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Wu J, Li C, Zhu L, Liu X, Peng B, Wang T, Yuan S, Zhang Y. Nonlinear and threshold effects of built environment on older adults' walking duration: do age and retirement status matter? Front Public Health 2024; 12:1418733. [PMID: 39005992 PMCID: PMC11239551 DOI: 10.3389/fpubh.2024.1418733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 06/17/2024] [Indexed: 07/16/2024] Open
Abstract
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.
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Affiliation(s)
- Jiani Wu
- State Key Laboratory of Ocean Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Chaoyang Li
- State Key Laboratory of Ocean Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Li Zhu
- JSTI Group, Nanjing, China
| | - Xiaofei Liu
- Key Laboratory of Advanced Public Transportation Science, China Academy of Transportation Sciences, Ministry of Transport, Beijing, China
| | - Bozhezi Peng
- State Key Laboratory of Ocean Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Tao Wang
- State Key Laboratory of Ocean Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Shengqiang Yuan
- Shanghai Municipal Engineering Design Institute (Group) Co., Ltd., Shanghai, China
| | - Yi Zhang
- State Key Laboratory of Ocean Engineering, Shanghai Jiao Tong University, Shanghai, China
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
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Kalu ME, Bello-Haas VD, Griffin M, Boamah S, Harris J, Zaide M, Rayner D, Khattab N, Abrahim S. A Scoping Review of Personal, Financial, and Environmental Determinants of Mobility Among Older Adults. Arch Phys Med Rehabil 2023; 104:2147-2168. [PMID: 37119957 DOI: 10.1016/j.apmr.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To synthesize available evidence of factors comprising the personal, financial, and environmental mobility determinants and their association with older adults' self-reported and performance-based mobility outcomes. DATA SOURCES PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Sociological Abstract, Allied and Complementary Medicine Database, and Cumulative Index to Nursing and Allied Health Literature databases search for articles published from January 2000 to December 2021. STUDY SECTION Using predefined inclusion and exclusion criteria, multiple reviewers independently screened 27,293 retrieved citations from databases, of which 422 articles underwent full-text screening, and 300 articles were extracted. DATA EXTRACTION The 300 articles' information, including study design, sample characteristics including sample size, mean age and sex, factors within each determinant, and their associations with mobility outcomes, were extracted. DATA SYNTHESIS Because of the heterogeneity of the reported associations, we followed Barnett et al's study protocol and reported associations between factors and mobility outcomes by analyses rather than by article to account for multiple associations generated in 1 article. Qualitative data were synthesized using content analysis. A total of 300 articles were included with 269 quantitative, 22 qualitative, and 9 mixed-method articles representing personal (n=80), and financial (n=1), environmental (n=98), more than 1 factor (n=121). The 278 quantitative and mixed-method articles reported 1270 analyses; 596 (46.9%) were positively and 220 (17.3%) were negatively associated with mobility outcomes among older adults. Personal (65.2%), financial (64.6%), and environmental factors (62.9%) were associated with mobility outcomes, mainly in the expected direction with few exceptions in environmental factors. CONCLUSIONS Gaps exist in understanding the effect of some environmental factors (eg, number and type of street connections) and the role of gender on older adults' walking outcomes. We have provided a comprehensive list of factors with each determinant, allowing the creation of core outcome set for a specific context, population, or other forms of mobility, for example, driving.
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Affiliation(s)
- Michael E Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Canada
| | - Sheila Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
| | - Salma Abrahim
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
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Akinci ZS, Delclòs-Alió X, Vich G, Salvo D, Ibarluzea J, Miralles-Guasch C. How different are objective operationalizations of walkability for older adults compared to the general population? A systematic review. BMC Geriatr 2022; 22:673. [PMID: 35971086 PMCID: PMC9377138 DOI: 10.1186/s12877-022-03233-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 06/09/2022] [Indexed: 01/10/2023] Open
Abstract
Background Walking is an essential activity for everyone and for older adults in particular, given that it is the most accessible form of physical activity and one of the healthiest transportation modes. Understanding how walkability (the potential of the environment to enable and/or encourage walking) has been objectively measured and analyzed for older adults is critical to create more inclusive, healthy, and sustainable environments and to promote healthy aging. Despite the numerous reviews on physical activity among older adults and its relationship with the built environment, the literature still lacks comparison reviews focusing specifically on objective operationalizations of walkability for older adults vs. the general population. Methods We conducted a systematic review of 146 empirical studies that measured walkability objectively in relation to walking-related outcomes. We compared studies focused on older adults (n = 24) and the general population (n = 122). Content analysis included the characteristics of the study design, walkability measures, spatial extent, and associations found between walkability and walking-related outcomes. Results In both groups of publications, the majority of studies were conducted in the US, Canada, and Europe, and largely in high-income countries. They were mostly published in health-related journals and used cross-sectional designs, operationalized walkability by using indexes, employed self-reported measures for walking-related outcomes, and found positive associations between walkability and walking outcomes. However, we observed some differences among studies focusing on older adults. Compared to studies focusing on the general population, a larger proportion of studies on older adults was conducted in the Middle East and Asia, and they used longitudinal designs, mixed methods to measure walking-related outcomes, variables related with land-use characteristics, safety from traffic and crime, and greenery, and a larger proportion found positive, as well as no associations between walkability and walking-related outcomes. Conclusion Although there is a promising increase in interest in older adults-focused walkability studies in the last decade, there is still a need for more studies focusing on different settings, using wider spatial extents, longitudinal designs, objective or mixed methods to collect outcome data, and specific variables and/or specially created indexes for older adults and for settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03233-x.
