Neighborhood Walkability Research Articles

Investigating equitable access of children and seniors to urban green spaces and its relationship with neighborhood walkability: a case study of Tehran, Iran

ABSTRACT This study investigates the distribution of urban green spaces for children and seniors in Tehran, delving into their connection with demographic attributes and the walkability of neighborhoods. The findings reveal an unequal distribution, confirmed by the Gini index for children (0.57) and seniors (0.62). Moreover, the Multiple Regression Analysis revealed that the apartment occupancy rate (r = –0.19) and migrant rate (r = –0.13) were inversely correlated with seniors’ access to green spaces, whereas the employment rate (r = 0.16), intersection density (r = 0.27), and land use mix (r = 0.20) exhibited positive associations. Additionally, concerning children, the findings indicated positive correlations between intersection density (r = 0.25) and land use mix (r = 0.12) and their access to green spaces. These findings underscore the importance of adopting a co-benefits strategy and taking into account demographic characteristics and neighborhood walkability in urban planning and decision-making to ensure fair access to urban green spaces for vulnerable populations. Implementing strategies like establishing green spaces in areas with lower walkability and improving neighborhood connectivity can greatly improve the accessibility of urban green spaces for both children and seniors.

Neighborhood-level social determinants of health and cardioprotective behaviors among church members in New Orleans, Louisiana

BackgroundFavorable neighborhood-level social determinants of health (SDoH) are associated with lower cardiovascular disease risk. Less is known about their influence on cardioprotective behaviors. We evaluated the associations between neighborhood-level SDoH and cardioprotective behaviors among church members in Louisiana. MethodsParticipants were surveyed between November 2021 to February 2022, and were asked about health behaviors, aspects of their neighborhood, and home address (to link to census tract and corresponding social deprivation index [SDI] data). Logistic regression models were used to assess the relation of neighborhood factors with the likelihood of engaging in cardioprotective behaviors: 1) a composite of healthy lifestyle behaviors [fruit and vegetable consumption, physical activity, and a tobacco/nicotine-free lifestyle], 2) medication adherence, and 3) receipt of routine medical care within the past year. ResultsParticipants (n = 302, mean age: 63 years, 77% female, 99% Black) were recruited from 12 churches in New Orleans. After adjusting for demographic and clinical factors, perceived neighborhood walkability or conduciveness to exercise (odds ratio [OR]=1.25; 95% CI: 1.03, 1.53), availability of fruits and vegetables (OR=1.23; 95% CI: 1.07, 1.42), and social cohesion (OR=1.55; 95% CI: 1.22, 1.97) were positively associated with the composite of healthy lifestyle behaviors. After multivariable adjustment, SDI was in the direction of association with all three cardioprotective behavior outcomes, but associations were not statistically significant. ConclusionsIn this predominantly Black, church-based population, neighborhood-level SDoH including the availability of fruits and vegetables, walkability or conduciveness to exercise, and social cohesion were associated with cardioprotective behaviors. Findings reiterate the need to address adverse neighborhood-level SDoH in the design and implementation of health interventions.

Navigating active Transit: How built environments shape commuting and leisure journeys

This study offers a nuanced investigation into the complexities of active travel behavior in low and middle-income countries (LMICs), with a specific focus on the Mumbai Metropolitan Region (MMR) in India. Utilizing a dual-method approach, the research employs Poisson regression models to analyze the frequency of active commuting and Cox proportional hazards models to explore the duration of such travel. The study reveals that urban design elements, socio-economic factors, and individual demographics collectively shape travel behavior, often in unexpected ways. Contrary to prevailing assumptions, walkable neighborhoods and enhanced public transit accessibility do not universally encourage active commuting. For example, while increased bus stop availability boosts the frequency of work-related active trips, its impact on leisure travel is minimal. Similarly, higher intersection density, generally associated with greater walkability, unexpectedly leads to longer travel durations. The study also finds that proximity to urban centers like the Central Business District exhibits a dual influence—promoting active commuting for work but slightly reducing it for leisure activities. These multifaceted findings underscore the need for more context-specific, multidimensional approaches in urban planning and policy formulation. Future research aims to expand upon these insights through quasi-experimental methods to better understand the socio-cultural, economic, and environmental intricacies influencing travel behavior in LMICs.

