Abstract
Older adults with functional limitations (FLs) often experience obstacles to walking. Although health promotion programs targeting physical activity are available in lower-income areas, few studies have compared the walking experiences of older adults who have FLs with those who do not in the community. The purpose of this cross-sectional survey was to compare perceptions of neighborhood walkability among older adults living in lower-income communities with and without FLs. Participants (N = 132) were recruited in 2018 at regional health clinics in Flint, Michigan. To be eligible, participants had to be 65 years of age or older, report no cognitive decline, and be Flint residents. Of the 132 participants, the mean age was 69.74 (SD = 4.97). The majority were female (66%); African American (77%); single, divorced, or widowed (72%); educated below the General Education Development level (57%), and had a FL (67%). Older adults with FLs were significantly (p < 0.05) less likely than those without to visit many places within walking distance, to have well-lit neighborhoods at night, and to reside in neighborhoods where sidewalks were separated from the road and traffic. Multiple regression analyses revealed that having a FL was associated with poorer neighborhood perceptions of mixed-land-use (b = −0.19, p < 0.05) and more walking hazards (b = −0.26, p < 0.05). Findings suggest that a FL is associated with perceptions of walkability. It is essential to develop disability-friendly support systems and accommodations to encourage walking in lower-income communities.
Highlights
The built environment refers to all buildings, spaces, and products which can be created or changed by people (1)
Older adults with functional limitations (FLs) were more likely to have experienced a fall in the past year, take >3 medications per day, use an assistive device, and report numbness in the feet than those without FLs (p < 0.05)
By analyzing data from a convenience sample collected from regional outpatient clinics, we demonstrated that older adults with FLs perceive that they live in neighborhoods with less mixed land-use and more walking hazards
Summary
The built environment refers to all buildings, spaces, and products which can be created or changed by people (1). The positive built environment is a primary predictor of “active aging,” which refers to the process of optimizing opportunities for health, participation, and security that will enhance the quality of life as individuals age (2). The Healthy People 2030 framework suggests that improved safety in neighborhoods is necessary to improve health (4). Research has consistently indicated that because of unsupportive features in their neighborhoods (5), older adults have an increased risk of falls (and fall related injuries), sedentary lifestyles (6), and poor mental health (7). One of the challenges to achieving “active aging” is declining function with age. The World Health Organization (WHO) defines functional limitation (FL) broadly, such that it includes
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