Transportation For Older Adults Research Articles

Association between choices of transportation means and instrumental activities of daily living: observational cohort study of community-dwelling older adults

IntroductionThe association between the physical health of older people and the frequency of going out has been reported, and in recent years, local governments have developed transportation support programs for older people. Although previous studies show an association between the frequency of going out and functional health status, little has been reported on the impact of the choice of means of transport on instrumental activities of daily living (IADL).ObjectiveTo evaluate the association between choice of transportation means and the risk of decline in IADL among older adults.MethodsWe conducted an observational, population (community-dwelling)-based cohort study using data from the Resident Health Status Survey, and longitudinal panel data at 2-time points in 2016 and 2019. In addition, we combined this panel data and a database on people who were certified as requiring long-term care to identify participants’ IADL. The propensity score matching method was used to classify the respondents into two groups, “active means of transportation” and “passive means of transportation,“ and determine the risk of a decline in means-tested independence after 3 years.ResultsActive means were used by 6,280 (76.2%) and passive means were used by 1,865 (22.6%). 999 (12.1%) individuals declined in IADL in 2019. The results of the comparison by balancing the attributes of “active means of transportation” and “passive means of transportation,“ with propensity score matching, showed that “passive means of transportation” were more likely to be “active” than “passive means of transportation,“ and “active” was more likely to be “passive” The risk of IADL decline was significantly higher than that of “active means of transportation” with an RR of 1.93 (95% CI: 1.62–2.30).ConclusionPassive means of transportation in older adults could be a possible risk for decreasing IADL 3 years later. Increasing the number of opportunities and places in the community for older adults to use active means of transportation may be effective in encouraging socially independent living among older adults.

Salutary Acute Effects of Exercise on Central Hemodynamics in Heart Failure With Preserved Ejection Fraction

BackgroundA warmup period of priming exercise has been shown to improve peripheral oxygen transport in older adults. We sought to determine the acute effects of priming exercise on central hemodynamics at rest and during a repeat exercise in heart failure with preserved ejection fraction (HFpEF). Methods and ResultsThis is a post hoc analysis from 3 studies. Patients with HFpEF (n = 42) underwent cardiac catheterization with simultaneous expired gas analysis at rest and during exercise (20 W for 5 minutes, priming exercise). Measurements were then repeated at rest and during a second bout of exercise at a 20-W workload (second exercise). During the priming exercise, patients with HFpEF displayed dramatic increases in biventricular filling pressures and exercise-induced pulmonary hypertension. After the priming exercise at rest, biventricular filling pressures and pulmonary artery (PA) pressures were lower and lung tidal volume was increased. During the second bout of exercise, biventricular filling (PA wedge pressure, 29 ± 8 mm Hg at second exercise vs 32 ± 7 mm Hg at first exercise, P = .0003) and PA pressures were lower, and PA compliance increased. ConclusionsThis study shows that short duration, submaximal priming exercise attenuates the pathologic increases in filling pressures, improving pulmonary vascular hemodynamics at rest and during repeat exercise in patients with HFpEF.

Older Motorcyclists Not Wearing A Helmet Properly And Drunk Riding: Evidence From A Linked Dataset

Motorcycles are a major means of transportation for older adults in many developing countries, and motorcycle safety is an important issue in an aging society

Everyday Walking Among Older Adults and the Neighborhood Built Environment: A Comparison Between Two Cities in North America.

A walkable neighborhood becomes particularly important for older adults for whom physical activity and active transportation are critical for healthy aging-in-place. For many older adults, regular walking takes place in the neighborhood and is the primary mode of mobility. This study took place in eight neighborhoods in Metro Portland (USA) and Metro Vancouver (Canada), examining older adults' walking behavior and neighborhood built environmental features. Older adults reported walking for recreation and transport in a cross-sectional telephone survey. Information on physical activity was combined with audits of 355 street segments using the Senior Walking Environmental Audit Tool-Revised (SWEAT-R). Multi-level regression models examined the relationship between built environmental characteristics and walking for transport or recreation. Older adults [N = 434, mean age: 71.6 (SD = 8.1)] walked more for transport in high-density neighborhoods and in Metro Vancouver compared to Metro Portland (M = 12.8 vs. M = 2.2 min/day; p < 0.001). No relationship was found between population density and walking for recreation. Older adults spent more time walking for transport if pedestrian crossing were present (p = 0.037) and if parks or outdoor fitness amenities were available (p = 0.022). The immediate neighborhood built environment supports walking for transport in older adults. Comparing two similar metropolitan areas highlighted that high population density is necessary, yet not a sufficient condition for walking in the neighborhood.

Let’s Stop Spinning Our Wheels: Strengthening the Case for Community-Engaged Transportation Solutions

On average in the United States, older adults outlive their ability to drive by seven years. Having safe, affordable and accessible alternative transportation options is critical to supporting the well-being of older adults and their ability to age in community. This symposium will provide evidence for utilizing community-engaged research strategies with diverse populations to identify the opportunities and barriers for the development and utilization of alternative transportation. The presentations will include up-to-date examples of innovative alternative transportation solutions and evaluation data. The first presentation will illustrate how community-based participatory research (CBPR) strategies were used to develop, use and evaluate alternative transportation options including walking, biking, fixed route busing, senior circulator, ride sharing and transit training in an age-friendly community. Data were collected through mapping the built environment, an electronic daily transportation diary app called “MyAmble” on tablets, walk audits and focus groups. The second presentation uses an environmental justice (EJ) framework to present the findings of a qualitative interpretive meta-synthesis (QIMS) about older adults’ experiences with outdoor spaces and buildings and transportation as part of the World Health Organization’s age-friendly network assessment. The third paper explores the barriers and facilitators of transportation among diverse older adults (English, Nepali, Khmer, Somali, Russian and Mandarin Chinese) using Rapid and Rigorous Qualitative Data Analysis (RADaR) technique. The final paper examines the challenges of rural transportation services supported by senior centers. The symposium will conclude with a critical reflection on the empirical contributions needed to advance scholarship on alternative transportation for older adults.