Longitudinal Impacts of Precision Greenness on Alzheimer’s Disease

BackgroundThe potential for greenness as a novel protective factor for Alzheimer’s disease (AD) requires further exploration.ObjectivesThis study assesses prospectively and longitudinally the association between precision greenness - greenness measured at the micro-environmental level, defined as the Census block - and AD incidence.DesignOlder adults living in consistently high greenness Census blocks across 2011 and 2016 were compared to those living in consistently low greenness blocks on AD incidence during 2012–2016.SettingMiami-Dade County, Florida, USA.Participants230,738 U.S. Medicare beneficiaries.MeasurementsU.S. Centers for Medicare and Medicaid Services Chronic Condition Algorithm for AD based on ICD-9 codes, Normalized Difference Vegetation Index, age, sex, race/ethnicity, neighborhood income, and walkability.ResultsOlder adults living in the consistently high greenness tertile, compared to those in the consistently low greenness tertile, had 16% lower odds of AD incidence (OR=0.84, 95% CI: 0.76–0.94, p=0.0014), adjusting for age, sex, race/ethnicity, and neighborhood income. Age, neighborhood income and walkability moderated greenness’ relationship to odds of AD incidence, such that younger ages (65–74), lower-income, and non-car dependent neighborhoods may benefit most from high greenness.ConclusionsHigh greenness, compared to low greenness, is associated with lower 5-year AD incidence. Residents who are younger and/or who reside in lower-income, walkable neighborhoods may benefit the most from high greenness. These findings suggest that consistently high greenness at the Census block-level, may be associated with reduced odds of AD incidence at a population level.

Perceived neighborhood walkable environment, neighborhood interaction and mental health among residents of different age groups: a case study in Shanghai, China

Purpose This study aims to investigate the relationships between the perceived neighborhood walkable environment (PNWE), neighborhood interaction (NI) and residents’ mental health, with a focus on examining differences among residents of different age groups.Design/methodology/approach Using an electronic survey questionnaire, data on PNWE, NI and mental health were collected from 1,159 residents across 205 communities in Shanghai, China. Our study utilized a structural equation modeling (SEM), employing the maximum likelihood estimation method. The structural equation model was fitted using the MPLUS software.Findings The mental health of young and middle-aged adults is generally poor, and they are at higher risk of depression than children and older adults. The effects of PNWE and NI on the mental health of residents varied among different age groups. As residents get older, their mental health is more affected by the PNWE. In addition, the influence of the PNWE on children and older adults’ mental health is direct and not mediated by NI. For young and middle-aged adults, the influence of the PNWE on their mental health needs to be mediated by NI.Originality/value This study marks the first examination of the relationship between PNWE, NI and mental health among different age groups of residents in China. The findings of this research can assist policymakers in gaining a deeper understanding of the underlying mechanisms by which PNWE affects mental health. Furthermore, it can contribute to the development of more targeted walkable environment designs aimed at enhancing mental health among various age groups.

