Does urban environment at birth and adolescence affect cardiometabolic morbidity in adolescents? Results from the PARIS birth cohort study.

Background/Objectives: Few studies have simultaneously evaluated spatial accessibility to both food destinations and spaces for physical activity in relation to body weight in children. The aim of this study was to determine whether spatial accessibility to food destinations and places for physical activity is associated with body weight among children, differentiating between boys and girls. Neighborhood socio-economic status and walkability were incorporated as covariates. Methods: This cross-sectional study was conducted in Valencia, Spain. The initial sample comprised a sample of 808 children. GIS-based procedures were used to evaluate access to food outlets, walkability and socio-economic status (i.e., household income) among home neighborhoods. Access to different types of food destinations and destinations where children can engage in physical activity was assessed using the Neighborhood Environment Walkability Scale for Youth (NEWS-Y-IPEN). Weight and height were objectively assessed. The body mass index (BMI) percentile was calculated. Mixed-model regression analyses were performed. Results: Being a boy was positively associated with BMI percentile (p = 0.003), whereas physical activity was negatively related to this outcome (p = 0.028) in the whole sample. None of the built environment attributes were significantly associated with BMI percentile in boys. Access to healthy restaurants (p = 0.035), as well as neighborhood income (p = 0.049), were negatively associated with BMI percentile among girls. Conclusions: The relationship between built environmental attributes and BMI varies significantly between boys and girls. Understanding these differences is key for designing effective public health interventions with the aim of reducing childhood obesity.

Comparing perceived and objective measures of neighbourhood built environments among youth and adults in Canada.

ABSTRACT This study examines how emotions and affective intensities – such as fear, anxiety, and defensive attitudes – influence school choice practices in the inner-city district of Berlin-Kreuzberg. Through interviews and ethnographic neighbourhood walks with parents – particularly mothers – the research gathered meaningful insights into their daily lives with their children. Parents perceived certain places, streets, and playgrounds as highly unsafe and consequently avoided them. While parents sought to protect their children by distancing themselves downwards, their expressions of racism and classism necessitated critical reflexivity on the part of the researcher. Employing affect-theoretical and power-critical frameworks, this study highlights how differing positionalities shape emotional experiences, resulting in a range of perspectives and attitudes among both researchers and participants.

Adolescents from underserved communities, particularly Black and Hispanic youth, engage in lower levels of physical activity (PA), increasing their risk for chronic disease. Conventional interventions often face barriers such as limited access to safe environments. Wearable mobile health technologies offer scalable and context-sensitive solutions; however, predictors of sustained adherence in school-based settings among high-risk populations remain underexplored. This study aims to examine the behavioral and contextual predictors of adherence to a consumer-grade wearable PA tracker among underserved high school students. In this school-based observational study, 63 students (mean age 14.8, SD 1.17 years) enrolled in physical education received Fitbit devices. Adherence was defined as ≥21 valid days of step count data. Measures included self-reported PA behaviors, neighborhood perceptions, physical fitness (including anthropometrics), and device adherence. Group comparisons were conducted using t tests and chi-square tests. Logistic regression was used to identify predictors of adherence. Overall, 73% (46/63) of participants met the adherence threshold. Adherent students reported fewer days of moderate-to-vigorous PA (2 vs 4 days/week; P=.004), lower team sports participation (21/46, 46% vs 12/17, 71%; P=.004), and higher perceived neighborhood safety (P=.02). In adjusted models, lower PA frequency, greater perceived safety, and neighborhood walkability significantly predicted adherence (χ² 6=16.23; P=.01, Nagelkerke R²=0.61). Wearable mobile health technologies show promise for engaging underserved adolescents in PA, particularly those with lower baseline activity and limited access to structured sports. Key predictors of adherence included perceived neighborhood walkability, team sports participation, and prior PA behavior. School-based deployment of wearable devices should emphasize personalized goals and autonomy-supportive strategies to foster sustained engagement and promote PA among high-risk youth.

