Psychometric properties of the Arabic version of the Age-Friendly Cities and Communities Questionnaire (AFCCQ-Arabic)

Background and objective: The World Health Organization has promoted the concept of Age-Friendly Cities and Communities (AFCC) as a response to global population aging. This approach aims to adapt physical and social environments to the needs of older adults, particularly in the context of ongoing urbanization. The Age-Friendly Cities and Communities Questionnaire (AFCCQ) was designed to assess older adults’ perceptions of age-friendliness in their communities but has not yet been validated in Arabic. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Arabic version of the AFCCQ (AFCCQ-Arabic), and to assess how older Arabs in Israel perceive the age-friendliness of their communities. This population is an ethnic minority facing dual challenges given its age and minority status. Methods: A cross-sectional sample of 202 Arab adults aged 60 and above was recruited through convenience sampling. Data were collected through face-to-face interviews using the AFCCQ-Arabic, which includes 23 items across nine domains. Results: The AFCCQ-Arabic demonstrated overall acceptable psychometric properties among older Arabs in Israel. Face and content validity were supported. Construct validity was assessed using Confirmatory Factor Analysis (CFA). The original model demonstrated good fit indices (CFI = 0.922; TLI = 0.900; RMSEA = 0.064; SRMR = 0.072). Most domains showed acceptable Composite Reliability (CR) values, indicating good internal consistency. However, item 3 demonstrated a low factor loading and reduced the CR value of the social participation domain. Additionally, the civic participation and employment domain showed low reliability (CR = 0.28). Domain-level scores revealed diverse perceptions of age-friendliness: high scores in respect and social inclusion, housing, civic participation and employment, and community support and health services; moderate scores in social participation, and communication and information; and low scores in transportation, outdoor spaces and buildings, and financial situation. Conclusion: Despite some psychometric limitations, the AFCCQ-Arabic was found to be reliable, valid, and culturally appropriate for use among older Arab adults in Israel. The variation in domain scores indicates service, infrastructure, and economic security gaps in Arab communities, underscoring the need for targeted policy interventions to promote equitable aging.