Environment and belonging at baseline among older adults in the Rijeka HORUS pilot

Background

Activity-friendly environments and neighbourhood social ties shape healthy ageing and influence non-communicable disease (NCD) risk. Within the Rijeka pilot of the HORUS project (GA 101136516), 9-month urban-based intervention targets older adults at risk of, or living with, NCDs. We characterised perceived environment and sense of belonging at baseline to inform stratified delivery and identify subgroups with weaker community connection.

Methods

Cross-sectional baseline analysis from a pre-post-controlled study (n = 156 intervention, n = 160 control). Use of environment was assessed with the Short ALPHA (10 items; 0–10, higher=more activity-friendly). Sense of belonging used the Neighbourhood Cohesion Scale: Social Cohesion (8 items; 8–40) and Neighbourhood Belonging (7 items; 7–35). Group differences were tested by linear regression adjusted for age and sex; internal consistency by Cronbach’s α.

Results

Groups differed at baseline in age (intervention 71.8±8.1 vs control 65.8±16.5 years, p < 0.001) and sex (87.5% vs 45.3% female, p < 0.001). Short ALPHA: 5.57±1.25 vs 5.79±1.43; adjusted β = +0.06 (95% CI − 0.26, +0.38), p = 0.72. Social Cohesion: 29.1±5.6 vs 26.7±5.6; adjusted β = +1.55 (95% CI + 0.10, +2.99), p = 0.036. Neighbourhood Belonging: 27.2±5.0 vs 25.4±5.4; adjusted β = +0.83 (95% CI − 0.50, +2.15), p = 0.22. Internal consistency was good for Social Cohesion (α = 0.84) and Neighbourhood Belonging (α = 0.89); low for Short ALPHA (α = 0.24), consistent with its formative-index design. Low cohesion (≤20) was found in 14.7% of controls vs 6.6% of intervention; low belonging (≤18) in 14.0% vs 4.6%.

Conclusions

Both groups perceive their neighbourhood as moderately activity-friendly. After adjustment, social cohesion remained higher in the intervention arm; belonging did not differ. The cohort is well-connected overall, yet a small low-cohesion subgroup is a priority for the social-environment components of HORUS.

Key messages

• Most older adults feel well-connected, but 7–15% report low social cohesion — a priority subgroup for targeted intervention within HORUS Rijeka.

• Even in urban settings, most older adults feel they belong — HORUS can build on this existing social fabric to strengthen those few who don’t.