Perceived unmet needs of an age-friendly environment: A qualitative exploration of older adults' perspectives in a Malaysian city.

This exploratory qualitative study investigates older adults' unmet needs in the age-friendly city of Ipoh, Malaysia. Seventeen participants were interviewed, including ten older adults residing in Ipoh City for at least six months, four carers, and three professional key informants. Interviews were conducted using semi-structured questions based on the WHO Age-Friendly Cities Framework. A 5P framework for active ageing based on the ecological ageing model was adapted for data analysis. The 5P framework consists of domains of person (micro), process (meso), place (macro), policymaking (macro), and prime, which allows for the dissection of older adults' unmet needs in planning for multilevel approaches, which were employed for analysis. Person: the personal needs requiring improvement included digital divide disparity, inadequate family support, and restricted sports activities attributed to physical limitations. Process: There were fewer social activities and a lack of low-cost and easily accessible venues for seniors. Economic challenges include expensive private healthcare services, variation in the quality of care in older residential care facilities, and limited savings for retirement. Place issues include unequal distribution of exercise equipment, public open spaces, the need for more conducive parking for seniors, and a place for social activities. Difficulties assessing public transportation, digitalized services, and unaffordable e-hailing services are common among seniors. Housing issues for seniors include a lack of barrier-free housing design and unaffordable housing. Policymaking: Insufficient private sector commitment to improving services to older adults, lack of policy governance on the quality of nursing homes, and insufficient multidisciplinary governance collaboration. Prime: Health promotion for preventing age-related illness is required to preserve health in old age, and full-time family caregivers' psychological well-being is often overlooked.

Perceived Gap of Age-Friendliness among Community-Dwelling Older Adults: Findings from Malaysia, a Middle-Income Country.

BACKGROUND: The United Nations predicts that the global population aged 65 years or above will double from 703 million in 2019 to 1.5 billion by 2050. In Malaysia, the older population has reached 2.4 million, accounting for nearly 8% of the population. This study aimed to evaluate the perceptions of the elderly on the importance and availability of the age-friendly features in eight domains specified by the Global Network of Age-Friendly City and Communities. METHODS: This was a cross-sectional study conducted by structured face-to-face and or telephone interviews. Gap score analysis was performed for 32 items of the 8 age-friendly domains. The gap scores were categorized as follows: 0 = not important OR important and element available; 1 = important but unsure whether the element is available; 2 = important but element not available. The gap scores were then dichotomized into "yes" and "no", and multivariate logistic regression analysis was subsequently performed. RESULTS: From the 1061 respondents, the housing (55.4%) and transportation (50.7%) domains reported the highest mean perceived gap scores. Out of the 32 elements, the highest mean gap percent scores were observed in elderly priority parking bays (83.8%), home visits by healthcare professionals (78.9%), financial assistance for home modification and purchase (66.3%), and affordable housing options (63.6%). Respondents in the city center reported higher gap scores for modified restrooms, parks, volunteer activities, and the internet; respondents in the non-city center reported higher gap scores for nursing homes, healthcare professionals, and cultural celebrations. Age, location, marital status, income, duration of stay, physical exercise, internet access, and intention to continue working were found to be associated with a higher perceived gap in specific domains. CONCLUSION: The most significant unmet needs were detected in the housing, transportation, and employment opportunities domains. Considerable disparities in the perceived gap were detected between the older population in the city center and non-city center. To address shortcomings in the local age-friendly setting, coordinated municipal policies, political commitment, and benchmarking of existing age-friendly cities are warranted.