cities and communities among older adults in Türkiye. Data were collected from 411 individuals aged 65 years and over in Burdur Province using sociodemographic questionnaires and scales measuring Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL), as well as the Age-Friendly Cities and Communities Questionnaire (AFCCQ-TR). The results reveal that perceptions of age-friendliness are significantly influenced by gender, age, marital status, health conditions and behaviours. Women, married participants, and younger age groups gave more positive evaluations, whereas chronic illness, falls, fractures, and risky health behaviours were associated with more negative perceptions. No significant associations were found between ADL/IADL and perceptions, emphasising the greater importance of social and environmental factors compared to functional independence in shaping urban experiences. These findings suggest that sustainable age-friendly urban policies should prioritise physical infrastructure, social participation, accessible healthcare, and digital inclusion. Measures such as establishing community centres, enhancing public transport and open spaces, supporting home-based healthcare, and promoting digital literacy could contribute to the creation of healthier, more socially resilient, and more environmentally sustainable cities for older populations. By offering empirical evidence from Türkiye, where age-friendly initiatives remain limited, the study contributes to international debates on sustainable cities and underscores the urgent need for context-specific, inclusive, and cross-sectoral strategies to support ageing populations in urban environments. Age-friendly cities older adults environmental gerontology aging 1. Introduction Population ageing and rapid urbanisation are among the most significant socio-demographic transformations facing today's societies (Liang & Ye, 2023 ). As the elderly population increases, there is an urgent need for living spaces that support the well-being and quality of life of older adults and adapt to the effects of social change (Ersözlü, 2024 ). This situation necessitates re-evaluating numerous areas, including health and care services, urban infrastructure, opportunities for social participation and environmental regulations. In this regard, the World Health Organisation (WHO) developed the ‘Age-Friendly Cities’ approach in 2006, aiming to increase the active participation of the elderly population in urban life and improve their quality of life (Buckner et al., 2018 ). The Age-Friendly Cities approach was developed to facilitate the integration of older people into city life, promoting active ageing through optimising health, participation and safety conditions (Buckner et al., 2018 ). The WHO defines this approach through eight key areas: outdoor spaces and buildings; transport; housing; social participation; respect and social inclusion; civic participation and employment; communication and information; and community support and health services (WHO, 2007). The literature emphasises that the most critical factors influencing the social participation of older adults are their physical and social environments (Özer, Turan & Teke, 2022 ). Safe, accessible and liveable urban areas are considered fundamental for enabling older individuals to move independently, continue with their daily activities and integrate into social life (Kalache, 2016 ; Dawal et al., 2015 ). The eight key areas identified by the WHO for age-friendly cities provide a comprehensive framework for improving the quality of life of older people by addressing these fundamental needs (Phillipson & Buffel, 2020 ). In this context, the age-friendly city approach is also closely related to the individual-environment interaction framework established by environmental gerontology. Environmental gerontology explains the ageing process as the dynamic interaction between individuals and their environment (Oswald, 2024 ). This approach developed from the 1960s onwards and was first theorised by Lawton and Nahemow in their 'ecological adaptation theory' (Lawton and Nahemow, 1973 ). According to this theory, older adults' independence and well-being depend on achieving a balance between their individual capacities and environmental demands (González, 2018 ; Di Ciaula & Portincasa, 2020 ). In other words, the fit between a person and their environment is a fundamental factor in determining their levels of independence, functionality, and social participation (Wahl and Gerstorf, 2020 ). Environmental gerontology posits that the well-being of older adults hinges not only on biological or individual factors, but also on supportive environmental conditions (Oswald, 2024 ). Therefore, accessible, safe, clean and inclusive urban environments are fundamental to supporting the social integration and subjective well-being of older adults (Oswald and Yeh, 2021 ; Edress et al., 2021). The WHO's age-friendly cities approach is therefore the practical counterpart of environmental gerontology. With two-thirds of the world's population now living in urban areas, it is crucial that cities adapt to their ageing populations (World Bank, 2017 ; Van Hoof et al., 2018 ). This issue has become a critical part of the policy agenda in both developed and developing countries experiencing rapid demographic transitions. However, existing literature shows that research on age-friendly cities has largely focused on Western countries, with insufficient attention given to developing countries (Zhang & Yang, 2023 ; Thurairaj et al., 2025 ). From Türkiye's perspective, according to TURKSTAT data, the population aged 65 and over increased by 20.7 per cent over the last five years, reaching 10.6 per cent of the total population by 2024, placing Türkiye in the 'very old society' category. (TURKSTAT, 2025). This proportion is projected to reach 13.5 per cent by 2030 and 27 per cent by 2060. However, it should be noted that 55.3 per cent of people aged 65 and over in Türkiye live in densely populated cities, while 14.6 per cent live in moderately populated cities (TURKSTAT, 2023). This rapid demographic shift necessitates a more urgent approach to making cities age-friendly in Türkiye. However, it is evident that age-friendly city initiatives in Türkiye remain quite limited. While over 1,600 cities and communities in 53 countries worldwide have joined the Global Network of Age-Friendly Cities and Communities (GNAFCC), only six municipalities in Türkiye — Istanbul's Beşiktaş and Kadıköy districts, İzmir's Bornova district, Antalya's Muratpaşa district, Adana's Seyhan district, and the metropolitan municipality of Mersin — are members of this network (WHO, 2024). Despite being a rapidly ageing country, this low number suggests that the age-friendly city approach is not being widely adopted at a local level. Furthermore, existing research has mostly focused on Western countries, with findings from developing countries being limited (Zhang & Yang, 2023 ). Ersözlü ( 2024 ) states that age-friendly environment studies in Türkiye are largely based on qualitative and compilation methods, while quantitative studies remain limited. While topics such as 'ageing in place' and 'age-friendly design' are prominent, themes frequently discussed in international literature, such as sustainability and environmental gerontology, have been relatively understudied in Türkiye. The limited planning and implementation of age-friendly cities in Türkiye, combined with the lack of studies focusing on the perceptions of older adults, creates a significant knowledge gap. However, effective and inclusive policies cannot be developed without understanding the needs, experiences and environmental perceptions of older adults (Phillipson & Buffel, 2020 ). Against this backdrop, our study seeks to address this shortcoming by examining the perceptions of older adults in Türkiye regarding age-friendly cities and communities from an environmental gerontology perspective within a quantitative framework. This study aims to systematically examine older adults' perceptions of age-friendly cities and communities in Türkiye, and to identify the key factors that influence these perceptions. 2. Methods 2.1. Study design This study adopted a cross-sectional, quantitative research design to investigate the determinants of perceptions of age-friendly cities and communities among older adults. This design was considered suitable because it enables associations to be examined between individual characteristics, functional capacity and environmental perceptions at a single point in time (Setia, 2016 ; Wang & Cheng, 2020 ). 2.2. Study participants This study focused on community-dwelling older adults aged 65 years and over living in Burdur Province in Türkiye. Located in southwestern Türkiye, Burdur is one of the central provinces of the Mediterranean Region and has one of the highest proportions of older adults in the country, with 16.3% of its population aged 65 and over. Furthermore, 34% of older adults in Burdur live alone, placing the province third nationwide in this respect (TURKSTAT, 2025). According to the Turkish Statistical Institute, the total population of individuals aged 65 and over in Türkiye is approximately 9,112,298. The sample size was determined using Cochran's formula for finite populations: $$\:\text{n}\:=\frac{N\:\times\:\:{Z}^{2}\:\times\:\:p\:\times\:\:(1-p)}{\left(N-1\right)\times\:\:{e}^{2}+\:{Z}^{2}\:\times\:\:p\:\times\:\:(1-p)}$$ Where n is the required sample size, \(\:N\) is the population size, \(\:Z\) is the Z-score corresponding to the desired confidence level, \(\:p\) is the estimated proportion of the population and e is the margin of error (Cochran, 1997). Using this formula with a 95% confidence level (Z = 1.96), a margin of error of 5% (e = 0.05) and an estimated proportion (p = 0.5), the minimum required sample size was calculated to be 384 participants. In this study, 411 older adults participated, which exceeded the minimum requirement and enhanced the reliability and statistical validity of the findings. Convenience sampling was employed due to practical and methodological considerations. Although it is a non-probability sampling technique, convenience sampling is widely used in the social sciences when probability sampling is not feasible due to constraints relating to time, resources or access (Etikan, Musa & Alkassim, 2016 ). 2.3. Instruments The study used the following data collection tools: a sociodemographic information form; the Katz Activities of Daily Living Scale; the Lawton Instrumental Activities of Daily Living Scale; and the Age-Friendly Cities and Communities Questionnaire (AFCCQ-TR). 2.3.1 Socio-demographic Information Form : The researchers created the sociodemographic information form. Consisting of three sections, the questionnaire covers the participant's demographic, economic and general health characteristics. 2.3.2 Katz Activities of Daily Living Scale : The Katz scale, developed by Katz and colleagues ( 1963 ), was designed to evaluate the independence of older adults across six activity domains: bathing, dressing, toileting, mobility, continence and eating. Arik and colleagues ( 2015 ) conducted a Turkish validity and reliability study. Each activity is rated as 0 (dependent) or 1 (independent). A score of 6 indicates complete independence, while a score of 0 indicates complete dependence. The scale is a valid and reliable tool for measuring the independence of older adults in daily living activities within Turkish culture. 2.3.3 Lawton Instrumental Activities of Daily Living Scale : The scale was developed by Lawton and Brody in 1969. Consisting of eight items, it measures the ability to perform various tasks such as using the telephone, shopping, preparing meals, cleaning the house, doing laundry, using public transport, managing medication and managing finances. Items on the scale are scored between 0 (unable or partially able) and 1 (able). A total score of 0 indicates low functioning/dependence, while a score of 8 indicates high functioning/independence. A study investigating the validity and reliability of the scale in Turkish was conducted by Güzel and colleagues ( 2024 ). The scale is a valid and reliable tool for measuring the independence of older adults in terms of their ability to perform instrumental activities of daily living within Turkish culture. 2.3.4 Age-Friendly Cities and Communities Questionnaire (AFCCQ-TR) : Dikken and colleagues ( 2020 ) developed the Age-Friendly Cities and Communities Survey to measure the age-friendliness of cities and communities. It was prepared according to criteria established by the World Health Organization (WHO) in 2015. It consists of 23 items and nine sub-dimensions. It is a 5-point Likert-type measure. The sub-dimensions of the scale are: Housing; Social Participation; Respect and Social Inclusion; Civic Participation and Employment; Communication and Information; Social Support and Health Services; Open Spaces and Buildings; Transport; and Financial Situation. A high score on the scale indicates that cities and communities are age-friendly. Özer and colleagues ( 2022 ) established the validity and reliability of the scale in Turkish. 2.4. Data analysis Data analysis was carried out using SPSS version 25. First, the internal consistency coefficients (Cronbach's alpha) of the scales were examined to ensure reliable measurements. The results showed that the scales had acceptable levels of internal consistency. Next, the assumptions of normality were tested. The skewness and kurtosis values of the scales were found to be within the acceptable range of ± 1.5, suggesting that the data were normally distributed (Kline, 2011 ). Based on these findings, the dataset was considered appropriate for parametric statistical analyses in terms of multivariate normality. Descriptive statistics were computed to summarise the sociodemographic characteristics of the participants. Group comparisons were then conducted to examine the effects of demographic and health-related variables on perceptions of age-friendly cities and communities. Depending on the number of categories within each variable, independent samples t-tests or one-way ANOVAs were applied. Following these analyses, the variables found to be statistically significant in the bivariate comparisons were included in a multiple linear regression model to identify predictors of perceptions of age-friendly cities and communities. Additionally, variance analyses were performed to examine the potential effects of Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) status on perception scores. The regression results are presented alongside standardised beta coefficients (β), standard errors (SE), significance levels (p-values) and 95% confidence intervals. 2.5. Ethical considerations The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Non-Interventional Clinical Research Ethics Committee at XXX University (decision number GO-2024/765). Informed consent was obtained from all participants before they took part. All questionnaires were completed anonymously, and participants were assured that the information provided would remain strictly confidential. 3. Results Of the 411 older adults who participated in the study, 50.1% were female (n = 206) and 49.9% were male (n = 205). The majority of participants were in the 65–74 age group (n = 357; 86.9%). Eighty-two per cent of participants stated that they were married (n = 337), while 18 per cent were single or widowed (n = 74). In terms of place of residence, 58.5% of participants lived in villages or towns (n = 264), while 41.5% lived in city or district centres (n = 147). In terms of educational level, 37.5% were illiterate or semi-literate (n = 154), 54.7% had completed eight years of education or less (n = 225) and only 7.8% had completed more than eight years of education (n = 32). Forty-six per cent of participants stated that their income was just enough, 20.7 per cent stated that it was sufficient, and 33.3 per cent stated that it was insufficient. In terms of health, 47.9 per cent of participants had a chronic illness (n = 197), 32.4 per cent had fallen in the past year (n = 133), and 18 per cent had experienced fractures (n = 74). When asked to rate their general health, 48% of participants rated it as good or very good (n = 197), while 52% rated it as poor or very poor (n = 214). The prevalence of smoking was 31.1% (n = 128), and the prevalence of alcohol consumption was 19.5% (n = 80). Analytical evaluations revealed that gender was a determining factor in the perception of age-friendly cities, with men achieving significantly lower total scale scores than women (p = 0.002). Men also reported more negative perceptions in the following sub-dimensions: social participation (p = 0.002), community support and health services (p = 0.001), outdoor spaces and buildings (p = 0.033), transport (p = 0.033) and financial situation (p = 0.003). The 65–74 age group scored higher on the communication and information dimension than those aged 75 and over (p = 0.006). Marital status showed a significant difference with respect to the 'respect' and 'social inclusion' dimensions, with single/widowed individuals scoring lower than married individuals (p = 0.019). Examining health variables revealed that individuals with chronic illnesses had lower total scale scores (p = 0.007). Those with a history of falling in the last year had lower scores in the transportation (p = 0.030) and financial situation (p = 0.020) dimensions, while those with a history of fractures had lower scores in the outdoor areas and buildings (p = 0.026), transportation (p = 0.027) and financial situation (p = 0.001) dimensions. Those with poor/very poor general health perception also had significantly lower total scale scores (p = 0.045). In terms of health behaviours, alcohol users had lower scores for social participation (p = 0.022), outdoor areas and buildings (p = 0.014), transport (p = 0.014) and financial situation (p = 0.010). The total scale score was also found to be significantly lower among smokers (p = 0.001). (Table 1 ). Table 1 Distribution of sociodemographic characteristics and general health status on the Age-Friendly Cities and Communities survey score Demographic characteristics