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Lee JS, Zegras PC, Ben-Joseph E. Safely active mobility for urban baby boomers: The role of neighborhood design. ACCIDENT; ANALYSIS AND PREVENTION 2013; 61:153-166. [PMID: 23777888 DOI: 10.1016/j.aap.2013.05.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Revised: 02/27/2013] [Accepted: 05/15/2013] [Indexed: 06/02/2023]
Abstract
Many urban designers and researchers argue that walkable urban environments can encourage older residents' walking activities that benefit their physical health. However, walking also exposes older adults to safety risks, including due to traffic accidents. This study seeks to reveal the interactions between urban form and safety affecting urban baby boomers' walking behavior. Spatial analysis reveals traffic collision patterns in urban Boston neighborhoods, detecting hotspots around activity centers. Structural equation modeling, estimated on individual data collected from a mail-back survey and utilizing numerous measures of neighborhood urban form and accessibility, then attempts to reveal the causal, interacting relationships between neighborhood-level urban form, traffic crashes, and baby boomers' walking behavior. The analysis identifies significant effects of walkable urban forms (e.g., mixed use, well-connected streets, and good access to potential destinations) on older adults' walking. Yet, accessibility to retail, as well as traffic speed and volume, are positively associated with the traffic collision frequency. The results suggest more cautious approaches may be necessary for designing urban spaces for walkability and also call into question prescriptions based on the "safety in numbers" hypothesis.
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Affiliation(s)
- Jae Seung Lee
- Hongik University, School of Urban and Civil Engineering, 94 Wausan-ro, K310, Mapo-gu, Seoul, 121-791, Republic of Korea.
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Rosso AL, Grubesic TH, Auchincloss AH, Tabb LP, Michael YL. Neighborhood amenities and mobility in older adults. Am J Epidemiol 2013; 178:761-9. [PMID: 23666814 DOI: 10.1093/aje/kwt032] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Diversity of neighborhood amenities may promote the mobility of older adults. A 2010 community-based sample of 510 adults aged ≥65 years in Philadelphia, Pennsylvania, and geospatial data from the Esri Business Analyst database (Esri, Inc., Redlands, California) were used to assess associations of neighborhood amenity diversity with mobility. Neighborhoods were defined by census tract, and diversity of amenities was derived by using the Leadership in Energy and Environmental Design's neighborhood development index (US Green Building Council, Washington, DC). Generalized estimating equations adjusted for demographic, socioeconomic, and neighborhood characteristics were used to estimate differences in mobility score by tertile of amenity diversity. Analyses were stratified by participants' routine travel habits (stayed at home, stayed in home zip code, or traveled beyond home zip code). We found that for those who spent most of their time in their home neighborhoods, mobility scores (from the Life-Space Assessment, which ranges from 0 to 104 points) were 8.3 points higher (95% confidence interval: 0.1, 16.6) among those who lived in neighborhoods with the most amenity diversity compared with those who lived in neighborhoods with the least amenity diversity. No significant associations between amenity diversity and mobility were observed for those who did not leave home or who regularly traveled outside their neighborhoods. Neighborhoods with a high diversity of amenities may be important promoters of mobility in older adults who do not routinely travel outside their neighborhoods.
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Affiliation(s)
- Andrea L Rosso
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
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Hunter RH, Anderson LA, Belza B, Bodiford K, Hooker SP, Kochtitzky CS, Marquez DX, Satariano WA. Environments for healthy aging: linking prevention research and public health practice. Prev Chronic Dis 2013; 10:E55. [PMID: 23597393 PMCID: PMC3640693 DOI: 10.5888/pcd10.120244] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Safe and well-designed community environments support healthful behaviors that help prevent chronic conditions and unintentional injuries and enable older adults to be active and engaged in community life for as long as possible. We describe the work of the Healthy Aging Research Network (HAN) and partners over the past decade to better understand place-based determinants of health and translate that knowledge to real-world practice, with a focus on environmental strategies. Using key components of the Knowledge to Action framework, we document the importance of a sustained, multidisciplinary, collaborative approach and ongoing interaction between researchers and communities. We share examples of practical tools and strategies designed to engage and support critical sectors with the potential to enhance the health and well-being of older adults and their communities. We conclude with a description of lessons learned in facilitating the translation of prevention research into practice.