Abstract A075: The Association between Food Deserts, Food Swamps, and Postmenopausal Breast Cancer Mortality in the United States

Abstract Purpose: Breast cancer (BRCA) is the 4th leading cause of cancer death in the United States (U.S.) and is one of 13 obesity-related cancers. Healthy food consumption is a protective factor shown to decrease obesity risk and postmenopausal BRCA mortality, respectively. However, residing in geographical areas with no access to healthy food options (food deserts) or unhealthy food options (food swamps) reduces access to healthy foods and has been severely understudied. Recently we found a 77% increased odds of overall obesity-related cancer mortality among U.S. counties with the worst food swamp scored counties/county equivalents. This current study examined the association between residing in food swamps and deserts with postmenopausal BRCA mortality. Methods: We conducted a cross sectional/ecological analysis utilizing 2010 – 2020 Center for Disease Control and Prevention postmenopausal BRCA mortality data (restricted to 45+ years old) and aggregated 2012 – 2020 data from the U.S. Department of Agriculture Food Environment Atlas data. Food swamp score (FS) was calculated as the ratio of fast-food and convenience stores to grocery stores and farmer’s markets. Food desert score (FD) was calculated as the proportion of residents living more than one mile (urban) or 10 miles (rural) from a grocery store and household income ≤ 200% of the federal poverty threshold. We categorized FD and FS to low, moderate, or high; higher scores indicated counties with poorer healthy food resources. Multilevel generalized mixed effects models were used to estimate the mentioned association. Results: 2,280 counties/county equivalents with high postmenopausal BRCA mortality rates had higher percentage of non-Hispanic (NH)-Black population (5.80 vs. 2.08), poverty rates (17.2 vs. 14.2), and high food swamp scored areas (39.0 vs. 24.5) versus counties/county equivalents with low postmenopausal BRCA mortality rates (p-value < 0.0001). After adjusting for age, percentage of NH-Blacks per county, and poverty rate, we found 42% increased odds of having high postmenopausal BRCA mortality rates among U.S. counties/county equivalents with high food swamp scores (adjusted odds ratio [AOR] = 1.42; 95% CI: 1.14 – 1.78). Conclusions: Sampled U.S. counties with the poorest food swamp environment had significantly increased odds of postmenopausal BRCA mortality. We suggest that local policymakers and community stakeholders should employ sustainable approaches at combating obesity and BRCA by increasing healthier accessible food sources (e.g. creating more walkable neighborhoods and community gardens). Citation Format: Malcolm Bevel, Meng-Han Tsai, April Parham, Sydney Andrzejak, Samantha Jones, Justin X Moore. The Association between Food Deserts, Food Swamps, and Postmenopausal Breast Cancer Mortality in the United States [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Breast Cancer Research; 2023 Oct 19-22; San Diego, California. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_1):Abstract nr A075.

Systematic Review of the Use of the Walk-Along Interview Method to Assess Factors, Facilitators and Barriers Related to Perceived Neighborhood Environment and Walking Activity in Healthy Older Adults

Background: Based on findings from a recent systematic review of the methodological aspects related to data collection for the walk-along interview (WAI) method applied to healthy older adults, complementary questions emerged, among them, what are the main outcomes of studies that have used the WAI? Objective: The aim of this systematic review is to identify the outcomes of published studies that have used the WAI method to identify correlates of the perceived neighborhood environment on walking activity in healthy older adults. Methods: In accordance with the PRISMA guidelines, a date-unrestricted search spanning four databases was performed. Of the 164 articles identified in the initial search, 31 articles published between 2012 and 2022 met the inclusion criteria. Results: The extracted outcomes were classified into two categories: (1) the relationship between the physical characteristics of the environment and walking among healthy older adults (e.g., pedestrian infrastructure, safety, access to facilities, aesthetics and environmental conditions) and (2) the facilitators and barriers to walking, based on the dimensions of the socioecological model. Conclusions: This review provides a valuable resource for researchers, students and professionals who wish to work with the WAI method, working on aging and age-friendly cities policies.

Individual and environmental variables related to outdoor walking among older adults: Verifying a model to guide the design of interventions targeting outdoor walking.

