The associations between neighborhood walkability attributes and objectively measured physical activity in older adults.

Yung Liao,Ming-Chun Hsueh,Jong-Hwan Park,Bo-I Chen,Ru Rutherford,Adewale L Oyeyemi

doi:10.1371/journal.pone.0222268

Abstract

A limited number of studies have used objective measures to examine the associations between the built environment and physical activity (PA) among older adults. This study aimed to examine geographic information systems-derived neighborhood walkability attributes and accelerometer measured PA in older adults. Data were collected from 124 older Taiwanese adults aged over 60 years (mean age: 69.9). Adjusted multiple linear regression was performed to explore the associations between five neighborhood walkability factors (population density, street connectivity, sidewalk availability, access to destinations, and public transportation) and five metrics of accelerometer-measured physical activity (total PA, moderate-to-vigorous PA, light PA, long moderate-to-vigorous PA bouts, and daily step counts). After adjusting for potential confounders, we found that greater sidewalk availability was positively associated with daily step counts in older adults (β = 0.165; 95% confidence interval: 0.006, 0.412; P = 0.043). No associations between other neighborhood environment attributes and PA metrics were observed. In conclusion, high sidewalk availability in the neighborhood may be supportive for older adults’ daily step counts. Further longitudinal research is needed to establish the causality between the built environment and objectively measured PA in older adults.

Highlights

Physical inactivity has led to colossal costs to global healthcare systems [1]
To address the rapidly aging population of Taiwan and to strengthen the evidence base and fill the research gap, this study aimed to examine the associations between GISderived neighborhood walkability attributes and accelerometer-determined physical activity in older adults
After adjusting for potential confounders, we found that sidewalk availability (β = 0.165; 95% confidence interval: 0.006, 0.412; p = 0.043) was positively associated with daily step counts

Summary

Introduction

Physical inactivity has led to colossal costs to global healthcare systems (approximately $53.8 billion) [1]. There has been strong evidence supporting the many health benefits of physical activity in older adults, such as decreased rates of all-cause mortality, non-communicable diseases, and functional limitations, as well as improved bone fitness, better cognitive function, and a lower risk of falling [2]. About 31.1% of the population in the world engages in sufficient physical activity [3], and physical activity levels have increased very little since 2012 [4]. In Taiwan, nearly 40% of Taiwanese older adults are physically inactive [5]. Strategies that encourage physical activity in older adults need to be developed to prevent non-communicable diseases and to minimize the burden on the healthcare system.

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Discussion

Conclusion