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Affiliation(s)
- Rebecca H Hunter
- Center for Health Promotion and Disease Prevention, University of North Carolina, 228 Indian Trail Rd, Chapel Hill, NC 27514, USA.
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Lehning AJ, Smith RJ, Dunkle RE. Do age-friendly characteristics influence the expectation to age in place? A comparison of low-income and higher income Detroit elders. J Appl Gerontol 2013; 34:158-80. [PMID: 24652879 DOI: 10.1177/0733464813483210] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Currently there is limited evidence linking age-friendly characteristics to outcomes in elders. Using a representative sample of 1,376 adults aged 60 and older living in Detroit, this study examined the association between age-friendly social and physical environmental characteristics and the expectation to age in place, and the potential differences between low- and higher-income elders. Based on U.S. Environmental Protection Agency's (EPA) age-friendly guide, we identified six factors reflecting age-friendly characteristics. Logistic regression models indicated that regardless of income level only neighborhood problems were significantly associated with expecting to age in place. Low-income elders were more likely to expect to age in place than their higher-income counterparts, and it is unclear whether this resulted from a desire to remain in the home or that there is no place else to go. Future research should address the ways in which financial resources affect the choices, expectations, and outcomes of aging in place.
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Determinants of neighborhood activity of adults age 70 and over: a mixed-methods study. J Aging Phys Act 2013; 20:148-70. [PMID: 22472577 DOI: 10.1123/japa.20.2.148] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND This mixed-methods study investigated personal, interpersonal, and environmental factors salient to decisions about being active in neighborhoods of different levels of deprivation. METHODS Twenty-five participants age 70 years and older (10 women) with diverse physical activity levels provided data on their weekly activity patterns (using accelerometry) and their perceived barriers to exercise (questionnaire). They also participated in semistructured individual interviews exploring the barriers and facilitators influencing neighborhood activity. RESULTS Functional limitations, lack of intrinsic motivation, and not having an activity companion were the highest impact barriers. Walkable access to amenities, positive physical activity perceptions, and existing habit of being active were the highest impact facilitators. CONCLUSIONS The perceived quality and accessibility of the built and natural environments influence neighborhood activity in older adults. However, this relationship might be altered through the influence of personal and interpersonal determinants such as maintenance of good health and functional ability and supportive social networks.
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Smith RJ, Lehning AJ, Dunkle RE. Conceptualizing age-friendly community characteristics in a sample of urban elders: an exploratory factor analysis. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2013; 56:90-111. [PMID: 23350565 PMCID: PMC5731635 DOI: 10.1080/01634372.2012.739267] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Accurate conceptualization and measurement of age-friendly community characteristics would help to reduce barriers to documenting the effects on elders of interventions to create such communities. This article contributes to the measurement of age-friendly communities through an exploratory factor analysis of items reflecting an existing US Environmental Protection Agency policy framework. From a sample of urban elders (n = 1,376), we identified 6 factors associated with demographic and health characteristics: access to business and leisure, social interaction, access to health care, neighborhood problems, social support, and community engagement. Future research should explore the effects of these factors across contexts and populations.
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Affiliation(s)
- Richard J Smith
- School of Social Work, Wayne State University, Detroit, MI 48202, USA.
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57
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Hernandez R, Prohaska TR, Wang PC, Sarkisian CA. The longitudinal relationship between depression and walking behavior in older Latinos: The "¡Caminemos!" study. J Aging Health 2012; 25:319-41. [PMID: 23264440 DOI: 10.1177/0898264312468488] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study sought to evaluate the relationship between baseline depression and prospective engagement in walking and exercise behavior after enrollment in an exercise intervention. METHODS The study used baseline, 1-month, 12-month, and 24-month in-person interview and pedometer data collected from Latinos aged >60 years participating in an exercise intervention (¡Caminemos!) at 27 senior centers (n = 572). RESULTS After joining an exercise intervention, and when using continuous pedometer data and scores from the Yale Physical Activity Survey (YPAS) as the outcomes of interest, older adults with baseline depression exhibited comparable levels of physical activity across time when compared to their nondepressed counterparts. Significant difference in physical activity levels between the depressed and nondepressed subgroups no longer existed within one month of initiating the exercise intervention. DISCUSSION Among sedentary older Latino adults, having depression may not delay exercise initiation nor does it appear to prevent achievement or maintenance of an exercise program.