To estimate the relationships between individual and environmental variables and outdoor walking (OW) in older adults with OW limitations through verifying a conceptual model. Baseline data from 205 older adults participating in a randomized trial of a park-based OW program were analyzed using structural equation modeling. We evaluated a three latent factor model: OW (accelerometry and self-report); individual factors (balance; leg strength; walking self-confidence, speed and endurance; mental health; education; income; car access); and environmental factors (neighbourhood walkability components). Mean age was 75 years; 73% were women. Individual factors was significantly associated with OW (β = 0.39, p < .01). Environmental factors was not directly associated with OW but was indirectly linked to OW through its significant covariance with the individual factors (β = 0.22, p < .01). The standardized factor loadings from the individual factors on walking self-confidence and walking capacity measures exceeded 0.65. Better walking capacity and more confidence in the ability to walk outdoors are associated with higher OW in older adults. Better neighbourhood walkability is indirectly associated with more OW. The conceptual model demonstrates an individual and environment association; if the capacity of the individual is increased (potentially through walking interventions), they may be able to better navigate environmental challenges.

Economic benefits of urban streetscapes: Analyzing the interrelationships between visual street environments and single-family property values in Seoul, Korea

Policymakers and planners often face questions about whether the creation of walkable environments can positively affect nearby housing prices. In response to this situation, numerous previous studies have examined the relationships between neighborhood-scale walkable environments and neighboring property values. However, it remains unknown if micro-scale visual streetscapes significantly affect nearby housing prices. This study builds upon prior literature by examining the economic effects of both neighborhood and streetscape walkability on single-family housing prices in Seoul, Korea. We use 14,686 housing sales transaction data between 2017 and 2019. In addition, this study utilizes a Deeplab V3+ deep learning model using 233,106 Google Street View (GSV) panoramic images to empirically identify micro-scale streetscapes. Based on such data, we employ a hedonic price model to examine the interrelationships between both macro- and micro-scale walkable environments and single-family housing prices. Our findings show that paved sidewalks on streets are associated with higher housing prices in disadvantaged neighborhoods, while street greenery and a sense of enclosure are positively correlated in advantaged areas. In particular, the sense of enclosure presents diminishing marginal effects. Our findings can help policymakers and planners establish detailed design strategies and guidelines for creating walkable environments that can maximize these economic benefits.

An exploratory study on the benefits of transit orientated development (TOD) to rail infrastructure projects

PurposeThe purpose of this study was to explore and critique the benefits and disbenefits that transport orientated development (TOD) brings to neighbourhoods in proximity to public transport hubs.Design/methodology/approachThis is an exploratory study that may also be described as a rapid review that aims to provide coverage of the available literature in a systematic process that is simplified to produce information in a timely manner. Due to the relatively small number of available studies from peer-reviewed sources, the variety of methods and data used and the constrained time available for this study, the study did not immediately lend itself to a more thorough systematic literature review.FindingsThe literature shows the discourse on TOD upholds its promise to create a high-density mixed-use walkable neighbourhood supported by transport infrastructure, increasing accessibility, minimising vehicle dependency, reducing traffic congestion, moderating urban sprawl and reducing pollution. There are few articles on the negative aspects of TOD, particularly concerning social exclusion, crime, sustainability and concerns about gentrification of neighbourhoods.Research limitations/implicationsThe study did not immediately lend itself to a more thorough systematic literature review due to the relatively small number of available studies, the variety of methods and data used and the constrained time available for this study.Originality/valueThis study allows social investigators, policymakers and developers understand the benefits and disbenefits of TOD including policy implications regarding potential criminogenic factors.

Assessing Physical Therapists' Outdoor Walking Recommendations and Neighborhood Walkability for Older Adults.

