Association of the Built Environment With Physical Activity and Obesity in Older Persons

TLDR

The Walkable and Bikable Communities Project developed a walkability score to predict walking likelihood in King County, Washington, but the link between walking frequency and obesity remains unclear. This study examined whether older adults residing in walkable neighborhoods are more physically active or less obese compared to those in less walkable areas. Using the Adult Changes in Thought cohort, participants’ addresses were geocoded and linked to the walkability score via a geographic information system for cross‑sectional analysis. Higher walkability scores were associated with significantly greater walking for exercise (e.g., OR 5.86–9.14 for men, OR 1.63–1.77 for women), while a non‑significant trend toward lower BMI in men was observed, indicating that neighborhood walkability correlates with physical activity in older adults.

Abstract

We examined whether older persons who live in areas that are conducive to walking are more active or less obese than those living in areas where walking is more difficult.We used data from the Adult Changes in Thought cohort study for a cross-sectional analysis of 936 participants aged 65 to 97 years. The Walkable and Bikable Communities Project previously formulated a walkability score to predict the probability of walking in King County, Washington. Data from the cohort study were linked to the walkability score at the participant level using a geographic information system. Analyses tested for associations between walkability score and activity and body mass index.Higher walkability scores were associated with significantly more walking for exercise across buffers (circular zones around each respondent's home) of varying radii (for men, odds ratio [OR]=5.86; 95% confidence interval [CI]=1.01, 34.17 to OR=9.14; CI=1.23, 68.11; for women, OR=1.63; CI=0.94, 2.83 to OR=1.77; CI=1.03, 3.04). A trend toward lower body mass index in men living in more walkable neighborhoods did not reach statistical significance.Findings suggest that neighborhood characteristics are associated with the frequency of walking for physical activity in older people. Whether frequency of walking reduces obesity prevalence is less clear.