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Affiliation(s)
- Rosalba Hernandez
- Northwestern Feinberg School of Medicine, Department of Preventive Medicine, Chicago, IL 60611, USA.
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Abstract
While a number of organizations and government entities have encouraged the development of more “age-friendly” environments, to date there has been limited research linking these environment features to elder outcomes. Using a representative sample of older adults living in Detroit, this study examined the association between age-friendly environment factors and self-rated health. Results indicated that access to health care, social support, and community engagement were each associated with better self-rated health, while neighborhood problems were associated with poorer self-rated health. Moreover, individual-level income and education no longer predicted self-rated health once age-friendly environment factors were taken into account. These findings highlight the need for more research documenting the effects of age-friendly environments, particularly across diverse contexts and populations.
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Nathan A, Pereira G, Foster S, Hooper P, Saarloos D, Giles-Corti B. Access to commercial destinations within the neighbourhood and walking among Australian older adults. Int J Behav Nutr Phys Act 2012; 9:133. [PMID: 23164357 PMCID: PMC3538606 DOI: 10.1186/1479-5868-9-133] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 11/13/2012] [Indexed: 01/07/2023] Open
Abstract
Background Physical activity, particularly walking, is greatly beneficial to health; yet a sizeable proportion of older adults are insufficiently active. The importance of built environment attributes for walking is known, but few studies of older adults have examined neighbourhood destinations and none have investigated access to specific, objectively-measured commercial destinations and walking. Methods We undertook a secondary analysis of data from the Western Australian state government’s health surveillance survey for those aged 65–84 years and living in the Perth metropolitan region from 2003–2009 (n = 2,918). Individual-level road network service areas were generated at 400 m and 800 m distances, and the presence or absence of six commercial destination types within the neighbourhood service areas identified (food retail, general retail, medical care services, financial services, general services, and social infrastructure). Adjusted logistic regression models examined access to and mix of commercial destination types within neighbourhoods for associations with self-reported walking behaviour. Results On average, the sample was aged 72.9 years (SD = 5.4), and was predominantly female (55.9%) and married (62.0%). Overall, 66.2% reported some weekly walking and 30.8% reported sufficient walking (≥150 min/week). Older adults with access to general services within 400 m (OR = 1.33, 95% CI = 1.07-1.66) and 800 m (OR = 1.20, 95% CI = 1.02-1.42), and social infrastructure within 800 m (OR = 1.19, 95% CI = 1.01-1.40) were more likely to engage in some weekly walking. Access to medical care services within 400 m (OR = 0.77, 95% CI = 0.63-0.93) and 800 m (OR = 0.83, 95% CI = 0.70-0.99) reduced the odds of sufficient walking. Access to food retail, general retail, financial services, and the mix of commercial destination types within the neighbourhood were all unrelated to walking. Conclusions The types of neighbourhood commercial destinations that encourage older adults to walk appear to differ slightly from those reported for adult samples. Destinations that facilitate more social interaction, for example eating at a restaurant or church involvement, or provide opportunities for some incidental social contact, for example visiting the pharmacy or hairdresser, were the strongest predictors for walking among seniors in this study. This underscores the importance of planning neighbourhoods with proximate access to social infrastructure, and highlights the need to create residential environments that support activity across the life course.
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Affiliation(s)
- Andrea Nathan
- Centre for the Built Environment and Health, School of Population Health, The University of Western Australia, Crawley, Australia.
