Neighborhood Walkability Among Older Adults With and Without Physical Disabilities

Abstract Older adults with physical disabilities (PDs) often experience obstacles to walking locally. Although health promotion programs targeting physical activity are available in lower income, few studies have compared the walking experiences of older adults in these communities who have PDs with those who do not. The purpose of this study was to compare perceptions of neighborhood walkability among adults living in lower income communities with and without PDs. Participants (N=132) were recruited in 2018 at a regional health clinic in Flint, MI. To be eligible, participants had to be over 65 years old and Flint residents. A subsample (N=12) were then followed up with in 2019/2020. We defined PDs as having difficulty performing one or more activities of daily living. Descriptive statistics and analysis of covariance (ANCOVA) were performed. Of the 132 participants, the mean age in 2018 was 69.75 (SD=5.00). The majority were female (68%); African American (80%); single, divorced, or widowed (80%); and educated below GED level (84%). Older adults with PDs were less likely than those without to visit stores within walking distance and walk in their neighborhoods, and more likely to complain about a lot of traffic along the street. Analysis of the longitudinal data show that older adults who had PDs at time 1 were more likely at time 2 to 1) state that their neighborhoods were unsafe; and 2) perceive their neighborhoods more negatively. Findings suggest it is essential to develop disability-friendly support systems and accommodations to encourage walking in lower income communities.

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Stages of Change in Physical Activity and Neighborhood Walkability Among Older Adults living in the Urban Setting

Innovation in Aging ◽

10.1093/geroni/igab046.2358 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 621-622

Author(s):

Rie Suzuki ◽

Jennifer Blackwood ◽

Noah Webster ◽

Shailee Shah

Keyword(s):

Physical Activity ◽

Older Adults ◽

Stages Of Change ◽

Readiness To Change ◽

Urban Setting ◽

Health Clinic ◽

Lower Income ◽

Neighborhood Walkability ◽

Insufficient Physical Activity ◽

The Mean

Abstract Insufficient physical activity (PA) is considered an independent risk factor for chronic diseases. Although older adults living in lower-income areas often experience obstacles to walking locally, few studies have compared their walking experiences and the degree of readiness to change on engaging in PA. The purpose of this study was to compare perceptions of neighborhood walkability by the stages of change among older adults living in a lower-income community. Participants were recruited in 2018 at a regional health clinic in Flint, MI. To be eligible, participants had to be over 65 years old and Flint residents. Of the 132 participants, the mean age was 69.74 (SD=5.00) years old. The majority of respondents were female (66%); African American (77%); single, divorced, or widowed (75%); and educated below a GED level (84%). The results showed that older adults at the pre-contemplation/contemplation stage (PC/C) were less likely to perceive the availability of sidewalks on most streets and more likely to complain about much traffic along the street than those at the action/maintenance stage (A/M) (p<0.05). After controlling for covariates, multiple regression analysis showed that those at PC/C were less likely to state that their neighborhoods were accessible (β = .17*) and to perceive the presence of walking hazard (e.g., lack of sidewalks) (β = -.17*). Those who engaged in PA less than 30 minutes per day perceived the neighborhoods were accessible (β = .23*). Findings suggest that it is essential to develop friendly support systems and accommodations to encourage walking in lower-income communities.

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Functional Limitations and Perceived Neighborhood Walkability Among Urban Dwelling Older Adults

Frontiers in Public Health ◽

10.3389/fpubh.2021.675799 ◽

2021 ◽

Vol 9 ◽

Author(s):

Rie Suzuki ◽

Jennifer Blackwood ◽

Noah J. Webster ◽

Shailee Shah

Keyword(s):

Older Adults ◽

General Education ◽

Functional Limitations ◽

Walking Distance ◽

Lower Income ◽

Cross Sectional Survey ◽

General Education Development ◽

Education Development ◽

Cross Sectional ◽

Neighborhood Walkability

Older adults with functional limitations (FLs) often experience obstacles to walking. Although health promotion programs targeting physical activity are available in lower-income areas, few studies have compared the walking experiences of older adults who have FLs with those who do not in the community. The purpose of this cross-sectional survey was to compare perceptions of neighborhood walkability among older adults living in lower-income communities with and without FLs. Participants (N = 132) were recruited in 2018 at regional health clinics in Flint, Michigan. To be eligible, participants had to be 65 years of age or older, report no cognitive decline, and be Flint residents. Of the 132 participants, the mean age was 69.74 (SD = 4.97). The majority were female (66%); African American (77%); single, divorced, or widowed (72%); educated below the General Education Development level (57%), and had a FL (67%). Older adults with FLs were significantly (p < 0.05) less likely than those without to visit many places within walking distance, to have well-lit neighborhoods at night, and to reside in neighborhoods where sidewalks were separated from the road and traffic. Multiple regression analyses revealed that having a FL was associated with poorer neighborhood perceptions of mixed-land-use (b = −0.19, p < 0.05) and more walking hazards (b = −0.26, p < 0.05). Findings suggest that a FL is associated with perceptions of walkability. It is essential to develop disability-friendly support systems and accommodations to encourage walking in lower-income communities.