Purpose: The purpose of this project was to improve exercise-friendliness of a low SES neighbourhood in the Netherlands. This neighbourhood was chosen because it scored below average on important health parameters like self-efficacy, resilience, and quality of life. Methods: We followed the Our Voice citizen science method, involving six steps of design thinking. To gather data on environmental attributes contributing to or impeding an exercise-friendly neighbourhood, we used the Discovery Tool app to conduct research walks, and simultaneously interviewed citizen scientists. All gathered data were analysed by citizen scientists with the goal of defining common themes. Based on these themes, citizen scientists developed ideas to improve the neighbourhood, regarding exercise opportunities. After prioritising one of the ideas, a survey was distributed to gather information on relevant prerequisites and a prototype was developed. The prototype was extensively tested and refined by citizen scientists until the final design was ready. At this stage government officials took over responsibility and implemented the final design. After project conclusion, we interviewed citizen scientists about their sense of engagement and learnings throughout the project. Results: Twenty-two citizen scientists participated in the research walks, leading to 118 photos of relevant neighbourhood features. Analysis of these photos led to the definition of five common themes: nature, grey features, sports & play, exercise/recreational routes, and maintenance. Based on the themes, ten ideas were formulated, out of which walking routes were prioritised. Citizen scientists developed a walking route passing all art objects in the neighbourhood. Prerequisites (e.g. length, accessibility, safety, and signage) were taken into account. Prototype testing led to refinement of the route, inclusion of more art objects, and higher engagement of the citizen scientists. In the end, the neighbourhood walking route was realised. Citizen scientists indicated that they felt satisfied having contributed to the project, just for being able to do something for the neighbourhood. Conclusions: Citizen science proved to be a valuable tool to work on actual improvement of the neighbourhood, reflecting residents’ wishes. It is also a powerful way to engage residents to neighbourhood projects. Support/Funding Source: This study was funded by ZonMw, The Netherlands.

Environmental exposures have a crucial role in the incidence and progression of heart failure (HF) by exacerbating genetic predisposition and other pathophysiological mechanisms. The exposome - encompassing pollution, climate and the urban environment - and the biological responses to these factors shape cardiovascular health in complex ways. Air, noise and light pollution, exposure to toxic metals, and extremes of temperature adversely affect HF outcomes. Social determinants of health, including socioeconomic status, amplify these environmental risks, disproportionately affecting vulnerable populations. Conversely, green spaces and walkable neighbourhoods are linked to a reduced risk of HF, improved vascular health and medication adherence. Emerging evidence suggests that environmental stressors influence HF outcomes from early life by altering gene expression through epigenetic mechanisms. Despite these insights, research gaps remain. Future studies must integrate environmental, genetic and multiomics data to refine risk prediction and guide targeted public health interventions. A comprehensive understanding of the exposome in the aetiology of HF is essential for developing prevention strategies that address both biological and social determinants of cardiovascular health.

Lahore has become the new hub of employment, higher learning, health and specialized services in Punjab, Pakistan due to rapid urbanization and urban primacy. Such a density has created extreme daily commuting streams between the peripheral settlements and secondary cities in the metropolitan centre leading to road congestion, environmental destruction, social strain, and deteriorating urban living conditions. This paper is in reaction to this and explains plans and design of Sahulat Nagar, an envisaged self-sufficient new town at the outside of the Lahore Metropolitan Boundary close to Muridke. The primary goal of the project is to transform urban development into a system where people no longer commute to the city but rather community through the formation of an entire city in which the people can live, work, learn, and receive healthcare without having to travel to Lahore on a daily basis. The study is based on a planning approach that utilizes a studio-based approach with assistance of secondary data, national planning standards, and an overview of urban literature on Pakistan to create an integrated master plan that focuses on mixed land use, employment creation, walkable neighbourhoods, and a robust town centre. The results indicate that the new towns that are planned in an appropriate manner may be crucial in alleviating the commuting stress on Lahore and enhancing the lives of people and facilitating balanced development of the region. The paper ends with recommendations on the policies to implement to use self-sufficient new town strategies as a model of urban growth in Pakistan.