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60
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Gallagher NA, Clarke PJ, Ronis DL, Cherry CL, Nyquist L, Gretebeck KA. Influences on neighborhood walking in older adults. Res Gerontol Nurs 2012; 5:238-50. [PMID: 22998660 DOI: 10.3928/19404921-20120906-05] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Accepted: 12/16/2011] [Indexed: 11/20/2022]
Abstract
The purpose of this cross-sectional survey study was to examine the influence of self-efficacy, outcome expectations, and environment on neighborhood walking in older adults with (n = 163, mean age = 78.7, SD = 7.96 years) and without (n = 163, mean age = 73.6, SD = 7.93 years) mobility limitations, controlling for demographic characteristics. Multiple regression revealed that in mobility-limited older adults, demographic characteristics, self-efficacy, and outcome expectations explained 17.4% of variance in neighborhood walking, while environment (neighborhood destinations and design) explained 9.4%. Destinations, self-efficacy, sex, and outcome expectations influenced walking. In those without mobility limitations, demographic characteristics, self-efficacy, and outcome expectations explained 15.6% of the variance, while environment explained 5.6%. Self-efficacy, sex, and design influenced walking. Neighborhood walking interventions for older adults should include self-efficacy strategies tailored to mobility status and neighborhood characteristics.
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Affiliation(s)
- Nancy A Gallagher
- College of Nursing, Michigan State University, East Lansing, MI, USA.
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Satariano WA, Guralnik JM, Jackson RJ, Marottoli RA, Phelan EA, Prohaska TR. Mobility and aging: new directions for public health action. Am J Public Health 2012; 102:1508-15. [PMID: 22698013 PMCID: PMC3464831 DOI: 10.2105/ajph.2011.300631] [Citation(s) in RCA: 207] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2011] [Indexed: 11/04/2022]
Abstract
Optimal mobility, defined as relative ease and freedom of movement in all of its forms, is central to healthy aging. Mobility is a significant consideration for research, practice, and policy in aging and public health. We examined the public health burdens of mobility disability, with a particular focus on leading public health interventions to enhance walking and driving, and the challenges and opportunities for public health action. We propose an integrated mobility agenda, which draws on the lived experience of older adults. New strategies for research, practice, and policy are needed to move beyond categorical promotion programs in walking and driving to establish a comprehensive program to enhance safe mobility in all its forms.
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Affiliation(s)
- William A Satariano
- School of Public Health, University of California, Berkeley, Berkeley, CA 94720, USA.
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Yen IH, Anderson LA. Built environment and mobility of older adults: important policy and practice efforts. J Am Geriatr Soc 2012; 60:951-6. [PMID: 22568533 DOI: 10.1111/j.1532-5415.2012.03949.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
As people age, they prefer to "age in place." The concept of aging in place refers to the ability to live in one's own home, wherever that might be, for as long as one can feel confident and comfortable. Where people live and whether these environments can support them are critical questions for public health and public policy, especially since the baby boomers began to turn 65 on January 1, 2011. Equally important for public policy, those aged 85 and older are the fastest growing population group in the United States. The Health and Aging Policy Fellows Program, with the Centers for Disease Control and Prevention Healthy Aging Program, has supported a project to determine how design features of the built environment can support the mobility of older adults. Mobility refers to physical activity, usually walking, but also encompasses the ability to stay connected to nearby community resources and services. The project's purpose is to investigate features that support mobility in built environments. This policy brief introduces the realist synthesis method used in the project and selected national initiatives and activities to place this work in a broader context. Given the importance of mobility concerns to older adults, it must be determined without delay which design features support mobility and how local areas can better prepare to support the health of their aging populations.
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Affiliation(s)
- Irene H Yen
- Department of Medicine, University of California at San Francisco, San Francisco, California 94118, USA.
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Mullen SP, McAuley E, Satariano WA, Kealey M, Prohaska TR. Physical activity and functional limitations in older adults: the influence of self-efficacy and functional performance. J Gerontol B Psychol Sci Soc Sci 2012; 67:354-61. [PMID: 22473023 PMCID: PMC3410698 DOI: 10.1093/geronb/gbs036] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Accepted: 02/15/2012] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Data from the Healthy Aging Network (HAN) study (Prohaska, T., Eisenstein, A., Satariano, W., Hunter, R., Bayles, C., Kurtovich, E., … Ivey, S. [2009]. Walking and the preservation of cognitive function in older populations. The Gerontologist, 49[Suppl. 1], S86-S93; and Satariano, W., Ivey, S., Kurtovich, E., Kealey, M., Hubbard, A., Bayles, C., … Prohaska, T. [2010]. Lower-body function, neighborhoods, and walking in an older population. American Journal of Preventive Medicine, 38, 419-428.) were used to examine the relationships among physical activity, self-efficacy, functional performance, and limitations. METHOD Interviews were conducted within homes and senior centers in 4 geographic regions across the United States. Participants were 884 older adults (M age = 74.8; 77% female; 35% minority status) who completed measures of walking behavior, way-finding self-efficacy, walking self-efficacy, functional performance, functional limitations, and demographic characteristics. RESULTS Path analysis within a covariance modeling framework revealed significant direct effects of walking on self-efficacy constructs, functional performance on functional limitations, and efficacy on limitations. Additionally, significant indirect effects were also found, including walking on limitations via walking self-efficacy and performance and walking self-efficacy on limitations via performance. Furthermore, we found support for invariance of the model across geographical grouping. DISCUSSION Our findings provide further validation for an efficacy-based model of functional limitations. Walking-related efficacy may help reduce or possibly delay the onset of functional limitations.