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THE BUILT ENVIRONMENT INFLUENCED THE INCIDENCE OF FALLS IN OLDER ADULTS LIVING IN THE UNDERSERVED COMMUNITY

Innovation in Aging ◽

10.1093/geroni/igz038.1076 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S292-S292

Author(s):

Rie Suzuki ◽

Jennifer Blackwood ◽

Shailee Shah ◽

Sabah Ganai ◽

Kimberly Warden

Keyword(s):

Physical Activity ◽

Older Adults ◽

Built Environment ◽

Walking Distance ◽

Health Clinic ◽

Cross Sectional Survey ◽

Eligibility Criteria ◽

Cross Sectional ◽

The Past ◽

Underserved Community

Abstract The built environment is commonly cited as a facilitator to local walking. Although health promotion programs targeting physical activity are available, few studies have investigated the associations of the perceived neighborhoods with the incidence of falls in the minority communities. Hence, the purpose of this preliminary study was to understand whether the perceived built environment influenced the fall experiences in older adults living in the underserved community. The preliminary cross-sectional survey was conducted at the regional health clinic in Flint, MI. Descriptive statistics and analysis of variance (ANOVA) were performed using SAS v8.4. The eligibility criteria included over 65 years old and Flint residents. Of 132 participants, the mean age was 69.75 (SD=5.00). The majority were female (68%), African Americans (80%), single, divorced or widowed (80%), and > GED (84%). The ANOVAs supported that “had fallen in the past year” was associated with “stores are within easy walking distance,” “easy to walk to a transit stop” and “there is a dirt strip that separates the streets from the sidewalks.” The fall experience was more likely to associate with the sedentary lifestyle and the comorbidities such as diabetes, fatigues, muscle spasms, and chronic pain. To summarize, the built environment increased the incidence of falls in the past year. Those who had fallen had poor health conditions. Further studies are needed for older adults to engage in physical activity. It is essential to develop the age-friendly support systems and accommodations to local walking in this community.

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Evaluation of a geriatric day rehabilitation centre: subjective and objective outcomes in community-dwelling older adults

Australian Journal of Primary Health ◽

10.1071/py08054 ◽

2009 ◽

Vol 15 (2) ◽

pp. 117 ◽

Cited By ~ 2

Author(s):

A. Foley ◽

S. Hillier ◽

R. Barnard

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Lower Limb ◽

Daily Living ◽

Community Dwelling ◽

Rehabilitation Centre ◽

Lower Limb Strength ◽

The Mean ◽

Community Dwelling Older Adults

Pre and post testing were conducted on community-dwelling older adults referred to a geriatric day rehabilitation centre (DRC). Consecutive DRC clients were screened for inclusion over a 16-month period and were eligible if: aged 60+ years; cognitively intact; and reason for referral involved spinal or lower limb musculoskeletal impairment, disability or surgery, and/or reduced functional mobility or falls. Clients were excluded if they had a neurological disorder, or did not complete the program. Outcome measures included: lower limb strength; balance; mobility; self-reported pain; activities of daily living; and quality of life. Data were summarised using descriptive statistics and analysed using paired t-tests. Of the 137 participants recruited, 110 were female and the mean age was 79.5 ± 7.3 years. In total, 106 participants completed the DRC program and were assessed at baseline and re-assessed at discharge. The mean length of stay was 12.4 ± 2.9 weeks, with 21.4 ± 5.4 attendances. From baseline to discharge, statistically significant differences were found for all objective measures of physical functioning, balance, and for all lower limb strength tests (P < 0.0001). Glasgow Pain Questionnaire scores demonstrated statistically significant improvements in all five domains of the scale (P < 0.0001). The Barthel Index and Multi-dimensional Functional Assessment Questionnaire both showed a statistically significant improvement in the level of independence in activities of daily living (ADL) (P < 0.05). The Assessment of Quality of Life Questionnaire showed a statistically significant improvement (P = 0.027). The Exercise Benefits/Barriers Scale also showed a statistically significant improvement over DRC attendance (P = 0.005). The Falls Efficacy Scale showed a positive change, but the improvement was not statistically significant (P = 0.80). The study’s results indicate that community-dwelling older adults with physical disabilities and multiple comorbidities who attended the interdisciplinary geriatric DRC, significantly improved their lower limb strength, balance and physical function, and also showed significant decreases in self-reported pain, and improvements in independence in ADL and quality of life. Given the limitations of the current study, further research, in the form of high quality studies with larger sample sizes that involve direct comparisons with other forms of care or against a control group, is needed to determine whether day rehabilitation centre programs provide the optimum mode of rehabilitation for this population in the most cost effective manner.