n Age-Friendly Cities and Communities Survey Housing p Social participation p Respect and social inclusion p Contact and information p Community support and health services p Outdoor areas and buildings p Transport p Financial situation p Total scale p Gender Female 206 .50 ± 3.05 .019 -1.46 ± 3.70 .002 .72 ± 2.03 .399 .06 ± 1.93 .233 -1.04 ± 6.53 .001 -1.26 ± 2.64 .033 − .98 ± 2.75 .033 − .61 ± 2.70 .003 -4.08 ± 19.67 .002 Male 205 1.17 ± 2.74 − .33 ± 3.65 .55 ± 2.09 .28 ± 1.88 1.02 ± 5.95 − .73 ± 2.37 − .41 ± 2.60 .17 ± 2.55 1.73 ± 17.38 Age 65–74 357 .89 ± 2.92 .314 − .92 ± 3.70 .573 .71 ± 2.02 .069 .27 ± 1.91 .006 .05 ± 6.36 .607 − .99 ± 2.52 .868 − .68 ± 2.69 .816 − .18 ± 2.65 .441 -0.85 ± 18.82 .366 75+ 54 .46 ± 2.88 − .74 ± 3.84 .16 ± 2.29 − .48 ± 1.71 − .42 ± 6.15 -1.05 ± 2.53 − .77 ± 2.68 − .48 ± 2.72 -3.33 ± 18.42 Marital Status Single/Widowed 74 1.05 ± 2.74 .481 − .22 ± 3.61 .087 .13 ± 2.12 .019 .01 ± 1.80 .421 .98 ± 5.93 .134 − .41 ± 2.57 .028 − .32 ± 2.75 .187 .58 ± 2.68 .004 2.08 ± 17.96 .132 Married 337 .78 ± 2.96 -1.04 ± 3.73 .75 ± 2.03 .21 ± 1.93 − .23 ± 6.40 -1.13 ± 2.49 − .78 ± 2.67 − .39 ± 2.62 1.02 ± 18.90 Living with Family 96 1.08 ± 2.91 .641 − .71 ± 3.75 .566 .71 ± 2.17 .128 .14 ± 1.84 .913 .56 ± 6.34 .436 -1.04 ± 2.57 .325 − .61 ± 2.75 .506 − .03 ± 2.66 .112 1.90 ± 18.61 .536 Spouse 241 .76 ± 2.92 -1.06 ± 3.69 .74 ± 1.99 .20 ± 1.88 − .34 ± 6.34 -1.10 ± 2.49 − .81 ± 2.66 − .43 ± 2.65 1.21 ± 18.87 Alone 74 .74 ± 2.94 − .60 ± 3.76 .20 ± 2.11 .10 ± 2.08 .32 ± 6.28 − .60 ± 2.54 − .41 ± 2.69 .24 ± 2.62 2.17 ± 18.71 Residence Province/District Center 147 1.1 ± 2.74 .098 − .62 ± 3.68 .265 .63 ± 1.99 .944 .36 ± 1.75 .128 .55 ± 6.08 .179 − .72 ± 2.55 .092 − .48 ± 2.61 .241 .08 ± 2.60 .085 1.48 ± 17.94 .086 Village/Town 264 .65 ± 3.00 -1.05 ± 3.73 .64 ± 2.10 .06 ± 1.97 − .32 ± 6.45 -1.15 ± 2.49 − .81 ± 2.72 − .39 ± 2.67 1.17 ± 19.14 Graduation Status Literate/Illiterate 154 1.19 ± 2.75 .133 − .32 ± 3.69 .051 .33 ± 2.04 .051 .22 ± 1.83 .769 .69 ± 5.92 .214 − .79 ± 2.56 .210 − .55 ± 2.68 .695 .12 ± 2.56 .125 0.90 ± 17.69 .219 8 Years and Under 225 .58 ± 2.99 -1.26 ± 3.76 .80 ± 2.05 .12 ± 2.00 − .45 ± 6.51 -1.05 ± 2.51 − .78 ± 2.72 − .43 ± 2.73 -2.50 ± 19.63 8+ 32 .90 ± 3.10 -1.09 ± 3.24 1.03 ± 2.11 .34 ± 1.51 − .31 ± 6.80 -1.62 ± 2.31 − .78 ± 2.48 − .37 ± 2.49 1.91 ± 17.20 Smoking Yes 128 .52 ± 3.08 .094 -1.32 ± 3.66 .094 .94 ± 1.90 .115 .16 ± 2.01 .043 − .70 ± 6.54 ..887 -1.23 ± 2.48 .094 − .93 ± 2.63 .160 − .64 ± 2.71 .145 1.73 ± 19.66 .001 No / Quit 283 1.05 ± 2.84 − .69 ± 3.73 .49 ± 2.11 .19 ± 1.87 .45 ± 6.21 − .84 ± 2.53 − .50 ± 2.71 .05 ± 2.61 1.08 ± 18.30 Alcohol Yes 80 .35 ± 3.20 .091 -1.72 ± 3.66 .022 .91 ± 1.89 .187 − .08 ± 2.09 .161 − .97 ± 6.88 .111 -1.62 ± 2.36 .014 -1.33 ± 2.61 .014 − .91 ± 2.73 .010 2.24 ± 20.11 .071 No 331 .97 ± 2.84 − .65 ± 3.71 .56 ± 2.11 .24 ± 1.84 .29 ± 6.18 − .84 ± 2.54 − .50 ± 2.69 − .05 ± 2.61 1.00 ± 18.31 Income Status Just Enough 189 .79 ± 2.91 .759 − .96 ± 3.51 .832 .66 ± 2.03 .676 .06 ± 1.88 .070 .13 ± 6.14 .499 − .99 ± 2.45 .972 − .53 ± 2.62 .392 − .21 ± 2.57 .958 -1.04 ± 18.09 .563 Enough 85 .69 ± 3.06 -1.01 ± 3.85 .47 ± 2.10 − .05 ± 1.89 − .72 ± 6.99 -1.05 ± 2.69 -1.01 ± 2.76 − .29 ± 2.77 -3.00 ± 20.19 Not Enough 137 .97 ± 2.86 − .74 ± 3.92 .71 ± 2.08 .47 ± 1.91 .23 ± 6.16 − .97 ± 2.52 − .72 ± 2.72 − .18 ± 2.72 -0.24 ± 18.84 Chronic Disease Status Yes 232 1.03 ± 2.85 .119 − .71 ± 3.76 .241 .42 ± 2.09 .016 .24 ± 1.86 .424 .47 ± 6.22 .076 − .87 ± 2.55 .261 − .60 ± 2.69 .416 .02 ± 2.65 .035 .04 ± 18.54 .145 No 179 .58 ± 2.99 -1.14 ± 3.65 .92 ± 1.99 .08 ± 1.95 − .64 ± 6.42 -1.16 ± 2.48 − .82 ± 2.67 − .53 ± 2.63 -2.71 ± 18.99 Falls in the Last Year Yes, I fell 133 1.04 ± 2.85 .039 − .69 ± 3.73 .099 .56 ± 2.10 .250 .23 ± 1.82 .340 .18 ± 6.12 .357 − .87 ± 2.52 .136 − .50 ± 2.67 .030 − .01 ± 2.61 .020 -0.468 ± 18.25 .077 No, I did not fall 278 .40 ± 3.03 -1.33 ± 3.66 .81 ± 1.97 .04 ± 2.07 − .42 ± 6.75 -1.27 ± 2.51 -1.11 ± 2.68 − .66 ± 2.71 -3.548 ± 19.66 Fractures in the Last Year Yes 74 .04 ± 3.13 0.09 -1.72 ± 3.66 0.34 .90 ± 1.76 .175 − .12 ± 2.18 .188 -1.09 ± 6.86 .131 -1.59 ± 2.36 .026 -1.32 ± 2.51 .027 -1.12 ± 2.53 .001 -6.04 ± 20.05 0.14 No 337 1.01 ± 2.84 − .71 ± 3.71 .58 ± 2.12 .24 ± 1.83 .22 ± 6.19 − .87 ± 2.54 − .56 ± 2.70 − .02 ± 2.65 − .11 ± 18.33 General Health Perception Good/Very Good 197 .61 ± 2.99 .138 -1.34 ± 3.57 .021 .77 ± 1.97 .206 .13 ± 1.86 .698 − .56 ± 6.35 .087 -1.21 ± 2.52 .096 − .86 ± 2.61 .234 − .65 ± 2.56 .234 1.32 ± 18.65 .045 Poor/Very Bad 214 1.04 ± 3.84 − .49 ± 3.81 .51 ± 2.14 .21 ± 1.94 .50 ± 6.27 − .80 ± 2.51 − .54 ± 2.75 .17 ± 2.69 1.28 ± 18.73 TOTAL 411 No statistically significant relationship was found between the scores of the Age-Friendly City and Community survey and activities of daily living (ADL) and instrumental activities of daily living (IADL) (p > 0.05). This indicates that older adults' functional independence levels do not directly reflect their perception of cities and communities as age-friendly. In other words, there is no meaningful connection between independence in ADLs and the perception of an age-friendly city. (Table 2 ). Table 2 The effect of ADL and IADL status on Age-Friendly Cities and Communities Sum of Squares df Mean Square F Sig. Age-Friendly Cities and Communities*ADL Between Groups(Combined) 220.911 2 110.456 0.313 .732 Within Groups 144205.765 408 353.446 Total 144426.676 410 Age-Friendly Cities and Communities *IADL Between Groups(Combined) 735.734 1 735.734 2.094 .149 Within Groups 143690.943 409 351.323 Total 144426.676 410 Regression analysis was performed using the significant parameters identified in the analytical evaluations (Table 3 ). Examining the results of the regression analysis revealed that gender is one of the strongest determinants of perception of age-friendly cities and communities. Women's total scale scores were significantly higher than men's, and women were found to have more positive perceptions of the sub-dimensions of housing, social participation, community support, health services and financial situation. Marital status was found to affect different dimensions differently: married individuals had a more positive perception in terms of respect and social inclusion, but a more negative perception in terms of financial situation. Chronic illness status also emerged as an important determinant: individuals with chronic illnesses scored lower in terms of respect and social inclusion. Furthermore, the age variable was found to be a significant negative predictor in the communication and information dimension, indicating that older people's perceptions of communication and access to information become more negative with age. Table 3 Results of lineer regression analysis Independent variable B SE β t p 95.0% Confidence Interval (Min-Max) Total scale score Gender 5.275 1.894 .141 2.785 .006 1.551/8.998 Housing Gender .610 .287 .104 2.126 .034 .046/1.174 Social participation Gender .933 .371 .126 2.514 .012 .204/1.663 Respect and social inclusion Marital status .303 .125 .119 2.424 .016 .057/.548 Chronic disease status .495 .204 .119 2.424 .016 .094/.897 Communication and information Age − .756 .277 − .134 -2.732 .007 -1.300/-.212 Community support and health services Gender 1.958 .617 .155 3.173 .002 .745/3.172 Financial status Gender .566 .263 .107 2.154 0.032 .049/1.083 Marital status − .324 .164 − .099 -1.971 .049 − .646/-.001 Chronic disease status − .558 .264 − .104 -2.117 .035 -1.076/-.040 4. Discussion This study aims to systematically examine older adults' perceptions of age-friendly cities and communities in Türkiye, and to identify the key factors that influence these perceptions. Our research findings reveal that gender, age, marital status, health status and health behaviours are significant factors influencing older adults' perceptions of age-friendly cities and communities. In our study, gender emerged as a determining factor in how age-friendly cities and communities are perceived. The significantly lower total scale scores achieved by men than by women suggest that women perceive their environments as more age-friendly. Similarly, men gave more negative evaluations of social participation, community support, healthcare services, outdoor spaces and buildings, transport and financial status. A study conducted in South Korea found that women gave more positive evaluations of the age-friendliness of the environment than men, particularly with regard to areas such as social participation, respect, and social inclusion (Choi & Woo, 2018 ). Similarly, a study in Beijing found that older women evaluated public spaces more positively due to their perceived social interaction and sense of community (Yu et al., 2018 ). Research shows that, when assessing the friendliness of their environment, women generally prioritise social connections and community support, while men focus more on physical aspects such as safety and accessibility for mobility (Barrio et al., 2021 ; Choi et al., 2019 ; Jiang et al., 2023 ). It has been suggested that traditional family structures, which see women spending more time inside the home and men spending more time outside, may make men more aware of deficiencies in age-friendly practices. In our study, age was found to play a decisive role in how an age-friendly city and society are perceived. Notably, differences between age groups were particularly evident in the communication and knowledge dimensions. Other studies also indicate that age is an important factor in shaping individuals' perceptions of age-friendly cities and societies (Ivan et al., 2024 ; Che et al., 2024 ; Flores et al., 2019 ). However, different age groups evaluate the age-friendliness of cities differently. Older individuals place greater importance on outdoor spaces, transportation, and healthcare services, whereas younger adults prioritise social participation and employment opportunities (Kohijoki & Koistinen, 2021 ). The higher scores achieved by the 65–74 age group compared to those aged 75 and over in our study may be related to their level of digital literacy and adoption of technology. The digital divide is particularly pronounced in older age groups, which is an important indicator of access to information and communication services in cities (Boot, 2023 ; Friemel, 2016 ). In our study, marital status emerged as another factor influencing perceptions of age-friendly cities and communities. Compared to married individuals, single or widowed individuals reported lower scores on the respect and social inclusion dimensions. This may be because their spouses provide them with social and emotional support, which increases their perception of community and belonging in an age-friendly city (Leng et al., 2024 ; Buffel and Phillipson, 2018 ). Married older adults may perceive their neighbourhoods as more supportive and harmonious because they often have a spouse with whom they can participate in community activities, thus increasing their social participation (Plouffe & Kalache, 2010 ; Rashid et al., 2021 ). Conversely, single, divorced or widowed individuals may experience isolation, leading to different perceptions of the age-friendly environment. Indeed, married individuals may feel more respected and included in society thanks to spousal support and stronger social networks (Gutiérrez-Vega et al., 2017 ; Shapira & Keyes, 2008). Therefore, it is important that age-friendly city policies include social inclusion programmes targeting older adults living alone with limited social support. In our study, health status also emerged as a significant factor in perceptions of age-friendly cities. Previous studies have reported that older adults with health problems tend to evaluate the age-friendliness of cities more negatively (Perek-Białas et al., 2024 ; Chui et al., 2022 ; Xie, 2018 ). Lower total age-friendly city scale scores among individuals with chronic diseases suggest that health issues can hinder access to living spaces, social participation and perception of financial status. Similarly, lower scores for transportation and financial status among participants with a history of falls in the past year suggest that falls can limit perceived safety and activities of daily living (Crews, 2022 ). Lower scores on the outdoor spaces and buildings, transportation, and financial status scales for individuals with a history of fractures suggest that physical limitations may negatively impact perceptions of environmental accessibility (Yuan et al., 2025 ). Participants who perceived their general health as poor or very poor had significantly lower total scale scores, demonstrating the importance of subjective health perception on the experience of an age-friendly city. In terms of health behaviours, individuals who consumed alcohol had lower scores for social participation, outdoor spaces and buildings, transport and financial status. This suggests that risky health behaviours negatively impact social and environmental participation (Fairbairn & Kang, 2025 ). Our study found no significant relationship between Age-Friendly Cities and Communities survey scores and ADL and IADL. This suggests that older adults' functional independence levels do not directly influence perceptions of cities and societies as age-friendly. In other words, being independent in daily activities is not a determining factor in how age-friendly a city is perceived to be. This suggests that the perception of an age-friendly city is influenced by factors beyond physical functioning, such as social participation, accessibility, community support and a sense of belonging. 5. Study limitations This study has several limitations. Firstly, as the research is based on a cross-sectional design, causal interpretations of the relationships between variables are not possible. Secondly, the study was conducted only in Burdur province using a convenience sampling method, which limits the generalisability of the results to the entire elderly population in Türkiye. While older adults' functionality was assessed using ADL and IADL measurements, it should be noted that the participants were mobile individuals. Furthermore, this study did not consider other potential factors that could influence participants' perceptions of an age-friendly city, such as cognitive function, mental health or social network structures. Another limitation is that data were collected from provincial and district centres and villages only. Studies investigating causality by separating urban and rural areas would further contribute to local policymaking. 6. Conclusion Consequently, age-friendly urban policies should encompass not only physical environmental improvements, but also social participation, community support and digital inclusion. In this context, local governments should establish neighbourhood community centres to increase social interaction among older adults, improve the accessibility of public spaces and make public transport systems more age-friendly. Social policies should include programmes that encourage social participation and volunteer-based support networks that foster intergenerational interaction for older adults who live alone or have limited social support. Healthcare services should expand home care, rehabilitation and preventive healthcare services for older adults with chronic illnesses, or a history of falls or fractures. This would ensure their safer participation in urban life. Digital literacy training should be provided for older adults, and information access points (e.g. e-municipality support units) should be set up. Declarations Ethical Approval The research was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval for the study was obtained from the Non-Interventional Ethics Committee of XXX University (Approval No: GO-2024/765). Informed consent was obtained from all participants prior to data collection, and they were informed of their right to withdraw from the study at any time without any consequences. Funding This research receive no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Author Contribution SS, ÖK: Conceptualization, Data curation, Formal analysis, Writing - original draftSS, ÖK: Conceptualization, Investigation, Writing - original draftSS, ÖK: Investigation, Data curation, Writing - original draftSS, ÖK: Investigation, Formal analysis, Writing - original draftSS: Supervision, Writing - review & editing.All authors approved the final manuscript for submission. Data Availability The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. References Arik, G., Varan, H. D., Yavuz, B. B., Karabulut, E., Kara, O., Kilic, M. K., Kizilarslanoglu, M. C., Sumer, F., Kuyumcu, M. E., Yesil, Y., Halil, M., & Cankurtaran, M. (2015). Validation of Katz index of independence in activities of daily living in Turkish older adults. Archives of gerontology and geriatrics, 61(3), 344–350. https://doi.org/10.1016/j.archger.2015.08.019 Barrio, É., Pinzón, S., Marsillas, S., & Garrido, F. (2021). Physical environment vs. social environment: what factors of age-friendliness predict subjective well-being in men and women?. International Journal of Environmental Research and Public Health, 18(2), 798. https://doi.org/10.3390/ijerph18020798 Boot, W. (2023). The State Of The Dıgıtal Dıvıde. Innovation in Aging , 7, 248 - 248. https://doi.org/10.1093/geroni/igad104.0818. Buckner, S., Mattocks, C., Rimmer, M., & L afortune, L. (2018). An evaluation tool for age-friendly and dementia friendly communities. Working with Older People , 22(1), 48–58.https://doi.org/10.1108/WWOP-11-2017-0032 Buffel, T. and Phillipson, C. (2018). A manifesto for the age-friendly movement: developing a new urban agenda. Journal of Aging & Social Policy , 30(2), 173-192. https://doi.org/10.1080/08959420.2018.1430414 Che, S., Lei, W., Hung, T., & Leong, S. (2024). Attitudes to ageing mediates the relationship between perception of age-friendly city and life satisfaction among middle-aged and older people in Macao: a cross-sectional study. BMC Geriatrics , 24. https://doi.org/10.1186/s12877-024-04961-y. Choi, M., & Woo, J. (2018). Older Adults’ Perceptions of the Age-Friendliness Of City: An Asian Experıence. Innovation in Aging . https://doi.org/10.1093/GERONI/IGY023.2465. Choi, M., Dabelko‐Schoeny, H., & White, K. (2019). Access to employment, volunteer activities, and community events