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      Walking-friendly built environments and objectively measured physical function in older adults

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          Highlights

          • It is not well known how urban design may influence physical function in dense areas.

          • Walkability attributes were associated with the physical function of elderly men.

          • No associations were found among elderly women.

          Abstract

          Background

          Few studies have examined the associations between urban design attributes and older adults’ physical function. Especially, it is not well known how built-environment attributes may influence physical function in Asian cities. The aim of this study was to examine associations between objectively measured environmental attributes of walkability and objectively assessed physical function in a sample of Japanese older adults.

          Methods

          Cross-sectional data collected in 2013 from 314 older residents (aged 65–84 years) living in Japan were used. Physical function was estimated from objectively measured upper- and lower-body function, mobility, and balance by a trained research team member. A comprehensive list of built-environment attributes, including population density, availability of destinations, intersection density, and distance to the nearest public transport station, were objectively calculated. Walk Score as a composite measure of neighborhood walkability was also obtained.

          Results

          Among men, higher population density, availability of destinations, and intersection density were significantly associated with better physical function performance (1-legged stance with eyes open). Higher Walk Score was also marginally associated with better physical function performance (1-legged stance with eyes open). None of the environmental attributes were associated with physical function in elderly women.

          Conclusion

          Our findings indicate that environmental attributes of walkability are associated with the physical function of elderly men in the context of Asia. Walking-friendly neighborhoods can not only promote older adults’ active behaviors but can also support their physical function.

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          Most cited references42

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          "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician.

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            Development and validation of a geriatric depression screening scale: a preliminary report.

            A new Geriatric Depression Scale (GDS) designed specifically for rating depression in the elderly was tested for reliability and validity and compared with the Hamilton Rating Scale for Depression (HRS-D) and the Zung Self-Rating Depression Scale (SDS). In constructing the GDS a 100-item questionnaire was administered to normal and severely depressed subjects. The 30 questions most highly correlated with the total scores were then selected and readministered to new groups of elderly subjects. These subjects were classified as normal, mildly depressed or severely depressed on the basis of Research Diagnostic Criteria (RDC) for depression. The GDS, HRS-D and SDS were all found to be internally consistent measures, and each of the scales was correlated with the subject's number of RDC symptoms. However, the GDS and the HRS-D were significantly better correlated with RDC symptoms than was the SDS. The authors suggest that the GDS represents a reliable and valid self-rating depression screening scale for elderly populations.
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              Built environmental correlates of older adults’ total physical activity and walking: a systematic review and meta-analysis

              Background Identifying attributes of the built environment associated with health-enhancing levels of physical activity (PA) in older adults (≥65 years old) has the potential to inform interventions supporting healthy and active ageing. The aim of this study was to first systematically review and quantify findings on built environmental correlates of older adults’ PA, and second, investigate differences by type of PA and environmental attribute measurement. Methods One hundred articles from peer-reviewed and grey literature examining built environmental attributes related to total PA met inclusion criteria and relevant information was extracted. Findings were meta-analysed and weighted by article quality and sample size and then stratified by PA and environmental measurement method. Associations (p < .05) were found in relation to 26 individual built environmental attributes across six categories (walkability, residential density/urbanisation, street connectivity, access to/availability of destinations and services, infrastructure and streetscape, and safety) and total PA and walking specifically. Reported individual- and environmental-level moderators were also examined. Results Positive environmental correlates of PA, ranked by strength of evidence, were: walkability (p < .001), safety from crime (p < .001), overall access to destinations and services (p < .001), recreational facilities (p < .001), parks/public open space (p = .002) and shops/commercial destinations (p = .006), greenery and aesthetically pleasing scenery (p = .004), walk-friendly infrastructure (p = .009), and access to public transport (p = .016). There were 26 individual differences in the number of significant associations when the type of PA and environmental measurement method was considered. No consistent moderating effects on the association between built environmental attributes and PA were found. Conclusions Safe, walkable, and aesthetically pleasing neighbourhoods, with access to overall and specific destinations and services positively influenced older adults’ PA participation. However, when considering the environmental attributes that were sufficiently studied (i.e., in ≥5 separate findings), the strength of evidence of associations of specific categories of environment attributes with PA differed across PA and environmental measurement types. Future research should be mindful of these differences in findings and identify the underlying mechanisms. Higher quality research is also needed. Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0558-z) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                Journal
                J Sport Health Sci
                J Sport Health Sci
                Journal of Sport and Health Science
                Shanghai University of Sport
                2095-2546
                2213-2961
                07 February 2020
                December 2020
                07 February 2020
                : 9
                : 6
                : 651-656
                Affiliations
                [a ]Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan
                [b ]Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
                [c ]Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
                [d ]Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4Z6, Canada
                [e ]Faculty of Kinesiology, University of Calgary, Calgary, Alberta T2N 4Z6, Canada
                [f ]School of Architecture, Planning and Landscape, University of Calgary, Calgary, Alberta T2N 4Z6, Canada
                [g ]Graduate School of Environmental Studies, Tohoku University, Sendai 980-0845, Japan
                [h ]Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba 305-8574, Japan
                [i ]Faculty of Liberal Arts and Sciences, Bunka Gakuen University, Tokyo 151-8523, Japan
                Author notes
                [* ]Corresponding author. mkoohsari@ 123456unimelb.edu.au
                Article
                S2095-2546(20)30015-6
                10.1016/j.jshs.2020.02.002
                7749248
                33308816
                fd38e4ce-ea98-432c-a74b-9d79c112d748
                © 2020 Published by Elsevier B.V. on behalf of Shanghai University of Sport.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 27 August 2019
                : 22 November 2019
                : 12 December 2019
                Categories
                Original Article

                elderly,functional test,neighborhood,urban design,walkability

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