Assessing age-friendly urban environments in Indonesia: Validation of the Indonesian age-friendly cities and communities questionnaire (AFCCQ) and differences across urban city categories
- 1Geriatric Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- 2Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
Abstract
Background/Objectives: The global aging population is growing rapidly, especially in Southeast Asia and Indonesia. This demographic shift poses significant challenges for urban planning and public health, as older adults face barriers to accessing essential services and engaging in their communities. This study assesses the age-friendliness of urban environments in Indonesia by evaluating the psychometric properties of an Indonesian-language version of the Age-Friendly Cities and Communities Questionnaire (AFCCQ) and comparing perceived age-friendliness across urban categories. Methods: A cross-sectional survey using the Indonesian version of the AFCCQ was conducted between 7 January and 3 February 2025. The AFCCQ covers nine domains: housing, social participation, respect and social inclusion, civic participation and employment, communication and information, community support and health services, outdoor spaces and buildings, transportation, and financial status. Validity was assessed using item–total Spearman correlations and exploratory factor analysis; reliability was assessed using Cronbach’s α. Differences in domain scores across five urban categories were examined using the Kruskal–Wallis test with Bonferroni adjustment across the nine domain-level tests (α = 0.05/9 = 0.0056). Results: The study involved 505 community-dwelling older adults aged ≥60 years, with a mean age of 69.4 years; 81.6% were female. The average AFCCQ score was 14.96 ± 10.46. Overall Cronbach’s α was 0.90. The KMO value was 0.83 and Bartlett’s test was significant (χ²(253) = 13,374.41, p < 0.001); the first unrotated component accounted for 35.92% of the variance, although 7 components had eigenvalues greater than 1. Nominally significant differences across city categories were observed in housing, social participation, and transportation (p < 0.05); none remained significant after Bonferroni adjustment for nine domain-level comparisons. These comparisons are reported as exploratory. Conclusion: The study indicates that the Indonesian AFCCQ has acceptable internal consistency. Item-level convergence was weak for the two respect and social inclusion items, and the exploratory factor analysis did not reproduce the nine-domain structure. Exploratory differences across urban categories suggest that perceived age-friendliness may vary by city size, particularly for housing, social participation, and transportation, and provide a basis for further investigation in representative samples. Confirmatory factor analysis and formal test–retest assessment in an independent Indonesian sample remain necessary.
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BibTeX
@article{sari2026assessing,
title = {{Assessing age-friendly urban environments in Indonesia: Validation of the Indonesian age-friendly cities and communities questionnaire (AFCCQ) and differences across urban city categories}},
author = {Nina Kemala Sari and Stepvia Stepvia and Muhana Fawwazy Ilyas},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0358251},
url = {https://doi.org/10.1371/journal.pone.0358251},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Assessing age-friendly urban environments in Indonesia: Validation of the Indonesian age-friendly cities and communities questionnaire (AFCCQ) and differences across urban city categories
AU - Nina Kemala Sari
AU - Stepvia Stepvia
AU - Muhana Fawwazy Ilyas
PY - 2026
DA - 2026/10/08
JO - PLOS One
DO - 10.1371/journal.pone.0358251
UR - https://doi.org/10.1371/journal.pone.0358251
AB - Background/Objectives: The global aging population is growing rapidly, especially in Southeast Asia and Indonesia. This demographic shift poses significant challenges for urban planning and public health, as older adults face barriers to accessing essential services and engaging in their communities. This study assesses the age-friendliness of urban environments in Indonesia by evaluating the psychometric properties of an Indonesian-language version of the Age-Friendly Cities and Communities Questionnaire (AFCCQ) and comparing perceived age-friendliness across urban categories. Methods: A cross-sectional survey using the Indonesian version of the AFCCQ was conducted between 7 January and 3 February 2025. The AFCCQ covers nine domains: housing, social participation, respect and social inclusion, civic participation and employment, communication and information, community support and health services, outdoor spaces and buildings, transportation, and financial status. Validity was assessed using item–total Spearman correlations and exploratory factor analysis; reliability was assessed using Cronbach’s α. Differences in domain scores across five urban categories were examined using the Kruskal–Wallis test with Bonferroni adjustment across the nine domain-level tests (α = 0.05/9 = 0.0056). Results: The study involved 505 community-dwelling older adults aged ≥60 years, with a mean age of 69.4 years; 81.6% were female. The average AFCCQ score was 14.96 ± 10.46. Overall Cronbach’s α was 0.90. The KMO value was 0.83 and Bartlett’s test was significant (χ²(253) = 13,374.41, p < 0.001); the first unrotated component accounted for 35.92% of the variance, although 7 components had eigenvalues greater than 1. Nominally significant differences across city categories were observed in housing, social participation, and transportation (p < 0.05); none remained significant after Bonferroni adjustment for nine domain-level comparisons. These comparisons are reported as exploratory. Conclusion: The study indicates that the Indonesian AFCCQ has acceptable internal consistency. Item-level convergence was weak for the two respect and social inclusion items, and the exploratory factor analysis did not reproduce the nine-domain structure. Exploratory differences across urban categories suggest that perceived age-friendliness may vary by city size, particularly for housing, social participation, and transportation, and provide a basis for further investigation in representative samples. Confirmatory factor analysis and formal test–retest assessment in an independent Indonesian sample remain necessary.
SN - 1932-6203
ER -