Abstract
Objectives: This study investigated the longitudinal association between changes in older adults’ physical activity and neighborhood walkability measured by geographic information systems (GISs, (ArcGIS, ESRI Inc., Redlands, CA, USA)). Methods: A mail survey was conducted for Japanese older adults who were randomly selected from three different settlement types. Data on walking, total moderate to vigorous physical activity (MVPA), and sociodemographic characteristics were collected at baseline (in 2010) and follow-up (in 2015). Multiple linear regression analyses were employed to assess the association between MVPA change and neighborhood walkability, adjusted for potential confounders. Effect sizes for independent variables on MVPA change were estimated. Results: Data from 731 community-dwelling older adults (43.7% women) were analyzed. During the follow-up, older adults’ MVPA was reduced by 94.4 min/week (−14.2%) on average (675.5 and 579.9 min/week in 2010 and 2015, respectively). Overall, older adults living in highly walkable areas showed a smaller reduction than those in low walkable areas (beta: 99.7 min/week, 95% confidence interval: 28.5–171.0). Similar associations were observed among those in the urban and suburban area, but not in the rural area. Walkability had larger effect sizes for explaining MVPA change than demographic characteristics. In addition, the findings for walking were similar to MVPA. Conclusion: Neighborhood walkability mitigated the 5-year reduction of walking and total MVPA among older adults, especially in urban areas.
Highlights
Increasing moderate to vigorous physical activity (MVPA) is considered an important strategy to reduce health risks globally [1,2]
The present study aimed to investigate the association between five-year changes in physical activity and neighborhood walkability measured using geographic information systems (GISs), among community-dwelling older adults in urban, suburban, and rural areas
This study examined the longitudinal association between GIS-measured neighborhood walkability and 5-year changes in older adults’ physical activity
Summary
Increasing moderate to vigorous physical activity (MVPA) is considered an important strategy to reduce health risks globally [1,2]. Creating built environments that support physical activity is recommended by national [3] and international authorities [4]. There is strong evidence that neighborhood walkability, which is often derived from street connectivity, residential density, and land use mix [5,6], is related to individual MVPA among younger adults [7,8,9,10], and older adults [11,12]. A recent systematic review of the relation between physical activity and built environment among older adults indicated that most (94%) of the studies had a cross-sectional design [12]. Cross-sectional study designs can suffer from reverse causation, with residential self-selection being a prominent example. Longitudinal study designs are important for providing stronger evidence regarding environmental causation
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