and perceptions of age-friendliness: the role of social connectedness. Journal of Applied Gerontology , 39(9), 1016-1024. https://doi.org/10.1177/0733464819847588 Chui, C., Lu, S., Chan, O., Cheung, J., Guo, Y., Liu, Y., Chan, S., Tang, J., Au, A., Wen, Z., Yu, R., Bai, X., Mok, K., Woo, J., & Lum, T. (2022). Changes in older adults' perceptions of age-friendliness in Hong Kong: A three-year mixed-methods study. Cities . https://doi.org/10.1016/j.cities.2022.103748. Cochran, W. G. (1977). Sampling techniques (3rd ed.). John Wiley & Sons. Crews, D. (2022). Aging, frailty, and design of built environments. Journal of Physiological Anthropology, 41. https://doi.org/10.1186/s40101-021-00274-w. Dawal, S. Z. M., Ismail, Z., Yusuf, K., Abdul-Rashid, S. H., Shalahim, N. S. M., Abdullah, N. S., & Kamil, N. S. M. (2015). Determination of the significant anthropometry dimensions for user-friendly designs of domestic furniture and appliances–Experience from a study in Malaysia . Measurement , 59, 205-215. Di Ciaula, A., & Portincasa, P. (2020). The environment as a determinant of successful aging or frailty. Mechanisms of Ageing and Development, 188. https://doi.org/10.1016/j.mad.2020.111244. Dikken, J., van den Hoven, R. F. M., van Staalduinen, W. H., Hulsebosch-Janssen, L. M. T., & van Hoof, J. (2020). How Older People Experience the Age-Friendliness of Their City: Development of the Age-Friendly Cities and Communities Questionnaire. International Journal of Environmental Research and Public Health , 17(18), 6867. doi:10.3390/ijerph17186867 Edrees, A., Kamel, S., Sabry, H., & Nessim, A. (2021). Visual Comfort in Elder Care Facilities: Promoting Environmental Gerontology Theory. Towards Implementation of Sustainability Concepts in Developing Countries. https://doi.org/10.1007/978-3-030-74349-9_18. Ersözlü, M. (2024). Descriptive Analysis and Evaluation of Age-Friendly Environment Studies in Turkiye. Journal of Aging and Environment, 1–19. https://doi.org/10.1080/26892618.2024.2375708 Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. American Journal of Theoretical and Applied Statistics, 5 (1), 1–4. https://doi.org/10.11648/j.ajtas.20160501.11 Fairbairn, C., & Kang, D. (2025). Social Drinking and Addiction: A Social-Cognitive Model for Understanding Alcohol Use Disorder Risk. Current Directions in Psychological Science . https://doi.org/10.1177/09637214251318272. Flores, R., Caballer, A., & Alarcón, A. (2019). Evaluation of an Age-Friendly City and Its Effect on Life Satisfaction: A Two-Stage Study. International Journal of Environmental Research and Public Health , 16. https://doi.org/10.3390/ijerph16245073. Friemel, T. (2016). The digital divide has grown old: Determinants of a digital divide among seniors. New Media & Society , 18, 313 - 331. https://doi.org/10.1177/1461444814538648. González, D. (2018). Natural Landscape and Environmental Gerontology. Environmental Analysis and Ecology Studies , 1, 1-3. https://doi.org/10.31031/EAES.2018.01.000525. Gutiérrez-Vega, M., Villar, O., Carrillo-Saucedo, I., & Montañez-Alvarado, P. (2017). The Possible Protective Effect of Marital Status in Quality of Life Among Elders in a U.S.-Mexico Border City. Community Mental Health Journal , 54, 480 - 484. https://doi.org/10.1007/s10597-017-0166-z. Güzel, A., Uçan Yamaç, S., Turan, S., Üner, S. (2024). Turkish validity and reliability of the Lawton instrumental activities of daily living scale. Turkish Journal of Public Health , 22(1), 59-71. https://doi.org/10.20518/tjph.1364063 Ivan, L., Dikken, J., & Van Hoof, J. (2024). Unveiling the experienced age-friendliness of older people in Bucharest: A comprehensive study using the validated Romanian age-friendly cities and communities questionnaire and cluster analysis. Habitat International. https://doi.org/10.1016/j.habitatint.2023.102973. Jiang, Y., Wu, Y., Li, S., Fu, S., Lv, Y., Lin, H., & Yao, Y. (2023). Editorial: Aging-friendly environments and healthy aging. Frontiers in Medicine , 10, 1211632. https://doi.org/10.3389/fmed.2023.1211632 Kalache, A. (2016). Active ageing and age-friendly cities—A personal account. In T. Moulaert & S. Garon (Eds.), Age-friendly cities and communities in international comparison (pp. 65–77). Springer. https://doi.org/10.1007/978-3-319-24031-2_5 Katz, S., Ford, A. B., Moskowıtz, R. W., Jackson, B. A., & Jaffe, M. W. (1963). Studies Of Illness In The Aged. The Index Of ADL: A Standardized Measure Of Biological And Psychosocial Function. JAMA , 185 , 914-919. https://doi.org/10.1001/jama.1963.03060120024016 Kline, R. B. (2011). Principles and practice of structural equation modeling (3rd ed.). Guilford Press. Kohijoki, A., & Koistinen, K. (2021). The city centre as an age-friendly shopping environment: a consumer perspective. Ageing and Society , 42, 2735 - 2756. https://doi.org/10.1017/S0144686X21000295. Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist , 9(3), 179–186. https://doi.org/10.1093/geront/9.3_Part_1.179 Lawton, M. P., & Nahemow, L. (1973). Ecology and the aging process. In C. Eisdorfer &M. P. Lawton (Eds.), The psychology of adult of development and aging (pp. 619-674). American Psychological Association . Leng, S., Lei, W., Hung, T., & Leong, S. (2024). Attitudes to ageing mediates the relationship between perception of age-friendly city and life satisfaction among middle-aged and older people in macao: a cross-sectional study. BMC Geriatrics , 24(1). https://doi.org/10.1186/s12877-024-04961-y Liang, Z., & Ye, C. (2023). Spatial production in the process of rapid urbanisation and ageing: A case study of the new type of community in suburban Shanghai. Habitat International . https://doi.org/10.1016/j.habitatint.2023.102883. Oswald, A., & Yeh, J. (2021). From Margin to Center: Intersectionality and the Politics of Environmental Gerontology. Innovation in Aging , 5, 397 - 397. https://doi.org/10.1093/geroni/igab046.1537. Oswald, F. (2024). Rethınkıng The Place of Place for Aging: Enduring and New Challenges for Environmental Gerontology. Innovation in Aging , 8, 394 - 394. https://doi.org/10.1093/geroni/igae098.1281. Özer, Z., Turan, G. B., & Teke, N. (2022). Age-friendly cities and communities questionnaire: A research on Turkish validity and reliability. Archives of Environmental & Occupational Health , 78(1), 38–47. https://doi.org/10.1080/19338244.2022.2061397 Perek-Białas, J., Skórska, P., Maj, M., Kazak, J., Dikken, J., & Van Hoof, J. (2024). The experienced age-friendliness in two Polish cities: An in-depth analysis of the views of older citizens. Habitat International . https://doi.org/10.1016/j.habitatint.2024.103201. Phillipson, C., & Buffel, T. (2020). Developing Age-friendly Cities: Policy Opportunities and Challenges. Journal of Elder Policy . https://doi.org/10.18278/jep.1.1.7. Plouffe, L. and Kalache, A. (2010). Towards global age-friendly cities: determining urban features that promote active aging . Journal of Urban Health , 87(5), 733-739. https://doi.org/10.1007/s11524-010-9466-0 Rashid, K., Mohamed, T., Azyze, S., Hazim, Z., Aziz, A., & Hashim, I. (2021). Determining the features of age friendly for city development. Planning Malaysia , 19. https://doi.org/10.21837/pm.v19i16.965 Setia, M. (2016). Methodology Series Module 3: Cross-sectional Studies. Indian Journal of Dermatology, 61, 261 - 264. https://doi.org/10.4103/0019-5154.182410. Shapiro, A., & Keyes, C. (2008). Marital Status and Social Well-Being: Are the Married Always Better Off?. Social Indicators Research, 88, 329-346. https://doi.org/10.1007/S11205-007-9194-3. Thurairaj, D., Rashid, S., & Nor, N. (2025). Challenges in implementing age-friendly cities: A systematic literature review. Multidisciplinary Reviews. https://doi.org/10.31893/multirev.2025334. Turkish Statistical Institute (TURKSTAT). (2025). İstatistiklerle Yaşlılar 2024 [Statistics on Older Persons 2024]. https://data.tuik.gov.tr/Bulten/Index?p=%C4%B0statistiklerle-Ya%C5%9Fl%C4%B1lar-2024-54079&dil=1 Turkish Statistical Institute. (2022). Urban/rural population statistics 2022. https://data.tuik.gov.tr/bulten/index?p=kent-kir-nufus-istatistikleri-2022-49755 Van Hoof J, Kazak JK, Perek-Białas JM, Peek S. Thechallenges of urban ageing: Making cities age-friendlyin Europe. International Journal of Environmental Research and Public Health . 2018;15(11):2473. doi:10.3390/ijerph15112473. Wahl, H., & Gerstorf, D. (2020). Person-Environment Resources for Aging Well: Environmental Docility and Life Space as Conceptual Pillars for Future Contextual Gerontology. The Gerontologist , 60 3, 368-375 . https://doi.org/10.1093/geront/gnaa006. Wang, X., & Cheng, Z. (2020). Cross-Sectional Studies: Strengths, Weaknesses, and Recommendations.. Chest, 158 1S, S65-S71 . https://doi.org/10.1016/j.chest.2020.03.012. World Bank. (2017). World development report 2017: Governance and the law. World Bank. https://doi.org/10.1596/978-1-4648-0950-7 World Health Organization (WHO). (2007). Ageing and life course, family and community health. Global Age-friendly Cities: A guide, World Health Organization: France. World Health Organization (WHO). (2015). Measuring the age friendliness of cities: A guide to using core indicators . World Health Organization. Xie, L. (2018). Age-Friendly Communities and Life Satisfaction Among the Elderly in Urban China. Research on Aging, 40, 883- 905. https://doi.org/10.1177/0164027518757760. Yu, R., Wong, M., & Woo, J. (2018). Perceptions of Neighborhood Environment, Sense of Community, and Self-Rated Health: an Age-Friendly City Project in Hong Kong. Journal of Urban Health , 96, 276-288. https://doi.org/10.1007/s11524-018-00331-3. Yuan, S., Maliki, N., & Cui, H. (2025). Public Perceptions of Resilient Design Characteristics in Urban Form. Sustainability. https://doi.org/10.3390/su17020614. Zhang, C., & Yang, J. (2023). Evaluation of the quality of theage-friendly environment in Liaoning Province. Sustainability ,15(22), 16134. https://doi.org/10.3390/su152216134 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7920642","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":544055666,"identity":"19b58a0a-0557-4650-97f7-e98a2cffb586","order_by":0,"name":"Sevinç Sütlü","email":"","orcid":"","institution":"Mehmet Akif Ersoy University","correspondingAuthor":false,"prefix":"","firstName":"Sevinç","middleName":"","lastName":"Sütlü","suffix":""},{"id":544055667,"identity":"4c250144-aa2b-434e-bcd1-cf113aa0952f","order_by":1,"name":"Özge Kutlu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABAklEQVRIiWNgGAWjYDACHiB+wGDDwCAB5ibwsDfA2Li1MDYkMKRBlB0AauE5AGYbENJyGK6FgaAWfp4z5g8S285H80t3Jz7+UJMmw8PAfPA2D8OffFxaJHt7DBsS227nzpxzdrPBgWM5PDwMbMnWPAwGlg04tBic54Fo2XAjd5vEAbYKHnsGHjNpoBacLoNqOZe7/0bu9h8H/lUAbeH/hl/LWbDDDuRukMjdxnCwDeQwHja8WiR7jhXOSDiXnDvjRu5mibN9aTw8zGzGlnMMjHFq4edJ3vDhQ5ldbv+M3I0fKr4l2/OwNz+88aZCDk/EYABmsINJ0DAKRsEoGAWjAAMAADXVVOzbCUN8AAAAAElFTkSuQmCC","orcid":"","institution":"Mehmet Akif Ersoy University","correspondingAuthor":true,"prefix":"","firstName":"Özge","middleName":"","lastName":"Kutlu","suffix":""}],"badges":[],"createdAt":"2025-10-22 08:42:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7920642/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7920642/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":95931929,"identity":"ebf7247f-20f4-4f42-8ce1-aab8ce3ecd4d","added_by":"auto","created_at":"2025-11-14 14:39:14","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":59264,"visible":true,"origin":"","legend":"","description":"","filename":"Manuscript.docx","url":"https://assets-eu.researchsquare.com/files/rs-7920642/v1/a4d31a0114b7e31be3e25555.docx"},{"id":95931930,"identity":"e2a0cd95-7d2b-4696-a4e4-6b981aa9bebf","added_by":"auto","created_at":"2025-11-14 14:39:14","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":5030,"visible":true,"origin":"","legend":"","description":"","filename":"2fbdc1d1abbb42cbb8e52086cc7e93f1.json","url":"https://assets-eu.researchsquare.com/files/rs-7920642/v1/8b0bcf1302a23c99327e1f76.json"},{"id":96243638,"identity":"fa9a4f0c-041f-4460-910e-e32c8b6b6d56","added_by":"auto","created_at":"2025-11-19 07:16:46","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":169070,"visible":true,"origin":"","legend":"","description":"","filename":"2fbdc1d1abbb42cbb8e52086cc7e93f11enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7920642/v1/3226031a214b7e90a09e1463.xml"},{"id":95931932,"identity":"7b392e64-c907-41a8-8d8b-2ed7e256a99e","added_by":"auto","created_at":"2025-11-14 14:39:14","extension":"xml","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":172357,"visible":true,"origin":"","legend":"","description":"","filename":"2fbdc1d1abbb42cbb8e52086cc7e93f11structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7920642/v1/3177046267023ec5753317df.xml"},{"id":95931933,"identity":"0280bad0-dec0-40fd-ba82-0081a4231690","added_by":"auto","created_at":"2025-11-14 14:39:14","extension":"html","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":183270,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7920642/v1/09ff9cdb9243d489e233ded9.html"},{"id":100814136,"identity":"4c970d54-5530-4b72-9c89-7229ff5e3b1c","added_by":"auto","created_at":"2026-01-21 16:12:10","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1194216,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7920642/v1/f991d98a-c415-4a51-bd88-19ccbaad919c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eExploring the Determinants of Age-Friendly Cities and Communities Perceptions Among Turkish Older Adults\u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003ePopulation ageing and rapid urbanisation are among the most significant socio-demographic transformations facing today's societies (Liang \u0026amp; Ye, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). As the elderly population increases, there is an urgent need for living spaces that support the well-being and quality of life of older adults and adapt to the effects of social change (Ers\u0026ouml;zl\u0026uuml;, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). This situation necessitates re-evaluating numerous areas, including health and care services, urban infrastructure, opportunities for social participation and environmental regulations. In this regard, the World Health Organisation (WHO) developed the \u0026lsquo;Age-Friendly Cities\u0026rsquo; approach in 2006, aiming to increase the active participation of the elderly population in urban life and improve their quality of life (Buckner et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe Age-Friendly Cities approach was developed to facilitate the integration of older people into city life, promoting active ageing through optimising health, participation and safety conditions (Buckner et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). The WHO defines this approach through eight key areas: outdoor spaces and buildings; transport; housing; social participation; respect and social inclusion; civic participation and employment; communication and information; and community support and health services (WHO, 2007). The literature emphasises that the most critical factors influencing the social participation of older adults are their physical and social environments (\u0026Ouml;zer, Turan \u0026amp; Teke, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Safe, accessible and liveable urban areas are considered fundamental for enabling older individuals to move independently, continue with their daily activities and integrate into social life (Kalache, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Dawal et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). The eight key areas identified by the WHO for age-friendly cities provide a comprehensive framework for improving the quality of life of older people by addressing these fundamental needs (Phillipson \u0026amp; Buffel, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). In this context, the age-friendly city approach is also closely related to the individual-environment interaction framework established by environmental gerontology.\u003c/p\u003e\u003cp\u003eEnvironmental gerontology explains the ageing process as the dynamic interaction between individuals and their environment (Oswald, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). This approach developed from the 1960s onwards and was first theorised by Lawton and Nahemow in their 'ecological adaptation theory' (Lawton and Nahemow, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e1973\u003c/span\u003e). According to this theory, older adults' independence and well-being depend on achieving a balance between their individual capacities and environmental demands (Gonz\u0026aacute;lez, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Di Ciaula \u0026amp; Portincasa, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). In other words, the fit between a person and their environment is a fundamental factor in determining their levels of independence, functionality, and social participation (Wahl and Gerstorf, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Environmental gerontology posits that the well-being of older adults hinges not only on biological or individual factors, but also on supportive environmental conditions (Oswald, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Therefore, accessible, safe, clean and inclusive urban environments are fundamental to supporting the social integration and subjective well-being of older adults (Oswald and Yeh, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Edress et al., 2021). The WHO's age-friendly cities approach is therefore the practical counterpart of environmental gerontology.