Abstract
BackgroundPerceived and objectively-assessed aspects of the neighbourhood physical environment have been postulated to be key contributors to regular engagement in active travel (AT) in older adults. We systematically reviewed the literature on neighbourhood physical environmental correlates of AT in older adults and applied a novel meta-analytic approach to statistically quantify the strength of evidence for environment-AT associations.MethodsForty two quantitative studies that estimated associations of aspects of the neighbourhood built environment with AT in older adults (aged ≥ 65 years) and met selection criteria were reviewed and meta-analysed. Findings were analysed according to five AT outcomes (total walking for transport, within-neighbourhood walking for transport, combined walking and cycling for transport, cycling for transport, and all AT outcomes combined) and seven categories of the neighbourhood physical environment (residential density/urbanisation, walkability, street connectivity, access to/availability of services/destinations, pedestrian and cycling infrastructure, aesthetics and cleanliness/order, and safety and traffic).ResultsMost studies examined correlates of total walking for transport. A sufficient amount of evidence of positive associations with total walking for transport was found for residential density/urbanisation, walkability, street connectivity, overall access to destinations/services, land use mix, pedestrian-friendly features and access to several types of destinations. Littering/vandalism/decay was negatively related to total walking for transport. Limited evidence was available on correlates of cycling and combined walking and cycling for transport, while sufficient evidence emerged for a positive association of within-neighbourhood walking with pedestrian-friendly features and availability of benches/sitting facilities. Correlates of all AT combined mirrored those of walking for transport. Positive associations were also observed with food outlets, business/institutional/industrial destinations, availability of street lights, easy access to building entrance and human and motorised traffic volume. Several but inconsistent individual- and environmental-level moderators of associations were identified.ConclusionsResults support strong links between the neighbourhood physical environment and older adults’ AT. Future research should focus on the identification of types and mixes of destinations that support AT in older adults and how these interact with individual characteristics and other environmental factors. Future research should also aim to clarify dose-response relationships through multi-country investigations and data-pooling from diverse geographical regions.
Highlights
Perceived and objectively-assessed aspects of the neighbourhood physical environment have been postulated to be key contributors to regular engagement in active travel (AT) in older adults
AT variables were categorised into: (a) total walking for transport; (b) within-neighbourhood walking for transport; (c) cycling for transport; and (d) total AT
Neighbourhood environmental correlates of total walking for transport After accounting for sample size and article quality, strong evidence (p < .01) of positive associations with total walking for transport was found for residential density/urbanisation, walkability, easy access to building entrance and several measures of access to/availability of services/destinations
Summary
Perceived and objectively-assessed aspects of the neighbourhood physical environment have been postulated to be key contributors to regular engagement in active travel (AT) in older adults. Active travel (AT), here defined as walking or cycling to a destination, can contribute substantiality to the accumulation of health-enhancing levels of PA in older adults. Older adults from Hong Kong, Chicago (USA) and Ghent (Belgium) reported AT accounted for 55% (169 min) of walking within the neighbourhood, 56% (159 min) of total walking and 42% (123 min) of total PA, respectively [4,5,6]. Changes in active commuting have been associated with corresponding changes in total PA without compensatory changes in leisure-time PA, suggesting a net benefit from engaging in AT [7, 8]. Older people appear to experience greater overall health benefits from transport mode shifts to AT than younger people [9]
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