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Affiliation(s)
- Sean P. Mullen
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign
| | - William A. Satariano
- Epidemiology Division, School of Public Health, University of California at Berkeley
| | - Melissa Kealey
- Epidemiology Division, School of Public Health, University of California at Berkeley
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Konagaya Y, Watanabe T, Ohta T. [Relationship between cognitive function and physical activities: a longitudinal study among community-dwelling elderly]. Nihon Ronen Igakkai Zasshi 2012; 49:752-759. [PMID: 23883640 DOI: 10.3143/geriatrics.49.752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM The purpose of this study was to evaluate whether physical activities reduce the risk of cognitive decline in community-dwelling elderly. We investigated correlations between cognitive functions at baseline and physical activities, correlations between cognitive functions at baseline and cognitive decline over 4 years, as well as correlations between physical activity at baseline and cognitive decline over 4 years. METHODS At baseline, 2,431 community-dwelling elderly completed the cognitive screening by telephone (TICS-J), and answered the questionnaires about physical activities. Of these, 1,040 subjects again completed the TICS-J over 4 years. Physical activities contained moving ability, walking frequency, walking speed, the exercise frequency. RESULTS At baseline, 870 elderly (age 75.87±4.96 (mean±SD) years, duration of education 11.05±2.41) showed normal cognitive functions and 170 (79.19±6.22, 9.61±2.23) showed cognitive impairment. The total TICS-J score was significantly higher in cognitive normal subjects compared with that of cognitive impaired subjects (36.02±1.89, 30.19±2.25, respectively, p<0.001). Logistic regression analyses showed that moving ability significantly reduced the risk of cognitive impairment in an unadjusted model, and walking speed also reduced the risk of cognitive impairment at baseline even in an adjusted model. Cognitive function at baseline might be a predictor of cognitive function over 4 years. The longitudinal study revealed that walking speed and exercise frequency significantly correlate with maintenance of cognitive function over 4 years. CONCLUSIONS This study provides that physical activities, especially walking speed have significant correlation with cognitive function.
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Affiliation(s)
- Yoko Konagaya
- Division of Research, Obu Dementia Care Research and Training Center
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Validation of walk score for estimating neighborhood walkability: an analysis of four US metropolitan areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 8:4160-79. [PMID: 22163200 PMCID: PMC3228564 DOI: 10.3390/ijerph8114160] [Citation(s) in RCA: 205] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 10/27/2011] [Accepted: 11/01/2011] [Indexed: 11/18/2022]
Abstract
Neighborhood walkability can influence physical activity. We evaluated the validity of Walk Score® for assessing neighborhood walkability based on GIS (objective) indicators of neighborhood walkability with addresses from four US metropolitan areas with several street network buffer distances (i.e., 400-, 800-, and 1,600-meters). Address data come from the YMCA-Harvard After School Food and Fitness Project, an obesity prevention intervention involving children aged 5–11 years and their families participating in YMCA-administered, after-school programs located in four geographically diverse metropolitan areas in the US (n = 733). GIS data were used to measure multiple objective indicators of neighborhood walkability. Walk Scores were also obtained for the participant’s residential addresses. Spearman correlations between Walk Scores and the GIS neighborhood walkability indicators were calculated as well as Spearman correlations accounting for spatial autocorrelation. There were many significant moderate correlations between Walk Scores and the GIS neighborhood walkability indicators such as density of retail destinations and intersection density (p < 0.05). The magnitude varied by the GIS indicator of neighborhood walkability. Correlations generally became stronger with a larger spatial scale, and there were some geographic differences. Walk Score® is free and publicly available for public health researchers and practitioners. Results from our study suggest that Walk Score® is a valid measure of estimating certain aspects of neighborhood walkability, particularly at the 1600-meter buffer. As such, our study confirms and extends the generalizability of previous findings demonstrating that Walk Score is a valid measure of estimating neighborhood walkability in multiple geographic locations and at multiple spatial scales.