\u003c/p\u003e\u003cp\u003eWith two-thirds of the world's population now living in urban areas, it is crucial that cities adapt to their ageing populations (World Bank, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Van Hoof et al., \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). This issue has become a critical part of the policy agenda in both developed and developing countries experiencing rapid demographic transitions. However, existing literature shows that research on age-friendly cities has largely focused on Western countries, with insufficient attention given to developing countries (Zhang \u0026amp; Yang, \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Thurairaj et al., \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). From T\u0026uuml;rkiye's perspective, according to TURKSTAT data, the population aged 65 and over increased by 20.7 per cent over the last five years, reaching 10.6 per cent of the total population by 2024, placing T\u0026uuml;rkiye in the 'very old society' category. (TURKSTAT, 2025). This proportion is projected to reach 13.5 per cent by 2030 and 27 per cent by 2060. However, it should be noted that 55.3 per cent of people aged 65 and over in T\u0026uuml;rkiye live in densely populated cities, while 14.6 per cent live in moderately populated cities (TURKSTAT, 2023). This rapid demographic shift necessitates a more urgent approach to making cities age-friendly in T\u0026uuml;rkiye.\u003c/p\u003e\u003cp\u003eHowever, it is evident that age-friendly city initiatives in T\u0026uuml;rkiye remain quite limited. While over 1,600 cities and communities in 53 countries worldwide have joined the Global Network of Age-Friendly Cities and Communities (GNAFCC), only six municipalities in T\u0026uuml;rkiye \u0026mdash; Istanbul's Beşiktaş and Kadık\u0026ouml;y districts, İzmir's Bornova district, Antalya's Muratpaşa district, Adana's Seyhan district, and the metropolitan municipality of Mersin \u0026mdash; are members of this network (WHO, 2024). Despite being a rapidly ageing country, this low number suggests that the age-friendly city approach is not being widely adopted at a local level. Furthermore, existing research has mostly focused on Western countries, with findings from developing countries being limited (Zhang \u0026amp; Yang, \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Ers\u0026ouml;zl\u0026uuml; (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) states that age-friendly environment studies in T\u0026uuml;rkiye are largely based on qualitative and compilation methods, while quantitative studies remain limited. While topics such as 'ageing in place' and 'age-friendly design' are prominent, themes frequently discussed in international literature, such as sustainability and environmental gerontology, have been relatively understudied in T\u0026uuml;rkiye. The limited planning and implementation of age-friendly cities in T\u0026uuml;rkiye, combined with the lack of studies focusing on the perceptions of older adults, creates a significant knowledge gap. However, effective and inclusive policies cannot be developed without understanding the needs, experiences and environmental perceptions of older adults (Phillipson \u0026amp; Buffel, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Against this backdrop, our study seeks to address this shortcoming by examining the perceptions of older adults in T\u0026uuml;rkiye regarding age-friendly cities and communities from an environmental gerontology perspective within a quantitative framework.\u003c/p\u003e\u003cp\u003eThis study aims to systematically examine older adults' perceptions of age-friendly cities and communities in T\u0026uuml;rkiye, and to identify the key factors that influence these perceptions.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003e2.1. Study design\u003c/h2\u003e\n \u003cp\u003eThis study adopted a cross-sectional, quantitative research design to investigate the determinants of perceptions of age-friendly cities and communities among older adults. This design was considered suitable because it enables associations to be examined between individual characteristics, functional capacity and environmental perceptions at a single point in time (Setia, \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e; Wang \u0026amp; Cheng, \u003cspan class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n \u003ch2\u003e2.2. Study participants\u003c/h2\u003e\n \u003cp\u003eThis study focused on community-dwelling older adults aged 65 years and over living in Burdur Province in T\u0026uuml;rkiye. Located in southwestern T\u0026uuml;rkiye, Burdur is one of the central provinces of the Mediterranean Region and has one of the highest proportions of older adults in the country, with 16.3% of its population aged 65 and over. Furthermore, 34% of older adults in Burdur live alone, placing the province third nationwide in this respect (TURKSTAT, 2025).\u003c/p\u003e\n \u003cp\u003eAccording to the Turkish Statistical Institute, the total population of individuals aged 65 and over in T\u0026uuml;rkiye is approximately 9,112,298. The sample size was determined using Cochran\u0026apos;s formula for finite populations:\u003c/p\u003e\n \u003cdiv id=\"Equa\" class=\"Equation\"\u003e\n \u003cdiv class=\"mathdisplay\" id=\"FileID_Equa\" name=\"EquationSource\"\u003e$$\\:\\text{n}\\:=\\frac{N\\:\\times\\:\\:{Z}^{2}\\:\\times\\:\\:p\\:\\times\\:\\:(1-p)}{\\left(N-1\\right)\\times\\:\\:{e}^{2}+\\:{Z}^{2}\\:\\times\\:\\:p\\:\\times\\:\\:(1-p)}$$\u003c/div\u003e\n \u003c/div\u003e\n \u003cp\u003eWhere n is the required sample size, \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:N\\)\u003c/span\u003e\u003c/span\u003e is the population size, \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:Z\\)\u003c/span\u003e\u003c/span\u003e is the Z-score corresponding to the desired confidence level, \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:p\\)\u003c/span\u003e\u003c/span\u003e is the estimated proportion of the population and e is the margin of error (Cochran, 1997). Using this formula with a 95% confidence level (Z\u0026thinsp;=\u0026thinsp;1.96), a margin of error of 5% (e\u0026thinsp;=\u0026thinsp;0.05) and an estimated proportion (p\u0026thinsp;=\u0026thinsp;0.5), the minimum required sample size was calculated to be 384 participants. In this study, 411 older adults participated, which exceeded the minimum requirement and enhanced the reliability and statistical validity of the findings.\u003c/p\u003e\n \u003cp\u003eConvenience sampling was employed due to practical and methodological considerations. Although it is a non-probability sampling technique, convenience sampling is widely used in the social sciences when probability sampling is not feasible due to constraints relating to time, resources or access (Etikan, Musa \u0026amp; Alkassim, \u003cspan class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n \u003ch2\u003e2.3. Instruments\u003c/h2\u003e\n \u003cp\u003eThe study used the following data collection tools: a sociodemographic information form; the Katz Activities of Daily Living Scale; the Lawton Instrumental Activities of Daily Living Scale; and the Age-Friendly Cities and Communities Questionnaire (AFCCQ-TR).\u003c/p\u003e\u003cspan\u003e\n \u003cp\u003e\u003cstrong\u003e2.3.1 Socio-demographic Information Form\u003c/strong\u003e: The researchers created the sociodemographic information form. Consisting of three sections, the questionnaire covers the participant\u0026apos;s demographic, economic and general health characteristics.\u003c/p\u003e\n \u003c/span\u003e\u003cspan\u003e\n \u003cp\u003e\u003cstrong\u003e2.3.2 Katz Activities of Daily Living Scale\u003c/strong\u003e: The Katz scale, developed by Katz and colleagues (\u003cspan class=\"CitationRef\"\u003e1963\u003c/span\u003e), was designed to evaluate the independence of older adults across six activity domains: bathing, dressing, toileting, mobility, continence and eating. Arik and colleagues (\u003cspan class=\"CitationRef\"\u003e2015\u003c/span\u003e) conducted a Turkish validity and reliability study. Each activity is rated as 0 (dependent) or 1 (independent). A score of 6 indicates complete independence, while a score of 0 indicates complete dependence. The scale is a valid and reliable tool for measuring the independence of older adults in daily living activities within Turkish culture.\u003c/p\u003e\n \u003c/span\u003e\u003cspan\u003e\n \u003cp\u003e\u003cstrong\u003e2.3.3 Lawton Instrumental Activities of Daily Living Scale\u003c/strong\u003e: The scale was developed by Lawton and Brody in 1969. Consisting of eight items, it measures the ability to perform various tasks such as using the telephone, shopping, preparing meals, cleaning the house, doing laundry, using public transport, managing medication and managing finances. Items on the scale are scored between 0 (unable or partially able) and 1 (able). A total score of 0 indicates low functioning/dependence, while a score of 8 indicates high functioning/independence. A study investigating the validity and reliability of the scale in Turkish was conducted by G\u0026uuml;zel and colleagues (\u003cspan class=\"CitationRef\"\u003e2024\u003c/span\u003e). The scale is a valid and reliable tool for measuring the independence of older adults in terms of their ability to perform instrumental activities of daily living within Turkish culture.\u003c/p\u003e\n \u003c/span\u003e\u003cspan\u003e\n \u003cp\u003e\u003cstrong\u003e2.3.4 Age-Friendly Cities and Communities Questionnaire (AFCCQ-TR)\u003c/strong\u003e: Dikken and colleagues (\u003cspan class=\"CitationRef\"\u003e2020\u003c/span\u003e) developed the Age-Friendly Cities and Communities Survey to measure the age-friendliness of cities and communities. It was prepared according to criteria established by the World Health Organization (WHO) in 2015. It consists of 23 items and nine sub-dimensions. It is a 5-point Likert-type measure. The sub-dimensions of the scale are: Housing; Social Participation; Respect and Social Inclusion; Civic Participation and Employment; Communication and Information; Social Support and Health Services; Open Spaces and Buildings; Transport; and Financial Situation. A high score on the scale indicates that cities and communities are age-friendly. \u0026Ouml;zer and colleagues (\u003cspan class=\"CitationRef\"\u003e2022\u003c/span\u003e) established the validity and reliability of the scale in Turkish.\u003c/p\u003e\n \u003c/span\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\n \u003ch2\u003e2.4. Data analysis\u003c/h2\u003e\n \u003cp\u003eData analysis was carried out using SPSS version 25. First, the internal consistency coefficients (Cronbach\u0026apos;s alpha) of the scales were examined to ensure reliable measurements. The results showed that the scales had acceptable levels of internal consistency. Next, the assumptions of normality were tested. The skewness and kurtosis values of the scales were found to be within the acceptable range of \u0026plusmn;\u0026thinsp;1.5, suggesting that the data were normally distributed (Kline, \u003cspan class=\"CitationRef\"\u003e2011\u003c/span\u003e). Based on these findings, the dataset was considered appropriate for parametric statistical analyses in terms of multivariate normality.\u003c/p\u003e\n \u003cp\u003eDescriptive statistics were computed to summarise the sociodemographic characteristics of the participants. Group comparisons were then conducted to examine the effects of demographic and health-related variables on perceptions of age-friendly cities and communities. Depending on the number of categories within each variable, independent samples t-tests or one-way ANOVAs were applied.\u003c/p\u003e\n \u003cp\u003eFollowing these analyses, the variables found to be statistically significant in the bivariate comparisons were included in a multiple linear regression model to identify predictors of perceptions of age-friendly cities and communities. Additionally, variance analyses were performed to examine the potential effects of Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) status on perception scores. The regression results are presented alongside standardised beta coefficients (\u0026beta;), standard errors (SE), significance levels (p-values) and 95% confidence intervals.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\n \u003ch2\u003e2.5. Ethical considerations\u003c/h2\u003e\n \u003cp\u003eThe study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Non-Interventional Clinical Research Ethics Committee at XXX University (decision number GO-2024/765). Informed consent was obtained from all participants before they took part. All questionnaires were completed anonymously, and participants were assured that the information provided would remain strictly confidential.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003eOf the 411 older adults who participated in the study, 50.1% were female (n\u0026thinsp;=\u0026thinsp;206) and 49.9% were male (n\u0026thinsp;=\u0026thinsp;205). The majority of participants were in the 65\u0026ndash;74 age group (n\u0026thinsp;=\u0026thinsp;357; 86.9%). Eighty-two per cent of participants stated that they were married (n\u0026thinsp;=\u0026thinsp;337), while 18 per cent were single or widowed (n\u0026thinsp;=\u0026thinsp;74). In terms of place of residence, 58.5% of participants lived in villages or towns (n\u0026thinsp;=\u0026thinsp;264), while 41.5% lived in city or district centres (n\u0026thinsp;=\u0026thinsp;147). In terms of educational level, 37.5% were illiterate or semi-literate (n\u0026thinsp;=\u0026thinsp;154), 54.7% had completed eight years of education or less (n\u0026thinsp;=\u0026thinsp;225) and only 7.8% had completed more than eight years of education (n\u0026thinsp;=\u0026thinsp;32). Forty-six per cent of participants stated that their income was just enough, 20.7 per cent stated that it was sufficient, and 33.3 per cent stated that it was insufficient. In terms of health, 47.9 per cent of participants had a chronic illness (n\u0026thinsp;=\u0026thinsp;197), 32.4 per cent had fallen in the past year (n\u0026thinsp;=\u0026thinsp;133), and 18 per cent had experienced fractures (n\u0026thinsp;=\u0026thinsp;74). When asked to rate their general health, 48% of participants rated it as good or very good (n\u0026thinsp;=\u0026thinsp;197), while 52% rated it as poor or very poor (n\u0026thinsp;=\u0026thinsp;214). The prevalence of smoking was 31.1% (n\u0026thinsp;=\u0026thinsp;128), and the prevalence of alcohol consumption was 19.5% (n\u0026thinsp;=\u0026thinsp;80).\u003c/p\u003e\u003cp\u003eAnalytical evaluations revealed that gender was a determining factor in the perception of age-friendly cities, with men achieving significantly lower total scale scores than women (p\u0026thinsp;=\u0026thinsp;0.002). Men also reported more negative perceptions in the following sub-dimensions: social participation (p\u0026thinsp;=\u0026thinsp;0.002), community support and health services (p\u0026thinsp;=\u0026thinsp;0.001), outdoor spaces and buildings (p\u0026thinsp;=\u0026thinsp;0.033), transport (p\u0026thinsp;=\u0026thinsp;0.033) and financial situation (p\u0026thinsp;=\u0026thinsp;0.003). The 65\u0026ndash;74 age group scored higher on the communication and information dimension than those aged 75 and over (p\u0026thinsp;=\u0026thinsp;0.006). Marital status showed a significant difference with respect to the 'respect' and 'social inclusion' dimensions, with single/widowed individuals scoring lower than married individuals (p\u0026thinsp;=\u0026thinsp;0.019). Examining health variables revealed that individuals with chronic illnesses had lower total scale scores (p\u0026thinsp;=\u0026thinsp;0.007). Those with a history of falling in the last year had lower scores in the transportation (p\u0026thinsp;=\u0026thinsp;0.030) and financial situation (p\u0026thinsp;=\u0026thinsp;0.020) dimensions, while those with a history of fractures had lower scores in the outdoor areas and buildings (p\u0026thinsp;=\u0026thinsp;0.026), transportation (p\u0026thinsp;=\u0026thinsp;0.027) and financial situation (p\u0026thinsp;=\u0026thinsp;0.001) dimensions. Those with poor/very poor general health perception also had significantly lower total scale scores (p\u0026thinsp;=\u0026thinsp;0.045). In terms of health behaviours, alcohol users had lower scores for social participation (p\u0026thinsp;=\u0026thinsp;0.022), outdoor areas and buildings (p\u0026thinsp;=\u0026thinsp;0.014), transport (p\u0026thinsp;=\u0026thinsp;0.014) and financial situation (p\u0026thinsp;=\u0026thinsp;0.010). The total scale score was also found to be significantly lower among smokers (p\u0026thinsp;=\u0026thinsp;0.001). (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e Distribution of sociodemographic characteristics and general health status on the Age-Friendly Cities and Communities survey score\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"20\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c16\" colnum=\"16\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c17\" colnum=\"17\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c18\" colnum=\"18\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c19\" colnum=\"19\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c20\" colnum=\"20\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eDemographic characteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"18\" nameend=\"c20\" namest=\"c3\"\u003e\u003cp\u003eAge-Friendly Cities and Communities Survey\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eHousing\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eSocial participation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eRespect and social inclusion\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eContact and information\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003eCommunity support and health services\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c12\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c13\"\u003e\u003cp\u003eOutdoor areas and buildings\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c14\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c15\"\u003e\u003cp\u003eTransport\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c16\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c17\"\u003e\u003cp\u003eFinancial situation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c18\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c19\"\u003e\u003cp\u003eTotal scale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c20\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c18\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e206\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.50\u0026thinsp;\u0026plusmn;\u0026thinsp;3.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.019\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.46\u0026thinsp;\u0026plusmn;\u0026thinsp;3.