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Affiliation(s)
- Zeynep S Akinci
- Grup d'Estudis en Mobilitat, Transport i Territori (GEMOTT), Departament de Geografia, Universitat Autònoma de Barcelona, Edifici B, Campus de Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain.
| | - Xavier Delclòs-Alió
- Grup de Recerca en Anàlisi Territorial i Estudis Turístics (GRATET), Departament de Geografia, Universitat Rovira i Virgili, Vila-seca, Spain
| | - Guillem Vich
- Grup d'Estudis en Mobilitat, Transport i Territori (GEMOTT), Departament de Geografia, Universitat Autònoma de Barcelona, Edifici B, Campus de Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain.,ISGlobal (Barcelona Institute for Global Health), Doctor Aiguader, 88, 08003, Barcelona, Spain
| | - Deborah Salvo
- People, Health and Place Unit; Prevention Research Center in St. Louis; Brown School; Washington University in St Louis , St. Louis, Missouri, USA
| | - Jesús Ibarluzea
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013, San Sebastian, Spain.,Faculty of Psychology of the University of the Basque Country, 20018, San Sebastian, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain.,Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain
| | - Carme Miralles-Guasch
- Grup d'Estudis en Mobilitat, Transport i Territori (GEMOTT), Departament de Geografia, Universitat Autònoma de Barcelona, Edifici B, Campus de Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain.,Institut de Ciència i Tecnologia Ambientals (ICTA), Universitat Autònoma de Barcelona - Edifici ICTA-ICP, Campus de Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain
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Census-Based Variables Are Informative about Subjective Neighborhood Relations, but Only When Adjusted for Residents’ Neighborhood Conceptions. SUSTAINABILITY 2022. [DOI: 10.3390/su14084434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Subjective neighborhood perceptions (such as attachment or satisfaction) have been linked to demographic factors and self-reported living conditions. There has been less success to include census-based variables. One explanation is the frequent a priori application of rigid neighborhood definitions. We assessed subjective neighborhood relations, demographic information, and self-defined neighborhoods via a postcard-based, participatory GIS approach. We linked several census-based variables (e.g., the proportion of seniors or the average members per household) to four different neighborhood definitions. We found that census-based variables allowed no prediction of neighborhood relations when adjusted to statistical districts, and a limited prediction when adjusted to two different-sized buffers. We found the best prediction of neighborhood relations through census-based variables when they were adjusted to self-defined neighborhoods. Larger households, fewer households per building, and a higher proportion of seniors benefited neighborhood relations. Our findings underline the importance of adjusting the definition of ‘neighborhood’ to that of the residents when studying neighborhood attachment or sense of community.
