Abstract

(1) Background: Although several neighborhood environmental factors have been identified to be associated with older adults’ physical activity, little research has been done in rural areas where the population is aging. This study aimed to investigate neighborhood environmental factors and the longitudinal change of physical activity status among rural older adults in Japan. (2) Methods: The study included 2211 older adults, aged over 60 years, residing in three municipalities in Shimane prefecture and participating at least twice in annual health checkups between 2010 and 2019. Physical activity was identified based on self-report. Hilliness, bus stop density, intersection density, residential density, and distance to a community center were calculated for each subject. Hazard ratios for the incidence of physical inactivity were estimated using Cox proportional hazards models. (3) Results: We found that 994 (45%) of the study subjects became physically inactive during the follow-up. Those living far from a community center had a lower risk of becoming physically inactive compared to those living close to a community center. When the analysis was stratified by residential municipality, this association remained in Ohnan town. Those living in hilly areas had a higher risk of becoming physically inactive in Okinoshima town. (4) Conclusions: The impact of neighborhood environmental factors on older adults’ physical activity status might differ by region possibly due to different terrain and local lifestyles.

Highlights

  • Physical activity (PA) is an important modifiable factor that can prevent non-communicable diseases (NCDs), including cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases; these are the four major NCDs that cause more than 36 million deaths, of which 14 million are premature deaths per year globally [1]

  • Strategies [6], and a 15% relative reduction in the global prevalence of insufficient PA was set as a primary target by 2030, which is aligned with the Sustainable Development Goals (SDGs) from WHO [7]

  • This study aimed to investigate associations between several neighborhood environmental factors and PA in older adults residing in aging Japanese rural communities by using a longitudinal study design

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Summary

Introduction

Physical activity (PA) is an important modifiable factor that can prevent non-communicable diseases (NCDs), including cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases; these are the four major NCDs that cause more than 36 million deaths, of which 14 million are premature deaths per year globally [1]. PA and major NCDs, a 10% relative reduction in the prevalence of insufficient PA was set as one of the nine primary targets to be attained by 2025 in the global action plan for NCDs [1]. In 2018, the global action plan for PA was built upon that for NCDs as well as existing PA strategies [6], and a 15% relative reduction in the global prevalence of insufficient PA was set as a primary target by 2030, which is aligned with the Sustainable Development Goals (SDGs) from WHO [7]. Res. Public Health 2021, 18, 1450 the global action plan for PA, and it is to be achieved by ensuring opportunities for PA to women, older adults, and rural and underprivileged residents [7]. This study aimed to investigate associations between several neighborhood environmental factors and PA in older adults residing in aging Japanese rural communities by using a longitudinal study design

Study Design
Study Subjects
Outcome
Exposure Variables
Covariates
Statistical Analysis
Hazard
Discussion
Conclusions
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