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.002\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.72\u0026thinsp;\u0026plusmn;\u0026thinsp;2.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.399\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.06\u0026thinsp;\u0026plusmn;\u0026thinsp;1.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.233\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e-1.04\u0026thinsp;\u0026plusmn;\u0026thinsp;6.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e-1.26\u0026thinsp;\u0026plusmn;\u0026thinsp;2.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.033\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.98\u0026thinsp;\u0026plusmn;\u0026thinsp;2.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.033\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.61\u0026thinsp;\u0026plusmn;\u0026thinsp;2.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.003\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e-4.08\u0026thinsp;\u0026plusmn;\u0026thinsp;19.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.002\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e205\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.17\u0026thinsp;\u0026plusmn;\u0026thinsp;2.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.33\u0026thinsp;\u0026plusmn;\u0026thinsp;3.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.55\u0026thinsp;\u0026plusmn;\u0026thinsp;2.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.28\u0026thinsp;\u0026plusmn;\u0026thinsp;1.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e1.02\u0026thinsp;\u0026plusmn;\u0026thinsp;5.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.73\u0026thinsp;\u0026plusmn;\u0026thinsp;2.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.41\u0026thinsp;\u0026plusmn;\u0026thinsp;2.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e.17\u0026thinsp;\u0026plusmn;\u0026thinsp;2.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e1.73\u0026thinsp;\u0026plusmn;\u0026thinsp;17.38\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"20\" nameend=\"c20\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e65\u0026ndash;74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e357\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.89\u0026thinsp;\u0026plusmn;\u0026thinsp;2.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.314\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.92\u0026thinsp;\u0026plusmn;\u0026thinsp;3.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.573\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.71\u0026thinsp;\u0026plusmn;\u0026thinsp;2.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.069\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.27\u0026thinsp;\u0026plusmn;\u0026thinsp;1.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.006\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e.05\u0026thinsp;\u0026plusmn;\u0026thinsp;6.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.607\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.99\u0026thinsp;\u0026plusmn;\u0026thinsp;2.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.868\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.68\u0026thinsp;\u0026plusmn;\u0026thinsp;2.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.816\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.18\u0026thinsp;\u0026plusmn;\u0026thinsp;2.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.441\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e-0.85\u0026thinsp;\u0026plusmn;\u0026thinsp;18.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.366\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e75+\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.46\u0026thinsp;\u0026plusmn;\u0026thinsp;2.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.74\u0026thinsp;\u0026plusmn;\u0026thinsp;3.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.16\u0026thinsp;\u0026plusmn;\u0026thinsp;2.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.48\u0026thinsp;\u0026plusmn;\u0026thinsp;1.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.42\u0026thinsp;\u0026plusmn;\u0026thinsp;6.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e-1.05\u0026thinsp;\u0026plusmn;\u0026thinsp;2.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.77\u0026thinsp;\u0026plusmn;\u0026thinsp;2.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.48\u0026thinsp;\u0026plusmn;\u0026thinsp;2.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e-3.33\u0026thinsp;\u0026plusmn;\u0026thinsp;18.42\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"20\" nameend=\"c20\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingle/Widowed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.05\u0026thinsp;\u0026plusmn;\u0026thinsp;2.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.481\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.22\u0026thinsp;\u0026plusmn;\u0026thinsp;3.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.087\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.13\u0026thinsp;\u0026plusmn;\u0026thinsp;2.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.019\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.01\u0026thinsp;\u0026plusmn;\u0026thinsp;1.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.421\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e.98\u0026thinsp;\u0026plusmn;\u0026thinsp;5.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.134\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.41\u0026thinsp;\u0026plusmn;\u0026thinsp;2.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.028\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.32\u0026thinsp;\u0026plusmn;\u0026thinsp;2.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.187\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e.58\u0026thinsp;\u0026plusmn;\u0026thinsp;2.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.004\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e2.08\u0026thinsp;\u0026plusmn;\u0026thinsp;17.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.132\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e337\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.78\u0026thinsp;\u0026plusmn;\u0026thinsp;2.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.04\u0026thinsp;\u0026plusmn;\u0026thinsp;3.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.75\u0026thinsp;\u0026plusmn;\u0026thinsp;2.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.21\u0026thinsp;\u0026plusmn;\u0026thinsp;1.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.23\u0026thinsp;\u0026plusmn;\u0026thinsp;6.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e-1.13\u0026thinsp;\u0026plusmn;\u0026thinsp;2.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.78\u0026thinsp;\u0026plusmn;\u0026thinsp;2.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.39\u0026thinsp;\u0026plusmn;\u0026thinsp;2.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e1.02\u0026thinsp;\u0026plusmn;\u0026thinsp;18.90\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"20\" nameend=\"c20\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLiving with\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFamily\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.08\u0026thinsp;\u0026plusmn;\u0026thinsp;2.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.641\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.71\u0026thinsp;\u0026plusmn;\u0026thinsp;3.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.566\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.71\u0026thinsp;\u0026plusmn;\u0026thinsp;2.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.128\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.14\u0026thinsp;\u0026plusmn;\u0026thinsp;1.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.913\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e.56\u0026thinsp;\u0026plusmn;\u0026thinsp;6.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.436\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e-1.04\u0026thinsp;\u0026plusmn;\u0026thinsp;2.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.325\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.61\u0026thinsp;\u0026plusmn;\u0026thinsp;2.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.506\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.03\u0026thinsp;\u0026plusmn;\u0026thinsp;2.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.112\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e1.90\u0026thinsp;\u0026plusmn;\u0026thinsp;18.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.536\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSpouse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e241\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.76\u0026thinsp;\u0026plusmn;\u0026thinsp;2.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.06\u0026thinsp;\u0026plusmn;\u0026thinsp;3.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.74\u0026thinsp;\u0026plusmn;\u0026thinsp;1.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.20\u0026thinsp;\u0026plusmn;\u0026thinsp;1.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.34\u0026thinsp;\u0026plusmn;\u0026thinsp;6.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e-1.10\u0026thinsp;\u0026plusmn;\u0026thinsp;2.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.81\u0026thinsp;\u0026plusmn;\u0026thinsp;2.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.43\u0026thinsp;\u0026plusmn;\u0026thinsp;2.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e1.21\u0026thinsp;\u0026plusmn;\u0026thinsp;18.87\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.74\u0026thinsp;\u0026plusmn;\u0026thinsp;2.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.60\u0026thinsp;\u0026plusmn;\u0026thinsp;3.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.20\u0026thinsp;\u0026plusmn;\u0026thinsp;2.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.10\u0026thinsp;\u0026plusmn;\u0026thinsp;2.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e.32\u0026thinsp;\u0026plusmn;\u0026thinsp;6.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.60\u0026thinsp;\u0026plusmn;\u0026thinsp;2.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.41\u0026thinsp;\u0026plusmn;\u0026thinsp;2.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e.24\u0026thinsp;\u0026plusmn;\u0026thinsp;2.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e2.17\u0026thinsp;\u0026plusmn;\u0026thinsp;18.71\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"20\" nameend=\"c20\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eResidence\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProvince/District Center\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e147\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.1\u0026thinsp;\u0026plusmn;\u0026thinsp;2.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.098\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.62\u0026thinsp;\u0026plusmn;\u0026thinsp;3.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.265\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.63\u0026thinsp;\u0026plusmn;\u0026thinsp;1.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.944\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.36\u0026thinsp;\u0026plusmn;\u0026thinsp;1.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.128\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e.55\u0026thinsp;\u0026plusmn;\u0026thinsp;6.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.179\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.72\u0026thinsp;\u0026plusmn;\u0026thinsp;2.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.092\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.48\u0026thinsp;\u0026plusmn;\u0026thinsp;2.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.241\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e.08\u0026thinsp;\u0026plusmn;\u0026thinsp;2.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.085\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e1.48\u0026thinsp;\u0026plusmn;\u0026thinsp;17.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.086\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVillage/Town\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e264\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.65\u0026thinsp;\u0026plusmn;\u0026thinsp;3.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.05\u0026thinsp;\u0026plusmn;\u0026thinsp;3.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.64\u0026thinsp;\u0026plusmn;\u0026thinsp;2.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.06\u0026thinsp;\u0026plusmn;\u0026thinsp;1.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.32\u0026thinsp;\u0026plusmn;\u0026thinsp;6.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e-1.15\u0026thinsp;\u0026plusmn;\u0026thinsp;2.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.81\u0026thinsp;\u0026plusmn;\u0026thinsp;2.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.39\u0026thinsp;\u0026plusmn;\u0026thinsp;2.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e1.17\u0026thinsp;\u0026plusmn;\u0026thinsp;19.14\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"20\" nameend=\"c20\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGraduation Status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLiterate/Illiterate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e154\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.19\u0026thinsp;\u0026plusmn;\u0026thinsp;2.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.133\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.32\u0026thinsp;\u0026plusmn;\u0026thinsp;3.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.051\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.33\u0026thinsp;\u0026plusmn;\u0026thinsp;2.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.051\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.22\u0026thinsp;\u0026plusmn;\u0026thinsp;1.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.769\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e.69\u0026thinsp;\u0026plusmn;\u0026thinsp;5.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.214\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.79\u0026thinsp;\u0026plusmn;\u0026thinsp;2.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.210\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.55\u0026thinsp;\u0026plusmn;\u0026thinsp;2.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.695\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e.12\u0026thinsp;\u0026plusmn;\u0026thinsp;2.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e0.90\u0026thinsp;\u0026plusmn;\u0026thinsp;17.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.219\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8 Years and Under\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e225\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.58\u0026thinsp;\u0026plusmn;\u0026thinsp;2.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.26\u0026thinsp;\u0026plusmn;\u0026thinsp;3.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.80\u0026thinsp;\u0026plusmn;\u0026thinsp;2.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.12\u0026thinsp;\u0026plusmn;\u0026thinsp;2.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.45\u0026thinsp;\u0026plusmn;\u0026thinsp;6.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e-1.05\u0026thinsp;\u0026plusmn;\u0026thinsp;2.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.78\u0026thinsp;\u0026plusmn;\u0026thinsp;2.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.43\u0026thinsp;\u0026plusmn;\u0026thinsp;2.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e-2.50\u0026thinsp;\u0026plusmn;\u0026thinsp;19.63\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8+\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.90\u0026thinsp;\u0026plusmn;\u0026thinsp;3.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.09\u0026thinsp;\u0026plusmn;\u0026thinsp;3.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.03\u0026thinsp;\u0026plusmn;\u0026thinsp;2.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.34\u0026thinsp;\u0026plusmn;\u0026thinsp;1.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.31\u0026thinsp;\u0026plusmn;\u0026thinsp;6.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e-1.62\u0026thinsp;\u0026plusmn;\u0026thinsp;2.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.78\u0026thinsp;\u0026plusmn;\u0026thinsp;2.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.37\u0026thinsp;\u0026plusmn;\u0026thinsp;2.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e1.91\u0026thinsp;\u0026plusmn;\u0026thinsp;17.20\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"20\" nameend=\"c20\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSmoking\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e128\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.52\u0026thinsp;\u0026plusmn;\u0026thinsp;3.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.094\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.32\u0026thinsp;\u0026plusmn;\u0026thinsp;3.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.094\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.94\u0026thinsp;\u0026plusmn;\u0026thinsp;1.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.115\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.16\u0026thinsp;\u0026plusmn;\u0026thinsp;2.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.043\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.70\u0026thinsp;\u0026plusmn;\u0026thinsp;6.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e..887\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e-1.23\u0026thinsp;\u0026plusmn;\u0026thinsp;2.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.094\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.93\u0026thinsp;\u0026plusmn;\u0026thinsp;2.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.160\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.64\u0026thinsp;\u0026plusmn;\u0026thinsp;2.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.145\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e1.73\u0026thinsp;\u0026plusmn;\u0026thinsp;19.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo / Quit\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e283\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.05\u0026thinsp;\u0026plusmn;\u0026thinsp;2.