Vol.:(0123456789) 1 3 Quality of Life Research https://doi.org/10.1007/s11136-019-02199-5 Association of the built environments and health‑related quality of life in community‑dwelling older adults: a cross‑sectional study Nuan‑Ching Huang 1,2  · Cordia Chu 3  · Shiann‑Far Kung 1,2  · Susan C. Hu 1,4 Accepted: 3 May 2019 © Springer Nature Switzerland AG 2019 Abstract Purpose The relationship between built environments and the quality of life (QoL) of the elderly has gained great attention in recent years. However, most QoL studies have been conducted in western countries; thus, limited research was found in Asia, in which the population density, urban forms, narrow roadways, and land use patterns are more compact and highly mixed in terms of use. Therefore, the purpose of this study was an interdisciplinary analysis of two national datasets, the National Land Use Investigation and the National Health Interview Survey, to explore the relationship between built environments and the health-related quality of life of older adults in Taiwan. Methods Eight types of built environments at the township level were calculated, and 1222 nationally representative older adults aged 65 and older were recruited. The outcome variable was health-related QoL as measured using the EQ-5D, includ- ing utility score and the EQ-VAS. Statistical methods included descriptive analysis, bivariate analysis, and mixed-efects logistic regression analysis, which were conducted using SAS 9.4 software. Results The results showed that a signifcant relationship exists between cultural and historical facilities and low EQ-VAS; none of the built environments were found to be related to the EQ-5D. Individual factors are the main determinants of the EQ-5D of older adults in Taiwan. Positive relationships were found if older adults were engaging in physical activities and social participation. Conclusions We suggest that building a supportive environment in which elderly people could consistently engage in physi- cal activities and social participation is another potential approach that might contribute to active aging. Keywords Built environments · Quality of life · The elderly · EQ-5D · Multi-level analysis Introduction Many countries worldwide face the challenge of a growing aging population. The global population of older persons in 2015 is projected to be more than double by 2050, reaching nearly 2.1 billion [1]. At least 22% of this population will Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11136-019-02199-5) contains supplementary material, which is available to authorized users. * Susan C. Hu shuhu@mail.ncku.edu.tw Nuan-Ching Huang sunnynching@gmail.com Cordia Chu c.chu@grifth.edu.au Shiann-Far Kung sfkung@mail.ncku.edu.tw 1 Healthy Cities Research Center, Research and Services Headquarters, National Cheng Kung University, No. 1, University Road, Tainan 701, Taiwan 2 Department of Urban Planning, College of Planning and Design, National Cheng Kung University, No. 1, University Road, Tainan 701, Taiwan 3 Centre for Environment and Population Health, School of Medicine, Grifth University, 170 Kessels Road, Nathan, QLD 4111, Australia 4 Department of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan 701, Taiwan