Neighborhood walkability is the extent to which built and social environments support walking. Walkability influences older adults' participation in outdoor physical activity. Identifying factors that influence physical therapists' (PTs) decisions about prescribing outdoor walking is needed, especially for those who are aging in place. The purpose of this study is to describe the neighborhood walkability knowledge, perceptions, and assessment practices of PTs who work with community-dwelling older adults. A cross-sectional survey was sent via email to 5,000 PTs nationwide. The 40-item survey assessed walking prescriptions, walkability perceptions and assessments, and gathered demographic data. Categorical variables were compared using Chi-square analyses. Using a total of 122 PTs who worked in outpatient geriatric physical therapy settings, a significant difference was found between perceptions of whether PTs should assess walkability and whether they actuallyassess walkability (χ2 = 78.7, p < .001). Decisions to prescribe outdoor walking were influenced by the availability (n = 79, 64.8%) and maintenance (n = 11, 9.0%) of sidewalks, crime (n = 9, 7.4%), terrain (n = 7, 5.7%), and aesthetics (n = 6, 4.9%). Objective walkability measures were not used by the respondents. When considering the assessment of walkability, PTs prioritize the built environment over the social environment. Although most believe it is the responsibility of the PT to assess walkability, most do not. Significance/Implications: Assessment of walkability may allow PTs to identify barriers and make more informed recommendations concerning outdoor walking for older adults. Objective measures are available for PTs when prescribing outdoor walking.

Uneven geography of health opportunities among subsidized households: Illustrating healthcare accessibility and walkability for public rental housing in Seoul, Korea.

Planners and policymakers significantly consider providing suitable living environments for marginalized households, beyond creating affordable homes. Previous studies have explored various socioeconomic attributes of neighborhoods with public rental housing (PRH), particularly regarding education, job, and transportation opportunities; however, we have a limited understanding of health opportunities among such subsidized households. This study, therefore, explores the accessibility and spatial equity of emergency medical services (EMS) and primary health care (PHC) for PRH residents in Seoul, Korea. The findings show that neighborhoods with PRHs are associated with lower odds ratios for EMS and PHC accessibility. In particular, the relationships between the locations of PRHs and medical services accessibility in neighborhoods varied across the types of PRHs. While neighborhoods with large-scale PRHs are associated with lower PHC access, those with small-scale PRHs are associated with lower EMS access. In addition, our findings show that PRHs tend to be located in neighborhoods with lower walkability. These results may help in empirically determining the spatial accessibility of PHC and EMS, as well as neighborhood walkability, which may affect the health status of individuals in subsidized households.

Correlates of Active School Transportation During the COVID-19 Pandemic Among Canadian 7- to 12-Year-Olds: A National Study.

Active school transportation (AST) is an important source of physical activity for children and a potentially important climate change mitigation strategy. However, few studies have examined factors associated with AST in the context of the COVID-19 pandemic. We used baseline data from a longitudinal survey to investigate correlates of AST during the second wave of COVID-19 (December 2020). We collected survey data from 2291 parents of 7- to 12-year-olds across Canada and linked this information with data on neighborhood walkability and weather from national databases. We assessed potential correlates representing multiple levels of influence of the social-ecological model. We used gender-stratified binary logistic regression models to determine the correlates of children's travel mode to/from school (dichotomized as active vs motorized), while controlling for household income. We examined the correlates of travel mode for both the morning and afternoon trips. Consistent correlates of AST among Canadian children during the COVID-19 pandemic included greater independent mobility, warmer outdoor temperature, having a parent who actively commuted to work or school, living in a household owning fewer vehicles, and living in a more walkable neighborhood. These findings were largely consistent between boys and girls and between morning and afternoon school trips. Policymakers, urban planners, and public health workers aiming to promote AST should focus on these correlates while ensuring that neighborhoods are safe for children. Future research should monitor the prevalence and correlates of AST as COVID-19 restrictions are removed.

Neighborhood Environments and Healthy Life Expectancy in Older Adults: A 6-year Longitudinal Cohort Study Based on Data from the Japan Gerontological Evaluation Study.