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.69\u0026thinsp;\u0026plusmn;\u0026thinsp;3.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.49\u0026thinsp;\u0026plusmn;\u0026thinsp;2.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.19\u0026thinsp;\u0026plusmn;\u0026thinsp;1.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e.45\u0026thinsp;\u0026plusmn;\u0026thinsp;6.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.84\u0026thinsp;\u0026plusmn;\u0026thinsp;2.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.50\u0026thinsp;\u0026plusmn;\u0026thinsp;2.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e.05\u0026thinsp;\u0026plusmn;\u0026thinsp;2.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e1.08\u0026thinsp;\u0026plusmn;\u0026thinsp;18.30\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"20\" nameend=\"c20\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAlcohol\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.35\u0026thinsp;\u0026plusmn;\u0026thinsp;3.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.091\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.72\u0026thinsp;\u0026plusmn;\u0026thinsp;3.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.022\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.91\u0026thinsp;\u0026plusmn;\u0026thinsp;1.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.187\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.08\u0026thinsp;\u0026plusmn;\u0026thinsp;2.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.161\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.97\u0026thinsp;\u0026plusmn;\u0026thinsp;6.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.111\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e-1.62\u0026thinsp;\u0026plusmn;\u0026thinsp;2.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.014\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e-1.33\u0026thinsp;\u0026plusmn;\u0026thinsp;2.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.014\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.91\u0026thinsp;\u0026plusmn;\u0026thinsp;2.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.010\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e2.24\u0026thinsp;\u0026plusmn;\u0026thinsp;20.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.071\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e331\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.97\u0026thinsp;\u0026plusmn;\u0026thinsp;2.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.65\u0026thinsp;\u0026plusmn;\u0026thinsp;3.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.56\u0026thinsp;\u0026plusmn;\u0026thinsp;2.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.24\u0026thinsp;\u0026plusmn;\u0026thinsp;1.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e.29\u0026thinsp;\u0026plusmn;\u0026thinsp;6.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.84\u0026thinsp;\u0026plusmn;\u0026thinsp;2.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.50\u0026thinsp;\u0026plusmn;\u0026thinsp;2.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.05\u0026thinsp;\u0026plusmn;\u0026thinsp;2.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e1.00\u0026thinsp;\u0026plusmn;\u0026thinsp;18.31\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"20\" nameend=\"c20\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIncome Status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eJust Enough\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e189\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.79\u0026thinsp;\u0026plusmn;\u0026thinsp;2.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.759\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.96\u0026thinsp;\u0026plusmn;\u0026thinsp;3.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.832\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.66\u0026thinsp;\u0026plusmn;\u0026thinsp;2.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.676\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.06\u0026thinsp;\u0026plusmn;\u0026thinsp;1.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.070\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e.13\u0026thinsp;\u0026plusmn;\u0026thinsp;6.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.499\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.99\u0026thinsp;\u0026plusmn;\u0026thinsp;2.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.972\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.53\u0026thinsp;\u0026plusmn;\u0026thinsp;2.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.392\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.21\u0026thinsp;\u0026plusmn;\u0026thinsp;2.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.958\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e-1.04\u0026thinsp;\u0026plusmn;\u0026thinsp;18.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e.563\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEnough\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.69\u0026thinsp;\u0026plusmn;\u0026thinsp;3.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.01\u0026thinsp;\u0026plusmn;\u0026thinsp;3.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.47\u0026thinsp;\u0026plusmn;\u0026thinsp;2.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.05\u0026thinsp;\u0026plusmn;\u0026thinsp;1.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.72\u0026thinsp;\u0026plusmn;\u0026thinsp;6.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e-1.05\u0026thinsp;\u0026plusmn;\u0026thinsp;2.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e-1.01\u0026thinsp;\u0026plusmn;\u0026thinsp;2.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.29\u0026thinsp;\u0026plusmn;\u0026thinsp;2.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e-3.00\u0026thinsp;\u0026plusmn;\u0026thinsp;20.19\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot Enough\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e137\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.97\u0026thinsp;\u0026plusmn;\u0026thinsp;2.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.74\u0026thinsp;\u0026plusmn;\u0026thinsp;3.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.71\u0026thinsp;\u0026plusmn;\u0026thinsp;2.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.47\u0026thinsp;\u0026plusmn;\u0026thinsp;1.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e.23\u0026thinsp;\u0026plusmn;\u0026thinsp;6.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.97\u0026thinsp;\u0026plusmn;\u0026thinsp;2.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.72\u0026thinsp;\u0026plusmn;\u0026thinsp;2.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.18\u0026thinsp;\u0026plusmn;\u0026thinsp;2.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e-0.24\u0026thinsp;\u0026plusmn;\u0026thinsp;18.84\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"20\" nameend=\"c20\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eChronic Disease Status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e232\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.03\u0026thinsp;\u0026plusmn;\u0026thinsp;2.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.119\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.71\u0026thinsp;\u0026plusmn;\u0026thinsp;3.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.241\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.42\u0026thinsp;\u0026plusmn;\u0026thinsp;2.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.016\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.24\u0026thinsp;\u0026plusmn;\u0026thinsp;1.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.424\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e.47\u0026thinsp;\u0026plusmn;\u0026thinsp;6.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.076\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.87\u0026thinsp;\u0026plusmn;\u0026thinsp;2.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.261\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.60\u0026thinsp;\u0026plusmn;\u0026thinsp;2.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.416\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e.02\u0026thinsp;\u0026plusmn;\u0026thinsp;2.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.035\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e.04\u0026thinsp;\u0026plusmn;\u0026thinsp;18.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.145\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e179\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.58\u0026thinsp;\u0026plusmn;\u0026thinsp;2.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.14\u0026thinsp;\u0026plusmn;\u0026thinsp;3.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.92\u0026thinsp;\u0026plusmn;\u0026thinsp;1.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.08\u0026thinsp;\u0026plusmn;\u0026thinsp;1.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.64\u0026thinsp;\u0026plusmn;\u0026thinsp;6.42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e-1.16\u0026thinsp;\u0026plusmn;\u0026thinsp;2.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.82\u0026thinsp;\u0026plusmn;\u0026thinsp;2.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.53\u0026thinsp;\u0026plusmn;\u0026thinsp;2.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e-2.71\u0026thinsp;\u0026plusmn;\u0026thinsp;18.99\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"20\" nameend=\"c20\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFalls in the Last Year\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes, I fell\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e133\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.04\u0026thinsp;\u0026plusmn;\u0026thinsp;2.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.039\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.69\u0026thinsp;\u0026plusmn;\u0026thinsp;3.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.099\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.56\u0026thinsp;\u0026plusmn;\u0026thinsp;2.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.250\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.23\u0026thinsp;\u0026plusmn;\u0026thinsp;1.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.340\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e.18\u0026thinsp;\u0026plusmn;\u0026thinsp;6.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.357\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.87\u0026thinsp;\u0026plusmn;\u0026thinsp;2.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.136\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.50\u0026thinsp;\u0026plusmn;\u0026thinsp;2.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.030\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.01\u0026thinsp;\u0026plusmn;\u0026thinsp;2.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.020\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e-0.468\u0026thinsp;\u0026plusmn;\u0026thinsp;18.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.077\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo, I did not fall\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e278\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.40\u0026thinsp;\u0026plusmn;\u0026thinsp;3.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.33\u0026thinsp;\u0026plusmn;\u0026thinsp;3.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.81\u0026thinsp;\u0026plusmn;\u0026thinsp;1.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.04\u0026thinsp;\u0026plusmn;\u0026thinsp;2.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.42\u0026thinsp;\u0026plusmn;\u0026thinsp;6.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e-1.27\u0026thinsp;\u0026plusmn;\u0026thinsp;2.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e-1.11\u0026thinsp;\u0026plusmn;\u0026thinsp;2.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.66\u0026thinsp;\u0026plusmn;\u0026thinsp;2.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e-3.548\u0026thinsp;\u0026plusmn;\u0026thinsp;19.66\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"20\" nameend=\"c20\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFractures in the Last Year\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.04\u0026thinsp;\u0026plusmn;\u0026thinsp;3.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.09\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.72\u0026thinsp;\u0026plusmn;\u0026thinsp;3.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.34\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.90\u0026thinsp;\u0026plusmn;\u0026thinsp;1.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.175\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.12\u0026thinsp;\u0026plusmn;\u0026thinsp;2.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.188\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e-1.09\u0026thinsp;\u0026plusmn;\u0026thinsp;6.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.131\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e-1.59\u0026thinsp;\u0026plusmn;\u0026thinsp;2.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.026\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e-1.32\u0026thinsp;\u0026plusmn;\u0026thinsp;2.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.027\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e-1.12\u0026thinsp;\u0026plusmn;\u0026thinsp;2.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e-6.04\u0026thinsp;\u0026plusmn;\u0026thinsp;20.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.14\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e337\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.01\u0026thinsp;\u0026plusmn;\u0026thinsp;2.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.71\u0026thinsp;\u0026plusmn;\u0026thinsp;3.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.58\u0026thinsp;\u0026plusmn;\u0026thinsp;2.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.24\u0026thinsp;\u0026plusmn;\u0026thinsp;1.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e.22\u0026thinsp;\u0026plusmn;\u0026thinsp;6.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.87\u0026thinsp;\u0026plusmn;\u0026thinsp;2.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.56\u0026thinsp;\u0026plusmn;\u0026thinsp;2.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.02\u0026thinsp;\u0026plusmn;\u0026thinsp;2.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.11\u0026thinsp;\u0026plusmn;\u0026thinsp;18.33\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"20\" nameend=\"c20\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGeneral Health Perception\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGood/Very Good\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e197\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.61\u0026thinsp;\u0026plusmn;\u0026thinsp;2.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.138\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.34\u0026thinsp;\u0026plusmn;\u0026thinsp;3.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.021\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.77\u0026thinsp;\u0026plusmn;\u0026thinsp;1.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.206\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.13\u0026thinsp;\u0026plusmn;\u0026thinsp;1.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.698\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.56\u0026thinsp;\u0026plusmn;\u0026thinsp;6.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.087\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e-1.21\u0026thinsp;\u0026plusmn;\u0026thinsp;2.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.096\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.86\u0026thinsp;\u0026plusmn;\u0026thinsp;2.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.234\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.65\u0026thinsp;\u0026plusmn;\u0026thinsp;2.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e.234\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e1.32\u0026thinsp;\u0026plusmn;\u0026thinsp;18.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e.045\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePoor/Very Bad\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e214\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.04\u0026thinsp;\u0026plusmn;\u0026thinsp;3.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.49\u0026thinsp;\u0026plusmn;\u0026thinsp;3.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.51\u0026thinsp;\u0026plusmn;\u0026thinsp;2.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e.21\u0026thinsp;\u0026plusmn;\u0026thinsp;1.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e.50\u0026thinsp;\u0026plusmn;\u0026thinsp;6.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.80\u0026thinsp;\u0026plusmn;\u0026thinsp;2.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.54\u0026thinsp;\u0026plusmn;\u0026thinsp;2.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u003cp\u003e.17\u0026thinsp;\u0026plusmn;\u0026thinsp;2.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u003cp\u003e1.28\u0026thinsp;\u0026plusmn;\u0026thinsp;18.73\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTOTAL\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e411\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c17\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c18\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c19\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c20\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eNo statistically significant relationship was found between the scores of the Age-Friendly City and Community survey and activities of daily living (ADL) and instrumental activities of daily living (IADL) (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). This indicates that older adults' functional independence levels do not directly reflect their perception of cities and communities as age-friendly. In other words, there is no meaningful connection between independence in ADLs and the perception of an age-friendly city. (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThe effect of ADL and IADL status on Age-Friendly Cities and Communities\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSum of Squares\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003edf\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMean Square\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eF\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSig.