Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstraße 30, 28215, Bremen, Germany.
Faculty of Human and Health Sciences, University of Bremen, Bremen, Germany.
Int J Health Geogr. 2020 Nov 9;19(1):47. doi: 10.1186/s12942-020-00243-z.
A supportive environment is a key factor in addressing the issue of health among older adults. There is already sufficient evidence that objective and self-reported measures of the neighborhood environment should be taken into account as crucial components of active aging, as they have been shown to influence physical activity; particularly in people aged 60+. Thus, both could inform policies and practices that promote successful aging in place. An increasing number of studies meanwhile consider these exposures in analyzing their impact on physical activity in the elderly. However, there is a wide variety of definitions, measurements and methodological approaches, which complicates the process of obtaining comparable estimates of the effects and pooled results. The aim of this review was to identify and summarize these differences in order to emphasize methodological implications for future reviews and meta analyzes in this field and, thus, to create a sound basis for synthesized evidence.
A systematic literature search across eight databases was conducted to identify peer-reviewed articles examining the association of objective and perceived measures of the neighborhood environment and objectively measured or self-reported physical activity in adults aged ≥ 60 years. Two authors independently screened the articles according to predefined eligibility criteria, extracted data, and assessed study quality. A qualitative synthesis of the findings is provided.
Of the 2967 records retrieved, 35 studies met the inclusion criteria. Five categories of methodological approaches, numerous measurement instruments to assess the neighborhood environment and physical activity, as well as several clusters of definitions of neighborhood, were identified.
The strength of evidence of the associations of specific categories of environmental attributes with physical activity varies across measurement types of the outcome and exposures as well as the physical activity domain observed and the operationalization of neighborhood. The latter being of great importance for the targeted age group. In the light of this, future reviews should consider these variations and stratify their summaries according to the different approaches, measures and definitions. Further, underlying mechanisms should be explored.
支持性环境是解决老年人健康问题的关键因素。已经有足够的证据表明，邻里环境的客观和自我报告测量应该被视为积极老龄化的关键组成部分，因为它们已经被证明会影响身体活动；特别是在 60 岁以上的人群中。因此，两者都可以为促进原地成功老龄化的政策和实践提供信息。与此同时，越来越多的研究考虑了这些暴露因素，分析它们对老年人身体活动的影响。然而，这些定义、测量和方法学方法多种多样，这使得获得可比的影响估计值和汇总结果变得复杂。本综述的目的是确定和总结这些差异，以便强调该领域未来综述和荟萃分析的方法学意义，并为综合证据奠定坚实的基础。
通过对八个数据库进行系统的文献检索，确定了 35 项审查客观和感知邻里环境指标与 60 岁及以上成年人客观测量或自我报告的身体活动之间关联的同行评议文章。两名作者根据预先确定的入选标准独立筛选文章，提取数据，并评估研究质量。提供了研究结果的定性综合。
在检索到的 2967 条记录中，有 35 项研究符合纳入标准。确定了五类方法学方法、用于评估邻里环境和身体活动的众多测量工具，以及邻里的几个定义集群。
特定类别的环境属性与身体活动之间关联的证据强度因结局和暴露的测量类型以及观察到的身体活动领域以及邻里的操作化而有所不同。对于目标年龄组而言，后者非常重要。有鉴于此，未来的综述应该考虑到这些差异，并根据不同的方法、措施和定义对其摘要进行分层。此外，应探索潜在机制。