A well-established association exists between health and neighborhood land use patterns, including parks, roads, and other physical environments, also called the built environment. Previous studies have demonstrated that the built environment influences health, particularly among older populations, because the scope of activities in such populations is limited. Herein, we investigated the association between specific neighborhood environments and the healthy life expectancy of older individuals. Data at two time points (2013 and 2019) from the Japan Gerontological Evaluation Study were used in this study. The study comprised a sample of 8,956 residents aged ≥65 years who were not certified for long-term care. Information on the presence or absence of eight types of neighborhood environments was collected using a questionnaire. A multistate life table analysis was conducted to determine the association between perceived neighborhood environments and healthy life expectancy. Significant differences were observed in the "parks and sidewalks suitable for exercise and walking" category. The group that perceived "parks and sidewalks suitable for exercise and walking" had an approximately 1.2-year longer healthy life expectancy than the group that did not perceive such parks and sidewalks. In addition, individuals who lived within walking distance of a park were more physically active than those who did not. Safe, walkable neighborhoods with excellent parks may encourage physical activity among older adults and extend their healthy lifespan. Future research is warranted to identify the underlying mechanisms.

Subjective walkability perceived by children and adolescents living in urban environments: A study protocol for participatory methods and scale development in the WALKI-MUC project.

Youth's perceptions of a city or neighbourhood's walkability are important for determining the physical activity (PA) friendliness of their environment. Traditional objective measures of walkability fail to incorporate children and youth's (CY) subjective perceptions of places that they perceive as supportive for play and exercise. Internationally, the most promising subjective measure is the Neighborhood Environment Walkability Scale for Youth (NEWS-Y) questionnaire. Yet, the NEWS-Y is not available for German-speaking adolescents. In the WALKI-MUC project, a combination of participatory research methods is used to identify CY's perceptions of PA-friendly places in Munich, Germany. Based on the findings, a German version of the NEWS-Y (NEWS-Y-G) for subjective walkability measurement is developed. CY aged six to 17 years from neighbourhoods with different objectively-measured walkability, take part in photovoice, walking interviews and mapping to gather their perceptions of PA-friendly places. The participatory study begins with an introductory workshop and concludes with a follow-up workshop, where characteristics of PA-friendly places are discussed in focus groups. In between these workshops, participants complete a photo mission with a walking interview, allowing for individual significance of PA-related places to be shared in a one-on-one setting with the researcher. The findings are used to adapt and translate the NEWS-Y for the German context. The newly developed NEWS-Y-G is then used to measure the subjective walkability perceived by a representative sample of adolescents in Munich. The WALKI-MUC project introduces a participatory methodology for researchers and urban planners to assess subjective walkability with CY. The combination of qualitative and quantitative walkability measurements is described in this study protocol. Findings on PA-friendly places contribute to environmental psychology and the development of the NEWS-Y-G adds a German-language instrument for subjective walkability measurement.

140 Association of neighborhood walkability with adverse pregnancy outcomes in gestational diabetes

140 Association of neighborhood walkability with adverse pregnancy outcomes in gestational diabetes

Ground Truthing: Perceived Versus Objectively Measured Built Environment Attributes in South African Communities

Introduction :No ground truthing study of ‘neighbourhood walkability’ has been conducted in Africa that contrasts the lived experience of the neighbourhood-built environment against objectively measured attributes using GIS and subscales of the NEWS-Africa instrument. Methods: This is a cross-sectional survey and observation study. A convenient sample of residents (n=52) aged 18-65 years from four urban suburbs in low- and high-income settings, self-reported transport, leisure-time physical activity (PA) and device-measured moderate-to-vigorous PA (MVPA) were assessed. Built environment constructs was derived from individual-level street network measures (1000m buffer, using ArcGIS 10.51). We also assessed PA between the four groups based on income and GIS walkability. Results: There was no significant relationship between self-reported MVPA and GIS-measured walkability in the study sample. Only intersection density had a significant inversely association with moderate and MVPA (rho=-0.31, P&lt;0.05) in the overall study sample. Self-report transport PA differed between groups (P&lt;0.013). Device-measured vigorous activity differed between groups and was lower in both Low-SES groups compared to the High-SES/Low Walkable group (P&lt;0.04). Total PA was not associated with GIS measured walkability, but inversely associated with positive perceived neighbourhood attributes. Conclusions: There is a modest inverse association between device-measured PA and GIS-measured intersection density. These results suggest that constructs of walkability, whether measured or perceived, may predict volitional and utilitarian PA differently in our study population.