\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge-Friendly Cities and Communities*ADL\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBetween Groups(Combined)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e220.911\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e110.456\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.313\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.732\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWithin Groups\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e144205.765\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e408\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e353.446\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e144426.676\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e410\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge-Friendly Cities and Communities *IADL\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBetween Groups(Combined)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e735.734\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e735.734\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.094\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.149\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWithin Groups\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e143690.943\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e409\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e351.323\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e144426.676\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e410\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eRegression analysis was performed using the significant parameters identified in the analytical evaluations (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Examining the results of the regression analysis revealed that gender is one of the strongest determinants of perception of age-friendly cities and communities. Women's total scale scores were significantly higher than men's, and women were found to have more positive perceptions of the sub-dimensions of housing, social participation, community support, health services and financial situation. Marital status was found to affect different dimensions differently: married individuals had a more positive perception in terms of respect and social inclusion, but a more negative perception in terms of financial situation. Chronic illness status also emerged as an important determinant: individuals with chronic illnesses scored lower in terms of respect and social inclusion. Furthermore, the age variable was found to be a significant negative predictor in the communication and information dimension, indicating that older people's perceptions of communication and access to information become more negative with age.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eResults of lineer regression analysis\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIndependent variable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eB\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSE\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eβ\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003et\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003e95.0% Confidence Interval (Min-Max)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal scale score\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5.275\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.894\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.141\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2.785\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.006\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1.551/8.998\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHousing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.610\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.287\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.104\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2.126\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.034\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e.046/1.174\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocial participation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.933\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.371\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.126\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2.514\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.012\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e.204/1.663\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eRespect and social inclusion\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarital status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.303\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.119\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2.424\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.016\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e.057/.548\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChronic disease status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.495\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.204\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.119\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2.424\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.016\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e.094/.897\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCommunication and information\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.756\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.277\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.134\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-2.732\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.007\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-1.300/-.212\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCommunity support and health services\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.958\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.617\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.155\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3.173\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.002\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e.745/3.172\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eFinancial status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.566\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.263\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.107\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2.154\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.032\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e.049/1.083\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarital status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.324\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.164\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.099\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-1.971\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.049\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.646/-.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChronic disease status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.558\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.264\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;.104\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e-2.117\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.035\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e-1.076/-.040\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis study aims to systematically examine older adults' perceptions of age-friendly cities and communities in T\u0026uuml;rkiye, and to identify the key factors that influence these perceptions. Our research findings reveal that gender, age, marital status, health status and health behaviours are significant factors influencing older adults' perceptions of age-friendly cities and communities.\u003c/p\u003e\u003cp\u003eIn our study, gender emerged as a determining factor in how age-friendly cities and communities are perceived. The significantly lower total scale scores achieved by men than by women suggest that women perceive their environments as more age-friendly. Similarly, men gave more negative evaluations of social participation, community support, healthcare services, outdoor spaces and buildings, transport and financial status. A study conducted in South Korea found that women gave more positive evaluations of the age-friendliness of the environment than men, particularly with regard to areas such as social participation, respect, and social inclusion (Choi \u0026amp; Woo, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Similarly, a study in Beijing found that older women evaluated public spaces more positively due to their perceived social interaction and sense of community (Yu et al., \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Research shows that, when assessing the friendliness of their environment, women generally prioritise social connections and community support, while men focus more on physical aspects such as safety and accessibility for mobility (Barrio et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Choi et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Jiang et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). It has been suggested that traditional family structures, which see women spending more time inside the home and men spending more time outside, may make men more aware of deficiencies in age-friendly practices.\u003c/p\u003e\u003cp\u003eIn our study, age was found to play a decisive role in how an age-friendly city and society are perceived. Notably, differences between age groups were particularly evident in the communication and knowledge dimensions. Other studies also indicate that age is an important factor in shaping individuals' perceptions of age-friendly cities and societies (Ivan et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Che et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Flores et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). However, different age groups evaluate the age-friendliness of cities differently. Older individuals place greater importance on outdoor spaces, transportation, and healthcare services, whereas younger adults prioritise social participation and employment opportunities (Kohijoki \u0026amp; Koistinen, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). The higher scores achieved by the 65\u0026ndash;74 age group compared to those aged 75 and over in our study may be related to their level of digital literacy and adoption of technology. The digital divide is particularly pronounced in older age groups, which is an important indicator of access to information and communication services in cities (Boot, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Friemel, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn our study, marital status emerged as another factor influencing perceptions of age-friendly cities and communities. Compared to married individuals, single or widowed individuals reported lower scores on the respect and social inclusion dimensions. This may be because their spouses provide them with social and emotional support, which increases their perception of community and belonging in an age-friendly city (Leng et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Buffel and Phillipson, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Married older adults may perceive their neighbourhoods as more supportive and harmonious because they often have a spouse with whom they can participate in community activities, thus increasing their social participation (Plouffe \u0026amp; Kalache, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Rashid et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Conversely, single, divorced or widowed individuals may experience isolation, leading to different perceptions of the age-friendly environment. Indeed, married individuals may feel more respected and included in society thanks to spousal support and stronger social networks (Guti\u0026eacute;rrez-Vega et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Shapira \u0026amp; Keyes, 2008). Therefore, it is important that age-friendly city policies include social inclusion programmes targeting older adults living alone with limited social support.\u003c/p\u003e\u003cp\u003eIn our study, health status also emerged as a significant factor in perceptions of age-friendly cities. Previous studies have reported that older adults with health problems tend to evaluate the age-friendliness of cities more negatively (Perek-Białas et al., \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Chui et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Xie, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Lower total age-friendly city scale scores among individuals with chronic diseases suggest that health issues can hinder access to living spaces, social participation and perception of financial status. Similarly, lower scores for transportation and financial status among participants with a history of falls in the past year suggest that falls can limit perceived safety and activities of daily living (Crews, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Lower scores on the outdoor spaces and buildings, transportation, and financial status scales for individuals with a history of fractures suggest that physical limitations may negatively impact perceptions of environmental accessibility (Yuan et al., \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eParticipants who perceived their general health as poor or very poor had significantly lower total scale scores, demonstrating the importance of subjective health perception on the experience of an age-friendly city. In terms of health behaviours, individuals who consumed alcohol had lower scores for social participation, outdoor spaces and buildings, transport and financial status. This suggests that risky health behaviours negatively impact social and environmental participation (Fairbairn \u0026amp; Kang, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eOur study found no significant relationship between Age-Friendly Cities and Communities survey scores and ADL and IADL. This suggests that older adults' functional independence levels do not directly influence perceptions of cities and societies as age-friendly. In other words, being independent in daily activities is not a determining factor in how age-friendly a city is perceived to be. This suggests that the perception of an age-friendly city is influenced by factors beyond physical functioning, such as social participation, accessibility, community support and a sense of belonging.\u003c/p\u003e"},{"header":"5. Study limitations","content":"\u003cp\u003eThis study has several limitations. Firstly, as the research is based on a cross-sectional design, causal interpretations of the relationships between variables are not possible. Secondly, the study was conducted only in Burdur province using a convenience sampling method, which limits the generalisability of the results to the entire elderly population in T\u0026uuml;rkiye. While older adults' functionality was assessed using ADL and IADL measurements, it should be noted that the participants were mobile individuals. Furthermore, this study did not consider other potential factors that could influence participants' perceptions of an age-friendly city, such as cognitive function, mental health or social network structures. Another limitation is that data were collected from provincial and district centres and villages only. Studies investigating causality by separating urban and rural areas would further contribute to local policymaking.\u003c/p\u003e"},{"header":"6. Conclusion","content":"\u003cp\u003eConsequently, age-friendly urban policies should encompass not only physical environmental improvements, but also social participation, community support and digital inclusion. In this context, local governments should establish neighbourhood community centres to increase social interaction among older adults, improve the accessibility of public spaces and make public transport systems more age-friendly. Social policies should include programmes that encourage social participation and volunteer-based support networks that foster intergenerational interaction for older adults who live alone or have limited social support. Healthcare services should expand home care, rehabilitation and preventive healthcare services for older adults with chronic illnesses, or a history of falls or fractures. This would ensure their safer participation in urban life. Digital literacy training should be provided for older adults, and information access points (e.g. e-municipality support units) should be set up.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003ch2\u003eEthical Approval\u003c/h2\u003e\u003cp\u003e The research was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval for the study was obtained from the Non-Interventional Ethics Committee of XXX University (Approval No: GO-2024/765). Informed consent was obtained from all participants prior to data collection, and they were informed of their right to withdraw from the study at any time without any consequences.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eThis research receive no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eSS, \u0026Ouml;K: Conceptualization, Data curation, Formal analysis, Writing - original draftSS, \u0026Ouml;K: Conceptualization, Investigation, Writing - original draftSS, \u0026Ouml;K: Investigation, Data curation, Writing - original draftSS, \u0026Ouml;K: Investigation, Formal analysis, Writing - original draftSS: Supervision, Writing - review \u0026amp; editing.All authors approved the final manuscript for submission.