Features of the physical environment, walking difficulty, and physical activity in old age

Abstract

Mobility enables engagement in out-of-home activities and thus is important for the well-being of older adults. Walking difficulty may limit mobility, and low physical activity is one risk factor for walking difficulty. Environmental features close to home may hinder or encourage physical activity in older adults. This study aimed to contribute knowledge on features of the physical environment that support the physical functioning and physical activity (PA) of older adults, and to investigate whether the associations between environmental features and PA may differ by perceived walking difficulty, type of residential neighbourhood, and day of the week. The data were collected as part of the Life- Space Mobility in Older People (n=848) project in structured interviews, performance tests, and accelerometer measurements (n=167) among communitydwelling 75- to 90-year-olds living in Central Finland. The data on environmental features were retrieved from open sources of geospatial data. The results showed that a more steeply sloping road network and lower PA were risk factors for developing walking difficulty. The supportiveness of the infrastructure for outdoor mobility and diversity of large natural, green areas were positively, and slope negatively, associated with PA. Perceived infrastructure-based facilitators in dispersed areas and nature-based destinations in city centres and densely populated areas outside centres were associated with higher PA. Perceived nature was a more important PA facilitator for older adults with than without walking difficulty. Among those with walking difficulty, the presence of waterside areas increased while higher diversity in large natural and green areas decreased the odds for higher PA. Among those without walking difficulty, higher diversity in large natural and green area increased the odds for higher PA and for perceiving nature as a facilitator for outdoor mobility. Naturebased features were associated with PA consistently throughout the week but infrastructure-based features only on weekdays. Depending on the home location, environmental features appear to support older adults’ engagement in outdoor PA. At the greatest, when converted to PA volumes, the difference in supportiveness might correspond to the difference in PA accumulation between older adults with and without walking difficulty. Keywords: outdoor mobility, mobility limitation, neighbourhood, infrastructure, nature, older adults