Alleys: The future of walkability in suburbs

Alleys have the potential to become the future of walkability in suburban areas. This study strongly advocates for the incorporation of alleyways as fundamental components of circulation systems when designing walkable suburban neighborhoods. For this purpose, a dataset comprising 30 neighborhood samples have been meticulously selected from the cities of Abu Dhabi and Dubai. The Edge Betweenness centrality measure is used to assess how the inclusion of alleys affects the estimated trips along the network segments. This is achieved by comparing the analysis values for two network scenarios: one before and one after the inclusion of alleys. The objective of this analysis is to ascertain the circumstances under which alleys are considered as either a complementary or compensatory system to streets. The results reveal that the principal determinant of alleys' capacity to complement or compensate for street networks depends on their relative density in relation to streets. Moreover, other attributes of alleys, such as their continuity, distribution within the network, and direction, have been demonstrated to influence their utilization as central links in the network. The valuable insights derived from this analysis are instrumental in informing urban policies and design practices, contributing to the creation of more walkable areas in suburban areas.

Linking Neighborhood Walkability to the Independence and Quality of Life of Older Adults across Canada

In car dependent societies, driving cessation may reduce older adults’ independence and quality of life. One way to maintain independence for older adults after quitting driving is to encourage walking to local destinations. This paper explores how neighborhood walkability impacts older adults’ ability to maintain their lifestyles as they age. Based on data collected from the 2023 Aging in Place survey (N=3,551), we analyze the relationship between survey respondents’ perceptions of transport in their neighborhood and its Walk Score across 6 Canadian regions. We explore the association between neighborhood walkability and respondents’ perception of their independence, quality of life, and likelihood of needing to move in the future. We find that those living in walkable neighborhoods believe that they will maintain their lifestyle when they stop driving compared to those who live in less walkable areas. The results indicate that neighborhood walkability is a key element in enabling older adults to keep their independence and sustain their lifestyle.

OUT-OF-HOME MOBILITY, DAILY WORKING MEMORY, AND NEIGHBORHOOD WALKABILITY IN HEALTHY OLDER ADULTS

Abstract Out-of-home mobility could enhance cognitive performance, but environmental contexts — such as neighborhood walkability — may influence the associations. This study examined daily out-of-home mobility in relation to daily cognitive performance in healthy older adults and the moderator effects of neighborhood walkability therein. Participants wore a custom-built mobile GPS sensor („uTrail“) and completed smartphone-based working memory assessments for 15 days, and responded to the baseline Neighborhood Environment Walkability Scale. Analyses included 947 days’ data from 109 Swiss older adults aged 65 to 89 years. Out-of-home mobility (i.e., out-of-home time, maximum distance from home) were extracted from the GPS data. Multilevel models showed that daily out-of-home time and daily maximum distance from home were not associated with daily working memory performance across the study sample, but the associations were moderated by neighborhood walkability. Out-of-home time and maximum distance from home were positively (vs. negatively) associated with working memory performance in participants who lived in neighborhood with higher (vs. lower) street connectivity and more (vs. less) access to places for walking and cycling. Additionally, maximum distance from home were positively (vs. negatively) associated with working memory performance in participants in neighborhood with lower (vs. higher) mixture of land use. To conclude, spending more time out of home and travelling longer distance away from home could be beneficial for daily cognitive performance of older adults who lived in well-connected and higher-walkable and -bikeable neighborhood. Travelling longer distance could also benefit those who lived in a neighborhood with a lower mixture of land use.