Van Holle Veerle, Van Cauwenberg Jelle, Gheysen Freja, Van Dyck Delfien, Deforche Benedicte, Van de Weghe Nico, De Bourdeaudhuij Ilse
Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
Research Foundation Flanders (FWO), Brussels, Belgium.
PLoS One. 2016 Feb 12;11(2):e0148398. doi: 10.1371/journal.pone.0148398. eCollection 2016.
Better physical functioning in the elderly may be associated with higher physical activity levels. Since older adults spend a substantial part of the day in their residential neighborhood, the neighborhood physical environment may moderate associations between functioning and older adults' physical activity. The present study investigated the moderating role of the objective and perceived physical environment on associations between Belgian older adults' physical functioning and transport walking, recreational walking, and moderate-to-vigorous physical activity.
Data from 438 older adults were included. Objective physical functioning was assessed using the Short Physical Performance Battery. Potential moderators included objective neighborhood walkability and perceptions of land use mix diversity, access to recreational facilities, access to services, street connectivity, physical barriers for walking, aesthetics, crime-related safety, traffic speeding-related safety, and walking infrastructure. Transport and recreational walking were self-reported, moderate-to-vigorous physical activity was assessed through accelerometers. Multi-level regression analyses were conducted using MLwiN to examine two-way interactions between functioning and the environment on both walking outcomes. Based on a previous study where environment x neighborhood income associations were found for Belgian older adults' moderate-to-vigorous physical activity, three-way functioning x environment x income interactions were examined for moderate-to-vigorous physical activity.
Objectively-measured walkability moderated the association between functioning and transport walking; this positive association was only present in high-walkable neighborhoods. Moreover, a three-way interaction was observed for moderate-to-vigorous physical activity. Only in high-income, high-walkable neighborhoods, there was a positive association between functioning and moderate-to-vigorous physical activity. No functioning x walkability interactions were observed for recreational walking, and none of the perceived environmental variables moderated the positive association between physical functioning and the physical activity outcomes.
For older adults with better physical functioning, living in a high-walkable neighborhood could be beneficial to engage in more transport walking. Living in high-income, high-walkable neighborhoods and having better functioning might also be beneficial for more engagement in moderate-to-vigorous physical activity. This might suggest a protective role of neighborhood walkability for preventing declining physical functioning and consequently decreasing physical activity levels in older adults. However, given the cross-sectional design of the present study, this suggestion needs to be confirmed through longitudinal assessment investigating over-time changes in the observed associations.
老年人更好的身体机能可能与更高的身体活动水平相关。由于老年人一天中的大部分时间都在其居住社区度过，社区的物理环境可能会调节身体机能与老年人身体活动之间的关联。本研究调查了客观和感知的物理环境对比利时老年人身体机能与交通步行、休闲步行以及中度至剧烈身体活动之间关联的调节作用。
纳入了438名老年人的数据。使用简短身体性能量表评估客观身体机能。潜在的调节因素包括客观的社区步行适宜性以及对土地利用混合多样性、休闲设施可达性、服务可达性、街道连通性、步行的物理障碍、美观、与犯罪相关的安全性、与交通超速相关的安全性以及步行基础设施的感知。交通和休闲步行通过自我报告，中度至剧烈身体活动通过加速度计进行评估。使用MLwiN进行多层次回归分析，以检验机能与环境在两种步行结果上的双向交互作用。基于之前一项对比利时老年人中度至剧烈身体活动发现环境x社区收入关联的研究，对中度至剧烈身体活动检验了机能x环境x收入的三向交互作用。
客观测量的步行适宜性调节了机能与交通步行之间的关联；这种正向关联仅在高步行适宜性社区中存在。此外，观察到了中度至剧烈身体活动的三向交互作用。仅在高收入、高步行适宜性社区中，机能与中度至剧烈身体活动之间存在正向关联。对于休闲步行，未观察到机能x步行适宜性的交互作用，并且没有任何感知环境变量调节身体机能与身体活动结果之间的正向关联。
对于身体机能较好的老年人，居住在高步行适宜性社区可能有利于进行更多的交通步行。居住在高收入、高步行适宜性社区且身体机能较好可能也有利于更多地参与中度至剧烈身体活动。这可能表明社区步行适宜性在预防老年人身体机能下降以及随之而来的身体活动水平降低方面具有保护作用。然而，鉴于本研究的横断面设计，这一推测需要通过纵向评估来证实，该评估要调查观察到的关联随时间的变化情况。
