Abstract
Maintaining physical activity in later life is important for maintaining health and function. Activity outdoors, such as walking, jogging and cycling, may provide an accessible, sociable and practical solution, but maintaining outdoor mobility may be a challenge in later life. Providing green environments which are supportive of physical activity may facilitate this, yet research into how greenspace could be best used is inconclusive. This study evaluates the role of greenspace in protecting against decline in physical activity over time in older adults.Data from the European Prospective Investigation of Cancer Norfolk, UK, cohort 1993–2009 (N=15,672) was used. Linear regression modelling was used to examine the association between exposure to greenspace in the home neighbourhood and change in overall, recreational and outdoor physical activity measured in terms of metabolic equivalent cost (MET) in hours/week. Mediation analysis was conducted to assess if dog walking explained the relationship between greenspace and physical activity change. Models were adjusted for known and hypothesised confounders.People living in greener neighbourhoods experienced less of a decline in physical activity than those living in less green areas. Comparing change for those living in the greenest versus least green quartiles, participants showed a difference in overall physical activity of 4.21 MET hours/week (trend P=0.001), adjusted for baseline physical activity, age, sex, BMI, social class and marital status. This difference was 4.03 MET hours/week for recreational physical activity (trend P<0.001) and 1.28 MET hours/week for outdoor physical activity (trend P=0.007). Dog walking partially mediated the association between greenspace and physical activity change, by 22.6% for overall, 28.1% for recreational and 50.0% for outdoor physical activity (all P<0.001).Greenspace in the home neighbourhood may be protective against decline in physical activity among older people as they age. Dog walking is a potential mechanism in this relationship, and warrants further investigation as a way of maintaining physical activity in later life.
Highlights
Retaining physical and psychological function in later life is an important part of ‘active ageing’ (World Health Organisation, 2002) through the ability to maintain independence in activities of daily living (McCusker, Kakuma, & Abrahamowicz, 2002)
Outdoor recreation, including walking, jogging and cycling, may be the best source of physical activity for older people, as it can be incorporated in daily life (Ogilvie et al, 2007), has been shown to lead to a decrease in all-cause mortality and chronic disease (Zhao et al, 2015), it facilitates social contact (World Health Organisation, 2002), can result in higher levels of physical activity (Kerr et al, 2012) and may provide additional health benefits over engaging in activity indoors (Thompson Coon et al, 2011)
Ethnicity has been found to be associated with physical activity (Gill, CelisMorales, & Ghouri, 2014), but it was not included in this analysis as 99.7% of the sample (N 1⁄4 15,529) were white, reflecting the population of Norfolk, which was 98.5% according to the 2001 Census (Office for National Statistics, 2001)
Summary
Retaining physical and psychological function in later life is an important part of ‘active ageing’ (World Health Organisation, 2002) through the ability to maintain independence in activities of daily living (McCusker, Kakuma, & Abrahamowicz, 2002). Dog walkers are more likely to achieve higher levels of physical activity than others (Cutt, Giles-Corti, & Knuiman, 2008), and as dog walking often occurs in greenspace (Richards, McDonough, Edwards, Lyle, & Troped, 2013), it may be one mechanism that explains higher levels of physical activity and sense of community in greener areas (Lachowycz & Jones, 2013; Toohey, McCormack, Doyle-Baker, Adams, & Rock, 2013) This lack of understanding limits our ability to provide greenspace or physical activity interventions that are most supportive of active ageing. It uses the European Prospective Investigation of Cancer (EPIC)-Norfolk cohort study in the UK, which provides data on a wide range of health and lifestyle factors, obtained over a 7.5 year follow-up period in a population-based sample of more than 25,000 adults (Ward Thompson, 2013)
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