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Exercise Improves Cognitive Function-A Randomized Trial on the Effects of Physical Activity on Cognition in Type 2 Diabetes Patients. J Pers Med 2021; 11:jpm11060530. [PMID: 34207584 PMCID: PMC8229798 DOI: 10.3390/jpm11060530] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/06/2021] [Accepted: 06/07/2021] [Indexed: 01/03/2023] Open
Abstract
Background: Lifestyle habits strongly influence health. It is strongly believed that physical activity may improve cognitive function. We examined the association between two kinds of physical activity and cognitive function in patients with type 2 diabetes. Methods: Using a random allocation sequence, 49 patients with type 2 diabetes (metformin, insulin, and diet-controlled) were randomized to a 12-week intervention of either walking 40 min three times a week (n = 17), performing pedometer-controlled activity (E-health, goal 10,000 steps a day, n = 17), or receiving standard care (n = 16 controls). We prospectively examined cognitive function, metabolic parameters, height, and weight. The groups were compared using linear regression adjusted for age. Results: Compared with the control group (n = 16), nonverbal memory improved significantly after the intervention in the walking group (n = 16) (28.2 (+/−6.1) vs. 35.3 (+/−5.3) p < 0.001) and the E-health (pedometer) group ((n = 17) (29.7 (+/−3.9) vs. 35.6 (+/−3.8) p < 0.001). The verbal memory test showed improvement in the walking and E-health groups. Cognitive attention/performance measured by the FAIR-test was also significantly enhanced in the walking group (252.4/304.3 p < 0.001, 51.87 (CI 27.13–76.62)) and the E-health-group (85.65 (CI: 52.04–119.26, p < 0.001)). Abdominal circumference (−3 cm (CI: −9.69–3.31, p < 0.001)), heart rate (−6.50 (CI: −9.69, −3.31, p < 0.001)) and fat percentage (−2.74 (CI: −4.71, −0.76, p < 0.007)) changed significantly in only the walking group. Conclusions: This is the first intervention study in patients with type 2 diabetes that shows that pedometer-supported training significantly improves brain function. Walking additionally improves body composition and waist circumference. Physical activity is an inexpensive treatment with substantial preventative and restorative properties for cognitive and memory brain function in patients with type 2 diabetes.
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Peters M, Muellmann S, Christianson L, Stalling I, Bammann K, Drell C, Forberger S. Measuring the association of objective and perceived neighborhood environment with physical activity in older adults: challenges and implications from a systematic review. Int J Health Geogr 2020; 19:47. [PMID: 33168094 PMCID: PMC7654613 DOI: 10.1186/s12942-020-00243-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/30/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND A supportive environment is a key factor in addressing the issue of health among older adults. There is already sufficient evidence that objective and self-reported measures of the neighborhood environment should be taken into account as crucial components of active aging, as they have been shown to influence physical activity; particularly in people aged 60+. Thus, both could inform policies and practices that promote successful aging in place. An increasing number of studies meanwhile consider these exposures in analyzing their impact on physical activity in the elderly. However, there is a wide variety of definitions, measurements and methodological approaches, which complicates the process of obtaining comparable estimates of the effects and pooled results. The aim of this review was to identify and summarize these differences in order to emphasize methodological implications for future reviews and meta analyzes in this field and, thus, to create a sound basis for synthesized evidence. METHODS A systematic literature search across eight databases was conducted to identify peer-reviewed articles examining the association of objective and perceived measures of the neighborhood environment and objectively measured or self-reported physical activity in adults aged ≥ 60 years. Two authors independently screened the articles according to predefined eligibility criteria, extracted data, and assessed study quality. A qualitative synthesis of the findings is provided. RESULTS Of the 2967 records retrieved, 35 studies met the inclusion criteria. Five categories of methodological approaches, numerous measurement instruments to assess the neighborhood environment and physical activity, as well as several clusters of definitions of neighborhood, were identified. CONCLUSIONS The strength of evidence of the associations of specific categories of environmental attributes with physical activity varies across measurement types of the outcome and exposures as well as the physical activity domain observed and the operationalization of neighborhood. The latter being of great importance for the targeted age group. In the light of this, future reviews should consider these variations and stratify their summaries according to the different approaches, measures and definitions. Further, underlying mechanisms should be explored.
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Affiliation(s)
- Manuela Peters
- Leibniz Institute for Prevention Research and Epidemiology–BIPS, Achterstraße 30, 28215 Bremen, Germany
- Faculty of Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Saskia Muellmann
- Leibniz Institute for Prevention Research and Epidemiology–BIPS, Achterstraße 30, 28215 Bremen, Germany
| | - Lara Christianson
- Leibniz Institute for Prevention Research and Epidemiology–BIPS, Achterstraße 30, 28215 Bremen, Germany
| | - Imke Stalling
- Institute for Public Health and Nursing Research (IPP), Working Group Epidemiology of Demographic Change, University of Bremen, Bremen, Germany
| | - Karin Bammann
- Institute for Public Health and Nursing Research (IPP), Working Group Epidemiology of Demographic Change, University of Bremen, Bremen, Germany
| | - Carina Drell
- Institute for Public Health and Nursing Research (IPP), Working Group Epidemiology of Demographic Change, University of Bremen, Bremen, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology–BIPS, Achterstraße 30, 28215 Bremen, Germany
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