Constraints to active transportation in older adults across four neighbourhoods: a descriptive study from Canada

ABSTRACT The purpose of this descriptive study was to compare perceived constraints to active transportation in older adults living in different neighbourhoods and thus, different built environments. An online survey was used to obtain information on perceived constraints to active transportation and linked to the Canadian Urban Environmental Health Research (CANUE) and Walk Score® data sets using postal codes. Data on active living environments (ALE) and walk, bike, and transit scores were used to describe the physical characteristics and active transportation friendliness of each neighbourhood represented by the respondents of the survey (n = 82). Significant variability was observed across neighbourhoods for most built environment characteristics. Nevertheless, the perceived constraints to active transportation of older residents of these neighbourhoods were consistent. In particular, cycling infrastructure, traffic conditions/safety, and sidewalk conditions were seen as consistent constraints. Interesting differences were observed when comparing newly developed neighbourhoods to more established ones. This small descriptive study provides further evidence that tackling constraints may require a more holistic approach, as changing one characteristic of the physical environment alone may not be sufficient to facilitate older adults with engaging in active transportation. These findings have important implications for the development of age-friendly policies pertaining to transportation and recreation.

The role of transportation in older adults' use of and satisfaction with primary care in China

IntroductionAccess to transportation is a major but oft-overlooked factor in the use of primary care and in the level of satisfaction with these services. This study uses an extended version of the Andersen Behavioral Model of Health Services Use to examine these two features of primary care in a nationally representative sample of older adults in China. MethodsData are from 1859 adults aged 65 years and older in Wave 1 of the WHO Study on Global AGEing and Adult Health (SAGE). We used a negative binominal regression to assess the association of mode, time and costs of transportation with frequency of primary care visits and an ordered logit regression to determine the level of satisfaction with those visits. FindingsFor persons who drive, taxi, or otherwise pay for transit, travel time is related to frequency of primary care visits. Transportation costs are also related to satisfaction, but $1 spent on transportation does not differ from $1 spent on other items related to a primary care visit. Individuals who walk have higher levels of satisfaction than those who drive. Other predisposing, enabling and need factors, including geography, socio-economic status, chronic health conditions and social supports are also associated with primary care visit frequency and satisfaction. ConclusionsPromoting active travel modes among the older population and community-level health facility planning enhances older adults’ use of and satisfaction with primary care visits. Transportation strategies should be an integral part of health interventions with this population.

Neighborhood walkability, physical activity, and walking for transportation: A cross-sectional study of older adults living on low income

BackgroundWalking, and in particular, outdoor walking, is the most common form of physical activity for older adults. To date, no study investigated the association between the neighborhood built environment and physical activity habits of older adults of low SES. Thus, our overarching aim was to examine the association between the neighborhood built environment and the spectrum of physical activity and walking for transportation in older adults of low socioeconomic status.MethodsCross-sectional data were from the Walk the Talk Study, collected in 2012. Participants (n = 161, mean age = 74 years) were in receipt of a rental subsidy for low income individuals and resided in neighbourhoods across Metro Vancouver, Canada. We used the Street Smart Walk Score to objectively characterize the built environment main effect (walkability), accelerometry for objective physical activity, and the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire to measure walking for transportation. We used regression analyses to examine associations of objectively measured physical activity [total volume, light intensity and moderate intensity physical activity (MVPA)] and self-reported walking for transportation (any, frequency, duration) with walkability. We adjusted analyses for person- and environment-level factors associated with older adult physical activity.ResultsNeighbourhood walkability was not associated with physical activity volume or intensity and self-reported walking for transportation, with one exception. Each 10-point increase in Street Smart Walk Score was associated with a 45% greater odds of any walking for transportation (compared with none; OR = 1.45, 95% confidence interval = 1.18, 1.78). Sociodemographic, physical function and attitudinal factors were significant predictors of physical activity across our models.ConclusionsThe lack of associations between most of the explored outcomes may be due to the complexity of the relation between the person and environment. Given that this is the first study to explore these associations specifically in older adults living on low income, this study should be replicated in other settings.

Neighbourhood environment, sitting time and motorised transport in older adults: a cross-sectional study in Hong Kong

ObjectivesSitting time is a public health concern. This study examined associations of objectively measured neighbourhood environmental attributes with non-transport sitting time and motorised transport in 484 Hong Kong older adults....

Volunteer Drivers: Their Contributions to Older Adults and to Themselves

ABSTRACT In 2004 and 2005 the Beverly Foundation surveyed volunteer drivers in an effort to better understand how and why they support older adults. The sample comprised 714 volunteer drivers from 367 communities, representing 40 states, who responded to the survey. Their responses provided qualitative and quantitative information about who they are, why they volunteer, the challenges they face, and the satisfaction they receive from volunteering to drive. They also addressed current topics including mobility and transportation for older adults, volunteerism and civic engagement, and an innovative method of joining the two sides of aging—the “wellderly” and the elderly. The involvement of volunteer drivers and the organizations that enable them to provide transportation services may be one solution for today and a hope of the future for meeting the transportation needs of older adults.