Background:It remains unclear whether individuals living in more walkable neighborhoods spend less time engaging in domain-specific sedentary behaviors, which vary by certain groups. Therefore, this study aimed to examine the associations between neighborhood walkability and total and domain-specific sedentary behavior, and to explore how this relationship varied by sociodemographic factors.Methods:Participants from AmeriSpeak who completed up to two activities completed over time in 24-hours in 2019 were included. Sedentary behavior outcomes (hours/day) included: (1) total sedentary behavior and (2) domain-specific sedentary behaviors (leisure, work, household, transport, personal, and other sedentary activities). Neighborhood walkability index was classified into four groups (least walkable [referent], below average, above average, and most walkable). Weighted generalized linear regression models were used to examine the associations, adjusting for covariates. Subsequently, such associations were stratified by sociodemographic factors.Results:Compared with the least walkable neighborhoods, below average, above average, and most walkable neighborhoods were positively associated with longer total sedentary behavior time (β = 0.53, 95% confidence interval [CI] = 0.06, 1.01; β = 0.78, 95% CI = 0.29, 1.27; and β = 1.40, 95% CI = 0.75, 2.05, respectively). For domain-specific sedentary behavior, neighborhoods with below average, above average, and most walkable neighborhoods were positively related to work sedentary behavior. However, neighborhood walkability was not related to other domain-specific sedentary behaviors. Lastly, adults aged 20–39 living in more walkable neighborhoods spent longer total sedentary behavior and work-related sedentary behavior.Conclusion:Residents living in highly walkable neighborhoods engaged in more total sedentary behavior and work-related sedentary time. Future research should explore how neighborhood environments collectively influence sedentary behavior.

Re-thinking Walkability: Synergizing the Pedestrian Environment and Land Use Patterns to Promote Physical Activity in Older Adults.

Latino persons with chronic spine pain (CSP) face distinct challenges to engaging in physical activity (PA) that may be explained by factors at multiple levels of the socioecological model and by intersecting oppressions. The objective of this study was to use the socioecological model and intersectionality framework to explore multilevel and intersecting determinants of PA among Latino persons with CSP using a qualitative approach. A purposive sample of Latino persons with CSP living in the United States near the US-Mexican border completed a demographic survey and participated in semistructured interviews. Interview questions related to PA experiences were based on the socioecological model and intersectionality framework. Interviews were audio recorded, transcribed verbatim, and coded deductively using rapid qualitative analysis in the original language (English or Spanish). Participants (N = 25, 65% women, 72% Spanish speakers) identified factors at the intrapersonal (eg,pain severity, mobility limitations, activity pacing, negative mental, and emotional states), interpersonal (eg,social support and competing social priorities), and environmental (eg,physical residence, neighborhood walkability, and neighborhood safety) levels. Individual PA experiences differed at varying intersections of culture with gender, geography, socioeconomic status, and employment status among Latino persons with CSP. Latino persons with CSP face multilevel barriers to PA engagement that vary across social identities and impact the support, safety, and resources needed to engage in PA. Study findings can inform future PA interventions that tailor strategies to the unique needs of this population, with the goal of improving PA levels and pain management.

The purpose of this study was to assess the associations between perceived socioenvironmental neighborhood attributes and objectively assessed habitual physical activity among US adults as well as whether associations vary by sociodemographic characteristics. We used data from the All of Us research program, a longitudinal cohort study of a diverse sample of Americans. Perceived neighborhood social cohesion, physical and social disorder, walkability, and sociodemographic characteristics were self-reported. Habitual physical activity was ascertained using Fitbit-derived step counts over ≥24weeks. Generalized additive mixed-effects models were used to test the associations between perceived socioenvironmental neighborhood attributes and daily step counts. Among participants (n = 6716), average daily step count was 7274.1 (SD = 3353.6). Social cohesion (B = 117.15, SE = 30.12, P < .001) and walkability (B = 72.74, SE = 31.43, P = .021) were positively associated with step count. The association of social cohesion with step count was moderated by age, being strongest among younger adults (B for interaction term = -5.43, SE = 2.00, P = .001), whereas the association between walkability and step count was moderated by income, being strongest for the lowest income group (B = -211.57, SE = 90.92, P = .020). Despite not finding main effects on step count for perceived physical disorder, age- and income-moderated effects were observed, with opposite-direction associations found for low (inverse) versus mid-upper income (direct) (B = 229.66, SE = 94.48, P = .015) and for younger (inverse) versus older (direct) adults (B for interaction term = 4.48, SE = 2.01, P = .030). Perceived neighborhood social cohesion, walkability, and physical disorder are associated with habitual physical activity among US adults. Age and income moderated the associations between neighborhood attributes and physical activity.

