|King, Abby - Stanford University|
|Salvo, Deborah - Stanford University|
|Banda, Jorge - Stanford University|
|Ahn, David - Stanford University|
|Gill, Thomas - Yale University|
|Miller, Michael - Wake Forest School Of Medicine|
|Newman, Ann - University Of Pittsburgh|
|Fielding, Roger - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
|Siordia, Carlos - University Of Pittsburgh|
|Moore, Spencer - University Of South Carolina|
|Folta, Sara - Tufts University|
|Spring, Bonnie - Northwestern University|
|Manini, Todd - University Of Florida|
|Pahor, Marco - University Of Florida|
Submitted to: International Journal of Behavioral Nutrition and Physical Activity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/9/2015
Publication Date: 12/18/2015
Citation: King, A.C., Salvo, D., Banda, J., Ahn, D.K., Gill, T., Miller, M., Newman, A.B., Fielding, R.A., Siordia, C., Moore, S., Folta, S., Spring, B., Manini, T., Pahor, M. 2015. An observational study identifying obese subgroups among older adults at increased risk of mobility disability: do perceptions of the neighborhood environment matter. International Journal of Behavioral Nutrition and Physical Activity. 12:157. doi: 10.1186/s12966-015-0322-1.
Interpretive Summary: The prevalence of obesity among older adults continues to increase. This study examined the role of the neighborhood built environment on obesity prevalence in a cohort of older adults. Among participants aged 70-78 years, the subgroups with the lowest obesity prevalence consisted of participants who reported living in neighborhoods with higher residential density. Among participants aged 79-89 years, the subgroup with the lowest obesity prevalence consisted of non African American/Black participants who reported living in neighborhoods with friends or acquaintances similar in demographic characteristics to themselves. The results suggest that features of the neighborhood built and social environments differentiate distinct groups of vulnerable older adults based on obesity prevalence.
Technical Abstract: BACKGROUND: Obesity is an increasingly prevalent condition among older adults, yet relatively little is known about how built environment variables may be associated with obesity in older age groups. This is particularly the case for more vulnerable older adults already showing functional limitations associated with subsequent disability. METHODS: The Lifestyle Interventions and Independence for Elders (LIFE) trial dataset (n=1600) was used to explore the associations between perceived built environment variables and baseline obesity levels. Age stratified recursive partitioning methods were applied to identify distinct subgroups with varying obesity prevalence. RESULTS: Among participants aged 70-78 years, four distinct subgroups, defined by combinations of perceived environment and race ethnicity variables, were identified. The subgroups with the lowest obesity prevalence (45.5-59.4 %) consisted of participants who reported living in neighborhoods with higher residential density. Among participants aged 79-89 years, the subgroup (of three distinct subgroups identified) with the lowest obesity prevalence (19.4%) consisted of non African American/Black participants who reported living in neighborhoods with friends or acquaintances similar in demographic characteristics to themselves. Overall support for the partitioned subgroupings was obtained using mixed model regression analysis. CONCLUSIONS: The results suggest that, in combination with race/ethnicity, features of the perceived neighborhood built and social environments differentiated distinct groups of vulnerable older adults from different age strata that differed in obesity prevalence. Pending further verification, the results may help to inform subsequent targeting of such subgroups for further investigation.