Abstract
BackgroundSupporting 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.MethodsData 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.ResultsChanges in neighbourhood walkability were not statistically significantly associated with changes in walking activity in older adults (β500m = − 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).ConclusionsThis 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.
Highlights
Supporting older adults to engage in physically active lifestyles requires supporting environments
Physical inactivity has been identified as the fourth leading risk factor for global mortality, and increasing physical activity (PA) is crucially important to reduce the risk of developing major chronic non-communicable diseases [1, 2]
Moderate to strong positive correlations were observed between the neighbourhood walkability index and all standardised neighbourhood walkability components at baseline (Table 2)
Summary
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 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. Identifying modifiable characteristics of the built environment associated with walking in older adults is important to inform interventions and policy measures supporting healthy and active ageing [6]. Research on the associations of the neighbourhood built environment with walking activity in older adults is scarce, not generalizable to Western European countries, and limited by methodological and conceptual issues [6, 11,12,13]
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