{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T11:45:41Z","timestamp":1774266341597,"version":"3.50.1"},"reference-count":55,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Ageing leads to physical, cognitive, and social changes that affect people\u2019s functioning and social participation. Health literacy, sociodemographic, and environmental factors influence health outcomes and access to care. This study aimed to characterize the health and functioning of Portuguese adults aged 65 and over, focusing on sociodemographic factors, health status, lifestyle, fall risk, functional capacity, and social participation, and on comparing rural and urban populations. Materials and Methods: An exploratory, cross-sectional study was conducted using data from older adults who completed the FallSensing screening protocol. Participants were classified by residence type (rural vs. urban), and group comparisons were made. Results: The sample (n = 474) was predominantly female (66.5%) with a mean age of 74.62 (\u00b16.49) years. Rural participants were older (76.87 \u00b1 6.89 vs. 73.50 \u00b1 5.87) and had higher body mass index (BMI) (28.32 \u00b1 4.31 vs. 27.51 \u00b1 4.12), lower educational attainment\u2014for example, 22.9% had no formal education compared to 7.0% of urban participants\u2014and a higher prevalence of hypertension (72.6% vs. 55.4%), whereas urban participants experienced higher rates of osteoporosis (24.4% vs. 14.3%), hearing loss (41.9% vs. 26.9%), and alcohol consumption (12.7% vs. 2.3%) (p \u2264 0.05). Rural residents also demonstrated significantly poorer results for grip strength (21.03 \u00b1 7.36 vs. 23.73 \u00b1 8.61), gait speed (1.17 \u00b1 0.44 vs. 1.45 \u00b1 0.39), and the Timed Up and Go (TUG) test (13.4 \u00b1 10.40 vs. 9.62 \u00b1 4.43), as well as lower exercise self-efficacy (12.83 \u00b1 4.97 vs. 14.28 \u00b1 4.40) (p &lt; 0.001), and more pronounced moderate-to-severe restrictions in social participation (28.0% vs. 15.7%) (p = 0.013). They reported greater use of assistive devices and more severe limitations in social participation. Although falls were reported more often in urban areas, rural residents experienced greater fall frequency. Conclusions: These findings suggest that rural living is associated with lower functional capacity and poorer health, underscoring the need for targeted physiotherapy and primary care strategies in rural settings.<\/jats:p>","DOI":"10.3390\/ijerph22121827","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T10:50:38Z","timestamp":1764931838000},"page":"1827","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Health and Functioning of Community-Dwelling Older Adults in Urban and Rural Areas of Portugal\u2014What Are the Implications for Physiotherapy Care?"],"prefix":"10.3390","volume":"22","author":[{"given":"Magda","family":"Reis","sequence":"first","affiliation":[{"name":"Coimbra Health School, Polytechnic University of Coimbra, Rua 5 de Outubro, 3045-043 Coimbra, Portugal"},{"name":"Fisioterapia, Centro Cir\u00fargico de Coimbra, Rua. Dr. Manuel Campos Pinheiro 51, 3045-089 Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Coimbra Health School, Polytechnic University of Coimbra, Rua 5 de Outubro, 3045-043 Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monserrat","family":"Conde","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Rd, Oxford OX2 6GG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2696-2086","authenticated-orcid":false,"given":"Anabela Correia","family":"Martins","sequence":"additional","affiliation":[{"name":"Coimbra Health School, Polytechnic University of Coimbra, Rua 5 de Outubro, 3045-043 Coimbra, Portugal"},{"name":"H&TR-Health & Technology Research Center, Coimbra Health School, Polytechnic University of Coimbra, Rua 5 de Outubro, 3045-043 Coimbra, Portugal"},{"name":"Center for Rehabilitation Research, Health School, Polytechnic of Porto, Rua Dr. Ant\u00f3nio Bernardino de Almeida, 4200-072 Porto, Portugal"},{"name":"SUScita\u2014Research Group on Sustainability, Cities and Urban Intelligence, 3045-093 Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Tornero-Qui\u00f1ones, I., S\u00e1ez-Padilla, J., Espina D\u00edaz, A., Abad Robles, M.T., and Sierra Robles, \u00c1. 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