Neighborhood Environmental Factors and Physical Activity Status among Rural Older Adults in Japan

Associations between physical activity and heart disease among middle-aged and older Chinese adults

Objective

To quantify the risk of heart diseases (HD) and determine the relationship between physical activity (PA) dimensions and HD among Chinese middle-aged and older individuals.

Methods

Using data from the China Health and Retirement Longitudinal Study (CHARLS, 2018), 16,927 participants were included in this study. Multivariate logistic regression was performed to determine the association between HD risk and PA dimensions, including volume, intensity, frequency, and duration. Restricted cubic spline analysis was conducted to assess the dose-response relationship between PA and HD risk.

Results

Compared to the least active participants, a low risk of HD was significantly associated with a higher PA volume. With regards to frequency, a lower HD risk was associated with performing vigorous PA except for 3-5 days/week. The frequency and duration of light as well as moderate PA had no significant associations with HD risk after adjusted by using covariates. A non-linear association was also noted, with increased PA being associated with decreased HD risk, with steeper reductions in HD risk at low activity levels than at high activity levels. There was a non-linear association between PA and HD risk in participants in male and aged older than 65 years.

Conclusions

An inverse non-linear dose-response association was detected between the total volume of PA and HD risk. As PA increased to 4,000 METs-min/week, HD risk in the overall population decreased by approximately 26%, while further increases in PA did not produce any further marked reduction in the risk. A vigorous intensity of PA was associated with a reduced risk of HD and is strongly recommended.

Factors associated with prefectural level physical activity in Japan: An ecological study

Background

Physical activity inequalities are an important global concern; nonetheless, few studies have comprehensively examined the association between physical activity inequalities and related factors. We aimed to explore factors associated with regional inequalities in physical activity in Japan.

Methods

We investigated the relationship of individual, psychological/behavioral, social, and built-environmental factors with the proportion of individuals with exercise habits across Japanese prefectures. We sourced data from open databases, including the Japanese National Health Insurance Claims and Nationwide Screening Program Database. We defined exercise habits as engaging in at least 30 min of moderate exercise at least twice a week. We employed multiple regression analysis to identify factors associated with prefectural level physical activity.

Results

The median proportion of individuals with exercise habits was 27% (interquartile range, 25-29). Higher frequency of exercise habits was associated with higher frequency of history of exercise (coefficients, 0.60; 95% confidence interval, 0.41-0.80) and lower proportion of female gender (coefficients, -1.74; 95% confidence interval, -2.80 to -0.69).

Conclusions

Exercise history and female gender may be related to prefectural level physical activity in Japan. Physical activity interventions should be promoted among women without exercise history.

Sedentary behaviour among older adults residing in flat and hilly neighbourhoods and its association with frailty and chronic disease status

BACKGROUND

Living in hilly neighbourhoods can be associated with sedentary behaviour, but no study has compared sedentary behaviour and its associations with frailty, chronic diseases, and poor health between flat and hilly neighbourhoods among older adults. This study, therefore, compared older adults' sedentary behaviour and its association with frailty, poor health, and chronic disease status between low and hilly neighbourhoods.

METHODS

This study utilised a STROBE-compliant cross-sectional design with sensitivity analyses and a common methods bias assessment. The participants were 1,209 people aged 50+ years who resided in flat (Ablekuma North, n = 704) and hilly (Kwahu East, n = 505) neighbourhoods in Ghana. The data were analysed with the independent samples t-test and hierarchical linear regression.

RESULTS

Older adults in the hilly neighbourhood were more sedentary than those in the flat neighbourhood. The association between sedentary behaviour and chronic disease status was significant in both neighbourhoods, but this relationship was stronger in the hilly neighbourhood. Older adults in the flat neighbourhood reported lower sedentary behaviour at higher frailty (β = -0.18; t = -3.2, p < 0.001), but those in the hilly neighbourhood reported higher sedentary behaviour at higher frailty (β = 0.16; t = 3.54, p < 0.001).

CONCLUSIONS

Older adults living in the hilly neighbourhood reported higher sedentary behaviour. In the hilly neighbourhood, sedentary behaviour was more strongly associated with frailty and chronic disease status. Older adults in hilly neighbourhoods may need extra support to avoid sedentary behaviour.

The relationship of single-family detached house prices with neighborhood walkability and disaster risk

People's preferences regarding their neighborhood environment can vary depending on their socioeconomic status and the cities where they live. This study aims to discern the relationship between neighborhood environment factors and single-family detached house sales by sale price and by central and noncentral cities. We analyzed sale prices in the Tokyo Metropolitan Area from 2015 to 2020. The neighborhood environment was assessed using flood/sediment risk and neighborhood walkability measured by net residential density, intersection density, and facility density (walking opportunity). Flood and sediment risk is a major concern that restricts the available land and is included as a negative aspect of the neighborhood environment, taking the topographic features into consideration. A comparison of the results showed that the preference for neighborhood walkability varies by socioeconomic status as well as by target cities. For most facility types, the number of walking opportunities within walking distance from houses was found to be positively related to the sale price of single-family detached houses in all quantiles. The relationship of house price with population and intersection density was found to vary depending on the price level, with a negative relationship with the sale price of relatively more expensive houses being exhibited. People who considered buying houses with relatively higher sale prices were found to devalue houses located in flood/sediment-hazardous areas more. However, it was also found that the negative relationship was slightly mitigated in the highest quantile of sale prices for houses in areas with a moderate flood risk (maximum flooding depth: 3-5 m). Plains near rivers with amenities offer high walkability but pose a flood risk, resulting in a trade-off between flood risk and neighborhood walkability. The findings suggest the use of indices representing diverse preferences in accordance with the target socioeconomic status when policymakers assess the neighborhood environment.

Hilly environment and frequency of going out-of-home among older adults: Examining moderating effect of driving status

AIM

The health benefits of "going out-of-home" frequently among older adults are well known. A hilly environment would inhibit this habit. This study examined (i) longitudinal associations between a hilly environment and the frequency of going out-of-home, and (ii) the moderating effect of driving status on their association among older adults.

METHODS

This study involved a longitudinal study design. Data on 856 older adults in Nada Ward, Kobe, Japan, was obtained from a three-wave questionnaire survey (Wave 1: December 2017 to January 2018; Wave 2: after 1 year; Wave 3: after 3 years). In each survey, the frequency of going out-of-home time was measured. The average land slope within 500 m network buffers of each participant's home was calculated as the index of the hilly environment. Driving status was also measured.

RESULTS

The latent growth model revealed that while a higher value of average land slope was not significantly associated with changes in the frequency of going out-of-home over time, it was significantly associated with a lower frequency of going out-of-home at the initial level. The interaction term in the latent growth model showed that driving status did not moderate the associations of the average land slope with the initial level of, and changes in, the frequency of going out-of-home.

CONCLUSIONS

Although it remains unclear whether a hilly environment would accelerate a decline in the frequency of going out-of-home over time, this study found that older adults living in a hilly environment were less likely to leave their homes. Geriatr Gerontol Int 2022; ••: ••-••.