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Michael YL, Gold R, Perrin NA, Hillier TA. Built environment and lower extremity physical performance: prospective findings from the study of osteoporotic fractures in women. J Aging Health 2011; 23:1246-62. [PMID: 21724965 DOI: 10.1177/0898264311412597] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We examined the association between walkability of the built environment and changes in physical performance among women aged 65 or older (n = 1,671, 253 neighborhoods). METHOD Street connectivity and street density, markers for neighborhood walkability, were assessed through linkage to secondary data sources. Physical performance was measured with timed-walk and chair-stand tests assessed during follow-up visits about every 2 years for 12 to 14 years. Multilevel models predicted change in physical performance, controlling for age, number of incident comorbidities, self-rated health, and death during follow-up. RESULTS Overall, physical performance declined during follow-up (p < .001). Neighborhood walkability had no effect on change in physical performance among women who reported not walking at baseline. However, among women who walked, greater neighborhood walkability was associated with a slower decline in dynamic leg strength, indicated by score on chair stand. DISCUSSION Neighborhood walkability may protect against decline in physical performance.
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Affiliation(s)
- Yvonne L Michael
- Drexel University School of Public Health, Department of Epidemiology and Biostatistics, Philadelphia, PA19102, USA.
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Rosso AL, Auchincloss AH, Michael YL. The urban built environment and mobility in older adults: a comprehensive review. J Aging Res 2011; 2011:816106. [PMID: 21766033 PMCID: PMC3134204 DOI: 10.4061/2011/816106] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Accepted: 05/03/2011] [Indexed: 11/20/2022] Open
Abstract
Mobility restrictions in older adults are common and increase the likelihood of negative health outcomes and premature mortality. The effect of built environment on mobility in older populations, among whom environmental effects may be strongest, is the focus of a growing body of the literature. We reviewed recent research (1990-2010) that examined associations of objective measures of the built environment with mobility and disability in adults aged 60 years or older. Seventeen empirical articles were identified. The existing literature suggests that mobility is associated with higher street connectivity leading to shorter pedestrian distances, street and traffic conditions such as safety measures, and proximity to destinations such as retail establishments, parks, and green spaces. Existing research is limited by differences in exposure and outcome assessments and use of cross-sectional study designs. This research could lead to policy interventions that allow older adults to live more healthy and active lives in their communities.
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Affiliation(s)
- Andrea L Rosso
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, 1505 Race Street, Mail Stop 1033, Bellet 6th Floor, Philadelphia, PA 19102, USA
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Eisenstein AR, Prohaska TR, Kruger J, Satariano WA, Hooker S, Buchner D, Kealey M, Hunter RH. Environmental correlates of overweight and obesity in community residing older adults. J Aging Health 2011; 23:994-1009. [PMID: 21508306 DOI: 10.1177/0898264311404557] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study examines the role of environmental correlates of overweight and obesity among older adults independent of walking activity and lower body function. METHODS In-person interviews were conducted with 789 adults aged 65 and older, residing in four areas in the U.S. Demographic information, general health, lower body function, walking behavior, and awareness of environmental infrastructure features using the modified Neighborhood Environment Walking Survey (NEWS) were obtained. Regression analyses examined the association between Body Mass Index (BMI) and environmental infrastructure features, adjusting for demographics and lower body function. RESULTS Older adults who perceived their neighborhood as less safe from crime and had reduced access to services were more likely to have higher BMI. Controlling for demographic and functional characteristics, access to services remained significant. This association remained significant for those with lower functional status. DISCUSSION This research suggests that neighborhood environment may have an influence on BMI above and beyond walking activity.
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