A Systematic Review and Evaluation of Measurement Instruments Assessing the Needs, Wellbeing, and Living Environments of Older Adults

Understanding the built environment’s impact on older adults’ wellbeing necessitates the identification of high-quality measures that capture environmental properties, wellbeing, and needs. Literature searches were conducted to identify instruments that measure (a) objective environmental properties, (b) wellbeing, (c) needs, and (d) environmental perception, which were evaluated using the COSMIN checklist. Another literature search was conducted to explore which instruments are used in studies examining objective and perceived qualities of the environment in relation to wellbeing. Of the 54 instruments evaluated, most showed strong content or construct validity, but weak or unreported test-retest reliability. Structural validity and internal consistency tended to be satisfactory in instruments assessing wellbeing and the intersection of environment and wellbeing. Instruments evaluating needs and the perceived environment generally had poor results in our evaluation. Our review of studies assessing both perceived and objective built environments alongside wellbeing indicates a lack of consistent use of validated instruments for older adult populations. We have identified instruments in each category with mostly sufficient psychometric properties, while the rest require improvement, particularly in terms of structural validity and reliability. Environment evaluation instruments mainly focus on outdoor spaces, leaving indoor spaces underrepresented in literature.