This study investigates the associations between social determinants of health (SDOH) and hypertension prevalence across Wisconsin communities, with particular attention to food environments, economic factors, and transportation patterns. Using data from the 2019–2020 Wisconsin State Inpatient Database (387,047 patients) and the 2020 AHRQ SDOH database, we employed spatial analysis and logistic regression models to examine relationships between hypertension prevalence and neighbourhood characteristics across 597 ZIP codes. Lower-income areas exhibited significantly higher hypertension prevalence (EE = 1.233, 95% CI: 1.128–1.347 for incomes under $14,999), neighbourhoods with greater food resource density showed protective associations (EE = 0.549, 95% CI: 0.474–0.636 for supermarket access). Active transportation patterns were associated with lower hypertension rates (EE = 0.879, 95% CI: 0.829–0.933 for walking). We observed a ‘Hispanic paradox’ in Milwaukee County, where Hispanic populations demonstrated lower hypertension prevalence despite socioeconomic disadvantages, whereas African American populations with similar disadvantages exhibited higher prevalence. Our proposed ‘Food Environment Synergy Model’ helps frame these findings by conceptualising food environments through three interacting dimensions: physical access, economic accessibility, and cultural dietary patterns. This integrated approach highlights how these dimensions collectively relate to unique risk and resilience profiles within communities, challenging conventional binary classifications of ‘food deserts’ versus ‘food secure’ areas. These findings indicate that addressing food access disparities, promoting walkable neighbourhoods, and preserving beneficial cultural dietary traditions may be related to lower hypertension prevalence and advance health equity in diverse communities. However, the analysis is cross-sectional, causality cannot be inferred; further longitudinal studies are needed to establish causal relationships.

BackgroundPrimary care diabetes management lacks objective, scalable methods for continuous physical activity surveillance. Bioelectrical impedance analysis (BIA), routinely collected in diabetes care, offers untapped potential as an automated digital biomarker but requires validation for behavioral phenotyping.ObjectiveThis study aims to evaluate the feasibility and predictive validity of multifrequency bioimpedance for physical activity detection and its association with glycemic control in type 2 diabetes.MethodsThis was a pragmatic quasi-experimental study using temporal allocation across three 4-month periods (January 2021-July 2023) in a Japanese primary care clinic, including comprehensive tracking with BIA-guided counseling (n=65), partial tracking (n=31), and standard care (n=100). Adults with type 2 diabetes (hemoglobin A1c [HbA1c] 7.0%‐10.0%) underwent monthly segmental multifrequency BIA. The primary outcome was HbA1c <7% at 4 months. Intervention-outcome associations were examined using chi-square trend tests and multivariable logistic regression adjusted for baseline HbA1c, the Walk Score (0‐100), and medication indicators. To assess temporal confounding, we conducted ANCOVA on 4-month HbA1c with baseline adjustment (age and BMI added in sensitivity analyses). Effect modification by built environment was tested via Walk Score×Intervention interaction. Predictive validity of left-arm 50-kHz reactance was assessed using area under receiver operating characteristic curve with 95% CI via 10-fold cross-validation.ResultsAmong 196 participants, the baseline characteristics (age, BMI, HbA1c, diabetes duration, and medications) did not differ across periods (all P>.05). HbA1c <7% achievement showed a gradient: 80% (52/65) comprehensive, 58% (18/31) partial, and 56% (56/100) standard care (χ²4 for trend=14.23; P<.001). ANCOVA of 4-month HbA1c (baseline-adjusted) showed no linear period trend (P=.25). A significant Walk Score×Intervention interaction was observed (β per 10-point Walk Score=−.55; 95% CI −1.03 to −0.06; P=.028), indicating differential effectiveness by neighborhood walkability. Left-arm 50-kHz reactance predicted target achievement (adjusted odds ratio per 1-SD increase =3.04; 95% CI 1.86‐4.97; P<.001; area under receiver operating characteristic curve=0.847, 95% CI 0.784‐0.910). Among achievers, reactance change correlated with HbA1c change (r=−0.392; P=.032) but not among nonachievers (r=−0.089; P=.54). After the inverse probability weighting was stabilized, each 1-SD increase in left-arm reactance was associated with a 12.1 percentage-point higher probability of target achievement (95% CI 5.2%‐19.0%).ConclusionsThis pragmatic implementation study demonstrates that automated BIA is feasible for routine diabetes care and suggests potential as a digital biomarker of activity-related glycemic control. While temporal allocation precludes definitive causal inference, and findings should be interpreted as associational, the observed Walk Score moderation and bioimpedance-HbA1c dose-response patterns are consistent with behavioral mechanisms rather than pure confounding. Left-arm reactance warrants randomized validation as a scalable, passive surveillance tool for precision diabetes management.