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eArik, G., Varan, H. D., Yavuz, B. B., Karabulut, E., Kara, O., Kilic, M. K., Kizilarslanoglu, M. C., Sumer, F., Kuyumcu, M. E., Yesil, Y., Halil, M., \u0026amp; Cankurtaran, M. (2015). Validation of Katz index of independence in activities of daily living in Turkish older adults. \u003cem\u003eArchives of gerontology and geriatrics,\u003c/em\u003e 61(3), 344\u0026ndash;350. https://doi.org/10.1016/j.archger.2015.08.019\u003c/li\u003e\n\u003cli\u003eBarrio, \u0026Eacute;., Pinz\u0026oacute;n, S., Marsillas, S., \u0026amp; Garrido, F. (2021). Physical environment vs. social environment: what factors of age-friendliness predict subjective well-being in men and women?. \u003cem\u003eInternational Journal of Environmental Research and Public Health,\u003c/em\u003e 18(2), 798. https://doi.org/10.3390/ijerph18020798\u003c/li\u003e\n\u003cli\u003eBoot, W. (2023). The State Of The Dıgıtal Dıvıde. \u003cem\u003eInnovation in Aging\u003c/em\u003e, 7, 248 - 248. https://doi.org/10.1093/geroni/igad104.0818.\u003c/li\u003e\n\u003cli\u003eBuckner, S., Mattocks, C., Rimmer, M., \u0026amp; L afortune, L. (2018). An evaluation tool for age-friendly and dementia friendly communities. \u003cem\u003eWorking with Older People\u003c/em\u003e , 22(1), 48\u0026ndash;58.https://doi.org/10.1108/WWOP-11-2017-0032\u003c/li\u003e\n\u003cli\u003eBuffel, T. and Phillipson, C. (2018). A manifesto for the age-friendly movement: developing a new urban agenda. \u003cem\u003eJournal of Aging \u0026amp; Social Policy\u003c/em\u003e, 30(2), 173-192. https://doi.org/10.1080/08959420.2018.1430414\u003c/li\u003e\n\u003cli\u003eChe, S., Lei, W., Hung, T., \u0026amp; Leong, S. (2024). Attitudes to ageing mediates the relationship between perception of age-friendly city and life satisfaction among middle-aged and older people in Macao: a cross-sectional study. \u003cem\u003eBMC Geriatrics\u003c/em\u003e, 24. https://doi.org/10.1186/s12877-024-04961-y.\u003c/li\u003e\n\u003cli\u003eChoi, M., \u0026amp; Woo, J. (2018). Older Adults\u0026rsquo; Perceptions of the Age-Friendliness Of City: An Asian Experıence. \u003cem\u003eInnovation in Aging\u003c/em\u003e. https://doi.org/10.1093/GERONI/IGY023.2465.\u003c/li\u003e\n\u003cli\u003eChoi, M., Dabelko‐Schoeny, H., \u0026amp; White, K. (2019). Access to employment, volunteer activities, and community events and perceptions of age-friendliness: the role of social connectedness. \u003cem\u003eJournal of Applied Gerontology\u003c/em\u003e, 39(9), 1016-1024. https://doi.org/10.1177/0733464819847588\u003c/li\u003e\n\u003cli\u003eChui, C., Lu, S., Chan, O., Cheung, J., Guo, Y., Liu, Y., Chan, S., Tang, J., Au, A., Wen, Z., Yu, R., Bai, X., Mok, K., Woo, J., \u0026amp; Lum, T. (2022). Changes in older adults\u0026apos; perceptions of age-friendliness in Hong Kong: A three-year mixed-methods study. \u003cem\u003eCities\u003c/em\u003e. https://doi.org/10.1016/j.cities.2022.103748.\u003c/li\u003e\n\u003cli\u003eCochran, W. G. (1977). \u003cem\u003eSampling techniques\u003c/em\u003e (3rd ed.). John Wiley \u0026amp; Sons.\u003c/li\u003e\n\u003cli\u003eCrews, D. (2022). Aging, frailty, and design of built environments. \u003cem\u003eJournal of Physiological Anthropology,\u003c/em\u003e 41. https://doi.org/10.1186/s40101-021-00274-w.\u003c/li\u003e\n\u003cli\u003eDawal, S. Z. M., Ismail, Z., Yusuf, K., Abdul-Rashid, S. H., Shalahim, N. S. M., Abdullah, N. S., \u0026amp; Kamil, N. S. M. (2015). Determination of the significant anthropometry dimensions for user-friendly designs of domestic furniture and appliances\u0026ndash;Experience from a study in Malaysia\u003cem\u003e. Measurement\u003c/em\u003e, 59, 205-215.\u003c/li\u003e\n\u003cli\u003eDi Ciaula, A., \u0026amp; Portincasa, P. (2020). The environment as a determinant of successful aging or frailty. \u003cem\u003eMechanisms of Ageing and Development,\u003c/em\u003e 188. https://doi.org/10.1016/j.mad.2020.111244.\u003c/li\u003e\n\u003cli\u003eDikken, J., van den Hoven, R. F. M., van Staalduinen, W. H., Hulsebosch-Janssen, L. M. T., \u0026amp; van Hoof, J. (2020). How Older People Experience the Age-Friendliness of Their City: Development of the Age-Friendly Cities and Communities Questionnaire. \u003cem\u003eInternational Journal of Environmental Research and Public Health\u003c/em\u003e, 17(18), 6867. doi:10.3390/ijerph17186867\u003c/li\u003e\n\u003cli\u003eEdrees, A., Kamel, S., Sabry, H., \u0026amp; Nessim, A. (2021). Visual Comfort in Elder Care Facilities: Promoting Environmental Gerontology Theory. Towards Implementation of Sustainability Concepts in Developing Countries. https://doi.org/10.1007/978-3-030-74349-9_18.\u003c/li\u003e\n\u003cli\u003eErs\u0026ouml;zl\u0026uuml;, M. (2024). Descriptive Analysis and Evaluation of Age-Friendly Environment Studies in Turkiye. \u003cem\u003eJournal of Aging and Environment,\u003c/em\u003e 1\u0026ndash;19. https://doi.org/10.1080/26892618.2024.2375708\u003c/li\u003e\n\u003cli\u003eEtikan, I., Musa, S. A., \u0026amp; Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. \u003cem\u003eAmerican Journal of Theoretical and Applied Statistics, 5\u003c/em\u003e(1), 1\u0026ndash;4. https://doi.org/10.11648/j.ajtas.20160501.11\u003c/li\u003e\n\u003cli\u003eFairbairn, C., \u0026amp; Kang, D. (2025). Social Drinking and Addiction: A Social-Cognitive Model for Understanding Alcohol Use Disorder Risk. \u003cem\u003eCurrent Directions in Psychological Science\u003c/em\u003e. https://doi.org/10.1177/09637214251318272.\u003c/li\u003e\n\u003cli\u003eFlores, R., Caballer, A., \u0026amp; Alarc\u0026oacute;n, A. (2019). Evaluation of an Age-Friendly City and Its Effect on Life Satisfaction: A Two-Stage Study. \u003cem\u003eInternational Journal of Environmental Research and Public Health\u003c/em\u003e, 16. https://doi.org/10.3390/ijerph16245073.\u003c/li\u003e\n\u003cli\u003eFriemel, T. (2016). The digital divide has grown old: Determinants of a digital divide among seniors. \u003cem\u003eNew Media \u0026amp; Society\u003c/em\u003e, 18, 313 - 331. https://doi.org/10.1177/1461444814538648.\u003c/li\u003e\n\u003cli\u003eGonz\u0026aacute;lez, D. (2018). Natural Landscape and Environmental Gerontology. \u003cem\u003eEnvironmental Analysis and Ecology Studies\u003c/em\u003e, 1, 1-3. https://doi.org/10.31031/EAES.2018.01.000525.\u003c/li\u003e\n\u003cli\u003eGuti\u0026eacute;rrez-Vega, M., Villar, O., Carrillo-Saucedo, I., \u0026amp; Monta\u0026ntilde;ez-Alvarado, P. (2017). The Possible Protective Effect of Marital Status in Quality of Life Among Elders in a U.S.-Mexico Border City. \u003cem\u003eCommunity Mental Health Journal\u003c/em\u003e, 54, 480 - 484. https://doi.org/10.1007/s10597-017-0166-z.\u003c/li\u003e\n\u003cli\u003eG\u0026uuml;zel, A., U\u0026ccedil;an Yama\u0026ccedil;, S., Turan, S., \u0026Uuml;ner, S. (2024). Turkish validity and reliability of the Lawton instrumental activities of daily living scale. \u003cem\u003eTurkish Journal of Public Health\u003c/em\u003e, 22(1), 59-71. https://doi.org/10.20518/tjph.1364063\u003c/li\u003e\n\u003cli\u003eIvan, L., Dikken, J., \u0026amp; Van Hoof, J. (2024). Unveiling the experienced age-friendliness of older people in Bucharest: A comprehensive study using the validated Romanian age-friendly cities and communities questionnaire and cluster analysis. \u003cem\u003eHabitat International.\u003c/em\u003e https://doi.org/10.1016/j.habitatint.2023.102973.\u003c/li\u003e\n\u003cli\u003eJiang, Y., Wu, Y., Li, S., Fu, S., Lv, Y., Lin, H., \u0026amp; Yao, Y. (2023). Editorial: Aging-friendly environments and healthy aging. \u003cem\u003eFrontiers in Medicine\u003c/em\u003e, 10, 1211632. https://doi.org/10.3389/fmed.2023.1211632\u003c/li\u003e\n\u003cli\u003eKalache, A. (2016). Active ageing and age-friendly cities\u0026mdash;A personal account. In T. Moulaert \u0026amp; S. Garon (Eds.), Age-friendly cities and communities in international comparison (pp. 65\u0026ndash;77). Springer. https://doi.org/10.1007/978-3-319-24031-2_5\u003c/li\u003e\n\u003cli\u003eKatz, S., Ford, A. B., Moskowıtz, R. W., Jackson, B. A., \u0026amp; Jaffe, M. W. (1963). Studies Of Illness In The Aged. The Index Of ADL: A Standardized Measure Of Biological And Psychosocial Function. \u003cem\u003eJAMA\u003c/em\u003e, \u003cem\u003e185\u003c/em\u003e, 914-919. https://doi.org/10.1001/jama.1963.03060120024016\u003c/li\u003e\n\u003cli\u003eKline, R. B. (2011). Principles and practice of structural equation modeling (3rd ed.). \u003cem\u003eGuilford Press.\u003c/em\u003e\u003c/li\u003e\n\u003cli\u003eKohijoki, A., \u0026amp; Koistinen, K. (2021). The city centre as an age-friendly shopping environment: a consumer perspective. \u003cem\u003eAgeing and Society\u003c/em\u003e, 42, 2735 - 2756. https://doi.org/10.1017/S0144686X21000295.\u003c/li\u003e\n\u003cli\u003eLawton, M. P., \u0026amp; Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. \u003cem\u003eThe Gerontologist\u003c/em\u003e, 9(3), 179\u0026ndash;186. https://doi.org/10.1093/geront/9.3_Part_1.179\u003c/li\u003e\n\u003cli\u003eLawton, M. P., \u0026amp; Nahemow, L. (1973). Ecology and the aging process. In C. Eisdorfer \u0026amp;M. P. Lawton (Eds.), The psychology of adult of development and aging (pp. 619-674). \u003cem\u003eAmerican Psychological Association\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eLeng, S., Lei, W., Hung, T., \u0026amp; Leong, S. (2024). Attitudes to ageing mediates the relationship between perception of age-friendly city and life satisfaction among middle-aged and older people in macao: a cross-sectional study. \u003cem\u003eBMC Geriatrics\u003c/em\u003e, 24(1). https://doi.org/10.1186/s12877-024-04961-y\u003c/li\u003e\n\u003cli\u003eLiang, Z., \u0026amp; Ye, C. (2023). Spatial production in the process of rapid urbanisation and ageing: A case study of the new type of community in suburban Shanghai. \u003cem\u003eHabitat International\u003c/em\u003e. https://doi.org/10.1016/j.habitatint.2023.102883.\u003c/li\u003e\n\u003cli\u003eOswald, A., \u0026amp; Yeh, J. (2021). From Margin to Center: Intersectionality and the Politics of Environmental Gerontology. \u003cem\u003eInnovation in Aging\u003c/em\u003e, 5, 397 - 397. https://doi.org/10.1093/geroni/igab046.1537.\u003c/li\u003e\n\u003cli\u003eOswald, F. (2024). Rethınkıng The Place of Place for Aging: Enduring and New Challenges for Environmental Gerontology. \u003cem\u003eInnovation in Aging\u003c/em\u003e, 8, 394 - 394. https://doi.org/10.1093/geroni/igae098.1281.\u003c/li\u003e\n\u003cli\u003e\u0026Ouml;zer, Z., Turan, G. B., \u0026amp; Teke, N. (2022). Age-friendly cities and communities questionnaire: A research on Turkish validity and reliability. \u003cem\u003eArchives of Environmental \u0026amp; Occupational Health\u003c/em\u003e, 78(1), 38\u0026ndash;47. https://doi.org/10.1080/19338244.2022.2061397\u003c/li\u003e\n\u003cli\u003ePerek-Białas, J., Sk\u0026oacute;rska, P., Maj, M., Kazak, J., Dikken, J., \u0026amp; Van Hoof, J. (2024). The experienced age-friendliness in two Polish cities: An in-depth analysis of the views of older citizens. \u003cem\u003eHabitat International\u003c/em\u003e. https://doi.org/10.1016/j.habitatint.2024.103201.\u003c/li\u003e\n\u003cli\u003ePhillipson, C., \u0026amp; Buffel, T. (2020). Developing Age-friendly Cities: Policy Opportunities and Challenges. \u003cem\u003eJournal of Elder Policy\u003c/em\u003e. https://doi.org/10.18278/jep.1.1.7.\u003c/li\u003e\n\u003cli\u003ePlouffe, L. and Kalache, A. (2010). Towards global age-friendly cities: determining urban features that promote active aging\u003cem\u003e. Journal of Urban Health\u003c/em\u003e, 87(5), 733-739. https://doi.org/10.1007/s11524-010-9466-0\u003c/li\u003e\n\u003cli\u003eRashid, K., Mohamed, T., Azyze, S., Hazim, Z., Aziz, A., \u0026amp; Hashim, I. (2021). Determining the features of age friendly for city development. \u003cem\u003ePlanning Malaysia\u003c/em\u003e, 19. https://doi.org/10.21837/pm.v19i16.965\u003c/li\u003e\n\u003cli\u003eSetia, M. (2016). Methodology Series Module 3: Cross-sectional Studies. \u003cem\u003eIndian Journal of Dermatology,\u003c/em\u003e 61, 261 - 264. https://doi.org/10.4103/0019-5154.182410.\u003c/li\u003e\n\u003cli\u003eShapiro, A., \u0026amp; Keyes, C. (2008). Marital Status and Social Well-Being: Are the Married Always Better Off?. \u003cem\u003eSocial Indicators Research,\u003c/em\u003e 88, 329-346. https://doi.org/10.1007/S11205-007-9194-3.\u003c/li\u003e\n\u003cli\u003eThurairaj, D., Rashid, S., \u0026amp; Nor, N. (2025). Challenges in implementing age-friendly cities: A systematic literature review. \u003cem\u003eMultidisciplinary Reviews.\u003c/em\u003e https://doi.org/10.31893/multirev.2025334.\u003c/li\u003e\n\u003cli\u003eTurkish Statistical Institute (TURKSTAT). (2025). İstatistiklerle Yaşlılar 2024 [Statistics on Older Persons 2024]. https://data.tuik.gov.tr/Bulten/Index?p=%C4%B0statistiklerle-Ya%C5%9Fl%C4%B1lar-2024-54079\u0026amp;dil=1\u003c/li\u003e\n\u003cli\u003eTurkish Statistical Institute. (2022). Urban/rural population statistics 2022. https://data.tuik.gov.tr/bulten/index?p=kent-kir-nufus-istatistikleri-2022-49755\u003c/li\u003e\n\u003cli\u003eVan Hoof J, Kazak JK, Perek-Białas JM, Peek S. Thechallenges of urban ageing: Making cities age-friendlyin Europe. \u003cem\u003eInternational Journal of Environmental Research and Public Health\u003c/em\u003e. 2018;15(11):2473. doi:10.3390/ijerph15112473.\u003c/li\u003e\n\u003cli\u003eWahl, H., \u0026amp; Gerstorf, D. (2020). Person-Environment Resources for Aging Well: Environmental Docility and Life Space as Conceptual Pillars for Future Contextual Gerontology. \u003cem\u003eThe Gerontologist\u003c/em\u003e, 60 3, 368-375 . https://doi.org/10.1093/geront/gnaa006.\u003c/li\u003e\n\u003cli\u003eWang, X., \u0026amp; Cheng, Z. (2020). Cross-Sectional Studies: Strengths, Weaknesses, and Recommendations.. Chest, 158 1S, S65-S71 . https://doi.org/10.1016/j.chest.2020.03.012.\u003c/li\u003e\n\u003cli\u003eWorld Bank. (2017). World development report 2017: Governance and the law. World Bank. https://doi.org/10.1596/978-1-4648-0950-7\u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO). (2007). Ageing and life course, family and community health. Global Age-friendly Cities: A guide, World Health Organization: France.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO). (2015). \u003cem\u003eMeasuring the age friendliness of cities: A guide to using core indicators\u003c/em\u003e. World Health Organization.\u003c/li\u003e\n\u003cli\u003eXie, L. (2018). Age-Friendly Communities and Life Satisfaction Among the Elderly in Urban China. \u003cem\u003eResearch on Aging,\u003c/em\u003e 40, 883- 905. https://doi.org/10.1177/0164027518757760.\u003c/li\u003e\n\u003cli\u003eYu, R., Wong, M., \u0026amp; Woo, J. (2018). Perceptions of Neighborhood Environment, Sense of Community, and Self-Rated Health: an Age-Friendly City Project in Hong Kong. \u003cem\u003eJournal of Urban Health\u003c/em\u003e, 96, 276-288. https://doi.org/10.1007/s11524-018-00331-3.\u003c/li\u003e\n\u003cli\u003eYuan, S., Maliki, N., \u0026amp; Cui, H. (2025). Public Perceptions of Resilient Design Characteristics in Urban Form. \u003cem\u003eSustainability.\u003c/em\u003e https://doi.org/10.3390/su17020614.\u003c/li\u003e\n\u003cli\u003eZhang, C., \u0026amp; Yang, J. (2023). Evaluation of the quality of theage-friendly environment in Liaoning Province. \u003cem\u003eSustainability\u003c/em\u003e,15(22), 16134. https://doi.org/10.3390/su152216134\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Age-friendly cities, older adults, environmental gerontology, aging","lastPublishedDoi":"10.21203/rs.3.rs-7920642/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7920642/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe ageing population and rapid urbanisation highlight the need for inclusive and sustainable cities that support the well-being of older adults. Drawing on the framework of environmental gerontology, this study explores the determinants of perceptions of age-friendly cities and communities among older adults in T\u0026uuml;rkiye. Data were collected from 411 individuals aged 65 years and over in Burdur Province using sociodemographic questionnaires and scales measuring Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL), as well as the Age-Friendly Cities and Communities Questionnaire (AFCCQ-TR). The results reveal that perceptions of age-friendliness are significantly influenced by gender, age, marital status, health conditions and behaviours. Women, married participants, and younger age groups gave more positive evaluations, whereas chronic illness, falls, fractures, and risky health behaviours were associated with more negative perceptions. No significant associations were found between ADL/IADL and perceptions, emphasising the greater importance of social and environmental factors compared to functional independence in shaping urban experiences. These findings suggest that sustainable age-friendly urban policies should prioritise physical infrastructure, social participation, accessible healthcare, and digital inclusion. Measures such as establishing community centres, enhancing public transport and open spaces, supporting home-based healthcare, and promoting digital literacy could contribute to the creation of healthier, more socially resilient, and more environmentally sustainable cities for older populations. By offering empirical evidence from T\u0026uuml;rkiye, where age-friendly initiatives remain limited, the study contributes to international debates on sustainable cities and underscores the urgent need for context-specific, inclusive, and cross-sectoral strategies to support ageing populations in urban environments.\u003c/p\u003e","manuscriptTitle":"Exploring the Determinants of Age-Friendly Cities and Communities Perceptions Among Turkish Older Adults","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-14 14:39:09","doi":"10.21203/rs.3.rs-7920642/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8f6af129-9e56-4109-846f-5031a5cb8f98","owner":[],"postedDate":"November 14th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-01-21T16:11:27+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-14 14:39:09","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7920642","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7920642","identity":"rs-7920642","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}