Neighborhood Resources Associated With Active Travel in Older Adults-A Cohort Study in Six European Countries

Nonlinear and threshold effects of built environment on older adults' walking duration: do age and retirement status matter?

Introduction

Walking plays a crucial role in promoting physical activity among older adults. Understanding how the built environment influences older adults' walking behavior is vital for promoting physical activity and healthy aging. Among voluminous literature investigating the environmental correlates of walking behaviors of older adults, few have focused on walking duration across different age groups and life stages, let alone examined the potential nonlinearities and thresholds of the built environment.

Methods

This study employs travel diary from Zhongshan, China and the gradient boosting decision trees (GBDT) approach to disentangle the age and retirement status differences in the nonlinear and threshold effects of the built environment on older adults' walking duration.

Results

The results showed built environment attributes collectively contribute 57.37% for predicting older adults' walking duration, with a higher predicting power for the old-old (70+ years) or the retired. The most influencing built environment attribute for the young-old (60-70 years) is bus stop density, whereas the relative importance of population density, bus stop density, and accessibility to green space or commercial facilities is close for the old-old. The retired tend to walk longer in denser-populated neighborhoods with better bus service, but the non-retired are more active in walking in mixed-developed environments with accessible commercial facilities. The thresholds of bus stop density to encourage walking among the young-old is 7.8 counts/km2, comparing to 6 counts/km2 among the old-old. Regarding the green space accessibility, the effective range for the non-retired (4 to 30%) is smaller than that of the retired (12 to 45%).

Discussion

Overall, the findings provide nuanced and diverse interventions for creating walking-friendly neighborhoods to promote walking across different sub-groups of older adults.

Non-linear Relationships Between the Built Environment and Walking Frequency Among Older Adults in Zhongshan, China

Aim: Promoting walking activity is an effective way to improve the health of older adults. Walking frequency is a critical component of walking behavior and an essential determinant of daily walking levels. To decipher the association between the built environment and walking frequency among older adults, this study's aims are as follows: (1) to empirically test whether non-linear relationships between the two exist, and (2) to identify the thresholds of the built environment characteristics that promote walking.

Methods: The walking frequency of old adults was derived from the Zhongshan Household Travel Survey (ZHTS) in 2012. The sample size of old adults aged 60 or over was 4784 from 274 urban and rural neighborhoods. A semi-parametric generalized additive model (GAMM) is used to analyze the non-linear or non-monotonic relationships between the built environment and the walking frequency among older adults.

Results: We found that non-linear relationships exist among five out of the six built environment characteristics. Within certain thresholds, the population density, sidewalk density, bus stop density, land use mixture, and the percentage of green space are positively related to older adults' walking trips. Furthermore, the land use mixture and the percentage of green space show an inverse “V”-shaped relationship.

Conclusions: Built environment features can either support or hinder the walking frequency among older adults. The findings in the current study contribute to effective land use and transport policies for promoting active travel among older adults.

Associations of changes in neighbourhood walkability with changes in walking activity in older adults: a fixed effects analysis

Background

Supporting older adults to engage in physically active lifestyles requires supporting environments. Walkable environments may increase walking activity in older adults, but evidence for this subgroup is scarce, and longitudinal studies are lacking. This study therefore examined whether changes in neighbourhood walkability were associated with changes in walking activity in older adults, and whether this association differed by individual-level characteristics and by contextual conditions beyond the built environment.

Methods

Data from 668 participants (57.8–93.4 years at baseline) across three waves (2005/06, 2008/09 and 2011/12) of the Longitudinal Aging Study Amsterdam (LASA) were used. These individuals did not relocate during follow-up. Self-reported outdoor walking activity in minutes per week was assessed using the LASA Physical Activity Questionnaire. Composite exposure measures of neighbourhood walkability (range: 0 (low)-100 (high)) within 500-m Euclidean buffer zones around each participant’s residential address were constructed by combining objectively measured high-resolution Geographic Information System data on population density, retail and service destination density, land use mix, street connectivity, green space density, and sidewalk density. Fixed effects linear regression analyses were applied, adjusted for relevant time-varying confounders.

Results

Changes in neighbourhood walkability were not statistically significantly associated with changes in walking activity in older adults (β_500m = − 0.99, 95% CI = -6.17–4.20). The association of changes in neighbourhood walkability with changes in walking activity did not differ by any of the individual-level characteristics (i.e., age, sex, educational level, cognitive impairment, mobility disability, and season) and area-level characteristics (i.e., road traffic noise, air pollution, and socioeconomic status).

Conclusions

This study did not show evidence for an association between changes in neighbourhood walkability and changes in walking activity in older adults. If neighbourhood walkability and walking activity are causally linked, then changes in neighbourhood walkability between 2005/06 and 2011/12 might have been not substantial enough to produce meaningful changes in walking activity in older adults.

Neighborhood environment, social participation, and physical activity in older adults with lower limb osteoarthritis: A mediation analysis

Older adults with lower limb osteoarthritis (LLOA) are highly dependent on their physical and social environment for being physically active. Longitudinal data from 2286 older adults (M_age = 73.8 years; 50.3% female) in six European countries were analyzed using cross-lagged Structural Equation Modeling (SEM) and multi-group SEM. In cross-sectional analyses, neighborhood resources were associated with physical activity (r = 0.26;p < .001) and social participation (r = 0.13;p = .003). Physical activity at follow-up was associated with neighborhood resources, with this relationship mediated by social participation in people with LLOA (β = 0.018;p = .013). To promote future physical activity, opportunities to socially engage in neighborhoods need to be targeted primarily to people with LLOA.