This cross-sectional study investigated the influence of neighborhood environments and health-related behaviors on self-rated health among older adults in Kitaibaraki City, Japan. A questionnaire was mailed to 5,000 individuals aged 65-85 years to collect data on demographics, social connections (Lubben Social Network Scale 6), social participation, and frequency of going out. Neighborhood walkability was assessed using Walk Score®. Path analysis with structural equation modeling was used to analyze 1,779 responses to evaluate direct and indirect effects on self-rated health. We found significant indirect effects of social connections on self-rated health via social participation (β = 0.058, p < .01) and frequency of going out (β = 0.051, p < .01). Direct effects of social participation (β = 0.194, p < .01) and frequency of going out (β = 0.194, p < .01) were also significant. Promoting social participation, encouraging outings, and strengthening social connections through community resources are crucial for increasing self-rated health.

Abstract Neighborhood walkability facilitates life sustaining activity such as obtaining nutrition, which is vital for cognitive health, but mechanisms are unknown. Convenience stores within the neighborhood may provide a source of nutrition if options are limited. The current study tested whether existence of convenience stores explained the relationship between neighborhood walkability and cognitive decline in Black older adults. Participants (N = 786; M-age=73.4; 79% female) were drawn from two prospective community-based aging studies in Chicago in which participants were administered a battery of cognitive tests assessing five cognitive domains from which a global composite was computed. Participant addresses were geocoded and linked to walkability scores and sum of convenience stores within 0.5 miles of the participant’s home. Multilevel regression analyses adjusting for demographics, health factors, and neighborhood SES examined whether the association between neighborhood walkability and cognitive trajectories was explained by convenience stores. More walkability was associated with better baseline visuospatial ability (B=.0015, SE=.0008, p=.0683), but faster decline (B=-.0002, SE=.0001, p=.0139). When adding convenience stores to the fully adjusted models, the effect of walkability on visuospatial ability became slightly stronger for the baseline effect (B=.0022, SE=.0009, p=.0219), while the longitudinal effect was unchanged (B=-.0002, SE=.0001, p=.0183). Walkability was not associated with any other cognitive domains at baseline or longitudinally. Although walkability may have a selective effect on decline in visuospatial abilities, these findings do not support convenience stores as a potential mechanism underlying neighborhood walkability and cognitive trajectories. Future studies are needed to examine other potential mechanisms linking walkability to change in cognition.

BackgroundNeighborhood physical environments may shape health behaviors, ultimately impacting cognitive health outcomes. However, previous studies have yielded mixed results, and few studies have included long‐term follow‐ups. The present study aims to investigate whether neighborhood walkability and healthy food environments are associated with longitudinal cognitive decline among women over midlife.MethodWe examined effects of walkability and healthy food environments on rates of decline in processing speed (Digit Symbol Substitution Test), working memory (Digit Span backwards), and immediate and delayed episodic memory (East Boston Memory Test) among 1391 women (49% non‐Hispanic White, 24% Black, 12% Chinese, 15% Japanese) enrolled in the Study of Women's Health Across the Nation (SWAN). Women were 49‐60 years old at cognitive baseline, and mean follow‐up was 10.2±3.5 years. Neighborhood walkability was assessed using the EPA's National Walkability Index. Healthy food environments were assessed using the CDC's Modified Retail Food Environment Index (mRFEI). Covariates were baseline age, race/ethnicity, education, study site, and time‐varying financial strain, smoking, alcohol use, hormone use, and menopause status.ResultWomen living in areas with higher walkability showed slower rates of decline in immediate (estimate=0.019, SE=0.009) and delayed recall (estimate=0.018, SE=0.008) (Figure 1). The pattern of results stayed similar after controlling baseline physical activity and cardiovascular risk factors. A significant walkability × financial strain interaction (estimate=0.194, SE=0.077) suggested that women exhibited lower immediate recall when they experienced higher financial strain, but only in areas with low walkability. For healthy food environments, there were no significant associations with any cognitive domains. However, significant three‐way food environments × race × time interactions for working memory (estimate=0.031, SE=0.013) and delayed recall (estimate=0.056, SE=0.022) suggested that healthy food environments were protective against more accelerated cognitive decline among Japanese women compared to White women.ConclusionMidlife women living in more walkable areas experienced slower decline in episodic memory over the 14‐year period spanning midlife. Healthy food environments showed different effects on cognitive decline across racial/ethnic groups. Future studies should investigate precise mechanisms that underline the observed associations to identify targeted policy recommendations and intervention strategies.

