The Relationship of Neighborhood Accessibility and Community Participation with Quality of Life and Loneliness Among Older Adults

Background: During COVID-19, older adults experienced significantly reduced Quality of life (QoL) and increased loneliness. Objective: To analyze a conceptual model wherein Perceived Accessibility of Living Environment and services (PALES) explains older adults’ multidimensional QoL (physical health, psychological health, social relationships, and environmental health) and loneliness, directly and indirectly. Participation in activities in the community serves as a mediator between accessibility and QoL and loneliness. Methodology: A cross-sectional survey of 495 Israeli participants over 60 was performed in 2021 during a slowdown in infection resulting from vaccination. Respondents completed four questionnaires: QoL, loneliness, participation in activities in the community, and PALES. Results: A path-analysis model showed that PALES has a direct effect only on psychological health QoL. The PALES had an indirect effect on all four domains of QoL as well as loneliness through the mediators of home activities, social activities, productivity, and electronic social networking. Conclusion: Accessible neighborhoods are not enough; rather, older adults should also be integrated with activities in the community to address multiple dimensions of QoL and loneliness.