Preserving older adults' routine outdoor activities in contrasting neighborhood environments through a physical activity intervention

Authors: KING, ABBY - Stanford University; SALVO, DEBORAH - Stanford University; BANDA, JORGE - Stanford University; AHN, DAVID - Stanford University; CHAPMAN, JAMES - University Of British Columbia; GILL, THOMAS - Yale University; FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; DEMONS, JAMEHL - Wake Forest University; TUDOR-LOCKE, CATRINE - University Of Massachusetts; ROSSO, ANDREA - University Of Pittsburgh; PAHOR, MARCO - University Of Florida; FRANK, LAWRENCE - University Of British Columbia

Submitted to: Preventive Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/25/2016
Publication Date: 12/28/2016
Citation: King, A., Salvo, D., Banda, J.A., Ahn, D.K., Chapman, J.E., Gill, T., Fielding, R.A., Demons, J., Tudor-Locke, C., Rosso, A., Pahor, M., Frank, L.D. 2016. Preserving older adults' routine outdoor activities in contrasting neighborhood environments through a physical activity intervention. Preventive Medicine. 96:87-93. https://doi.org/10.1016/j.ypmed.2016.12.049.

Interpretive Summary: While neighborhood design can potentially influence routine outdoor physical activities (PA) little is known concerning its effects on such activities among older adults attempting to increase their PA levels. We evaluated the effects of living in neighborhoods differing in compactness on changes in routine outdoor activities (e.g. walking, gardening, yard work) among older adults at increased mobility disability risk participating in the LIFE-Pilot PA trial (ages 70-89 years; from Dallas, TX, San Francisco Bay area, Pittsburgh, PA, and Winston-Salem, NC). PA increased weekly exercise participation and leisure time walking relative to control, irrespective of how compact participants' neighborhoods were. However, walking for errands decreased significantly more in PA relative to control, particularly among those living in less compact neighborhoods. PA participants living in less compact neighborhoods maintained or increased participation in gardening and yard work to a greater extent than controls. These results indicate that environmental differences in neighborhoods influence some of the behavioral responses to a structured PA program.

Technical Abstract: While neighborhood design can potentially influence routine outdoor physical activities (PA), little is known concerning its effects on such activities among older adults attempting to increase their PA levels. We evaluated the effects of living in neighborhoods differing in compactness on changes in routine outdoor activities (e.g., walking, gardening, yard work) among older adults at increased mobility disability risk participating in the LIFE-Pilot PA trial (2003-07; ages 70-89 years; from Dallas, TX, San Francisco Bay area, Pittsburgh, PA, and Winston-Salem, NC). Analyses were conducted on the 400 LIFE-Pilot participants randomized to a one-year endurance-plus-strengthening PA intervention or health education control that completed one-year PA assessment (CHAMPS questionnaire). Outcomes of interest were exercise and leisure walking, walking for errands, and moderate-intensity gardening. Neighborhood compactness was assessed objectively using geographic information systems via a subsequent grant (2008-12). PA increased weekly exercise and leisure walking relative to control, irrespective of neighborhood compactness. However, walking for errands decreased significantly more in PA relative to control (net mean [SD] difference=16.2 min/week [7.7], p=0.037), particularly among those living in less compact neighborhoods (net mean [SD] difference=29.8 [10.8] minutes/week, p=0.006). PA participants living in less compact neighborhoods maintained or increased participation in gardening and yard work to a greater extent than controls (net mean [SD] difference= 29.3 [10.8] minutes/week, p = 0.007). The results indicate that formal targeting of active transport as an adjunct to structured PA programs may be important to diminish potential compensatory responses in functionally impaired older adults. Structured endurance-plus strengthening PA may help older adults maintain or increase such routine activities over time.