BackgroundPhysical activity has been associated with preserved executive functions and brain health in aging. A potential element promoting physical activity is neighborhood walkability – a measurement of how friendly an area is to walk. We evaluated the associations of walkability with executive functions and gray matter volumes and its interaction with age in cognitively unimpaired (CU) older adults and patients with mild cognitive impairment (MCI) and dementia.MethodWe included 1543 participants from UBRAIN study recruited in Clinic and Sant Pau Hospitals (Barcelona, Spain) ‐18.8% CU, 46.7% MCI, and 34.5% dementia (55% Alzheimer's Disease, 20.5% Frontotemporal dementia, 14.5% Lewy body, other 10%, Table 1). Executive functions (Trail Making Test and WAIS Digits forward and backward) and MRI‐based gray matter (GM) volumes in temporo‐parietal regions including medial temporal structures, were considered as outcomes. The walkability index included 8 indices (eg. street connectivity, slopes) assessed within a 100m radius around participant residences. We ran linear regression models, both in the full sample and in CU, and in patients with MCI and dementia separately, adjusted by sex, age and education and evaluated the interaction of walkability with age.ResultIn the full sample, there was a main effect of walkability on WAIS Digits forward scores (β=3.774, p <0.001) such that living in more walkable areas was associated with better performance, but no main effect on GM volume or interactions with age was observed. When stratified by the diagnostic group, the main effect was observed only in CU (β=5.429, p = 0.01) and patients with dementia (β=5.448, p = 0.025), but not in MCI participants (p = 0.345). In CU, higher walkability counteracted the effect of age on temporo‐parietal GM volumes (β=2.84, p = 0.001, Figure 1).ConclusionLiving in more walkable areas was associated with better attention in both CU and patients with dementia and attenuated the effect of age on brain structure in CU. Walkability may be a protective factor in aging and dementia. Further research is needed to determine whether this effect operates through increased physical activity.

BackgroundPrevious evidence suggests that urban design features, like neighbourhood walkability, are associated with cognitive outcomes and mental well‐being in older adults. Here, we examined associations between walkability and cerebrospinal fluid (CSF) markers of amyloid, neurodegeneration, and neuroinflammation, as well as depressive symptoms, considering neighbourhood deprivation and cognitive status.MethodWe analysed cross‐sectional data from 255 participants (both cognitively impaired and unimpaired) from the Sant Pau Initiative on Neurodegeneration (SPIN) cohort. The predictors included walkability assessed within 300m radius around participants’ residences. Outcomes included CSF biomarkers of AD pathology (Aβ42), neurodegeneration (T‐tau), and neuroinflammation (YKL‐40), as well as depressive symptoms (Geriatric Depression Scale; GDS‐30). Participants also had data on neighbourhood deprivation levels measured with the Area Deprivation Index (ADI). We performed multiple linear regression models to examine associations between walkability and the outcomes, with stratification by neighbourhood deprivation level (low, medium, high) and cognitive status (CU, MCI and Dementia). All models were adjusted for age, sex, education, APOE ε4 status, and MMSE scores.ResultParticipants’ age ranged from 45 to 87, 53% were women, and 26% were diagnosed with dementia (39% AD, 18% Lewy Body and 17% Frontotemporal Dementia; Table 1). In the whole sample, higher walkability was only associated with lower T‐tau levels, with no associations observed for other outcomes (Table 2). Stratified analyses by area deprivation, showed that higher walkability was associated with lower T‐tau and YKL‐40 levels among individuals living in areas with higher ADI. Additionally, higher walkability was marginally associated with lower GDS‐30 scores among individuals in medium‐deprivation areas. Stratified analyses by cognitive status, showed that higher walkability was associated with lower Aβ burden only among individuals with dementia (Figure 1).ConclusionOur findings link neighbourhood walkability to neurodegeneration, as well as neuroinflammation and depressive symptoms in highly and moderately deprived areas and to lower Aβ in individuals with a dementia diagnosis. Future research should explore the mediating mechanisms linking walkability to brain and mental health, including physical activity and mental health promotion. Urban planning strategies may consider both walkability and neighbourhood socioeconomic context to optimize cognitive and mental health outcomes in aging populations.

The association between intrinsic capacity and functional ability in older adults - exploring the role of the physical environment.