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Planning Walkable Neighborhoods for “Aging in Place”: Lessons from Five Aging-Friendly Districts in Singapore

Sustainability ◽

10.3390/su13041742 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1742

Author(s):

Yiqi Tao ◽

Wei Zhang ◽

Zhonghua Gou ◽

Boya Jiang ◽

Yi Qi

Keyword(s):

Physical Activity ◽

Older Adults ◽

Aging In Place ◽

Activity Levels ◽

Neighborhood Walkability ◽

Site Survey ◽

Physical Activity Levels ◽

The Mean ◽

A Site ◽

The City

Today, “walkability” is considered a critical component of an aging-friendly neighborhood. This study examined the relationships between the neighborhood physical environment, walkability, and physical activity levels of older residents in Singapore. Five neighborhoods notable for their “aging in place” strategies were selected for a site survey. A questionnaire focusing on the evaluation of neighborhood walkability was administered to older adults in these neighborhoods. The questionnaire included three sections: neighborhood satisfaction, walkability, and the daily physical activity of older adults. The results indicated that adequate physical facilities and connectivity to the city were critical to older adults’ satisfaction with their neighborhoods. The mean walking time significantly dropped as the number of nearby facilities increased, and the number of facilities was negatively correlated with the daily activity levels of older adults. Thus, planners should attempt to calibrate the provision of neighborhood facilities to maintain the physical activity levels of older adults.

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The Validation of a Pocket Worn Activity Tracker for Step Count and Physical Behavior in Older Adults during Simulated Activities of Daily Living

Gerontology and Geriatric Medicine ◽

10.1177/2333721420951732 ◽

2020 ◽

Vol 6 ◽

pp. 233372142095173

Author(s):

Darcy Ummels ◽

Wouter Bijnens ◽

Jos Aarts ◽

Kenneth Meijer ◽

Anna J. Beurskens ◽

...

Keyword(s):

Older Adults ◽

Daily Living ◽

Sedentary Time ◽

Correlation Coefficients ◽

Step Count ◽

Percentage Error ◽

Cross Sectional ◽

Physical Behavior ◽

Activity Tracker ◽

The Mean

Purpose: The purpose of this study was to validate optimized algorithm parameter settings for step count and physical behavior for a pocket worn activity tracker in older adults during ADL. Secondly, for a more relevant interpretation of the results, the performance of the optimized algorithm was compared to three reference applications Methods: In a cross-sectional validation study, 20 older adults performed an activity protocol based on ADL with MOXMissActivity versus MOXAnnegarn, activPAL, and Fitbit. The protocol was video recorded and analyzed for step count and dynamic, standing, and sedentary time. Validity was assessed by percentage error (PE), absolute percentage error (APE), Bland-Altman plots and correlation coefficients. Results: For step count, the optimized algorithm had a mean APE of 9.3% and a correlation coefficient of 0.88. The mean APE values of dynamic, standing, and sedentary time were 15.9%, 19.9%, and 9.6%, respectively. The correlation coefficients were 0.55, 0.91, and 0.92, respectively. Three reference applications showed higher errors and lower correlations for all outcome variables. Conclusion: This study showed that the optimized algorithm parameter settings can more validly estimate step count and physical behavior in older adults wearing an activity tracker in the trouser pocket during ADL compared to reference applications.

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The Effect of Group Movie Therapy on the Activities of Daily Living Among the Older Adults

Journal of Client-centered Nursing Care ◽

10.32598/jccnc.5.4.280.2 ◽

2019 ◽

Vol 5 (4) ◽

pp. 223-230

Author(s):

Narges Yaghini ◽

◽

Fatemeh Sadat Izadi-Avanji ◽

Sedigheh Miranzadeh ◽

Hossain Akbari ◽

...

Keyword(s):

Older Adults ◽

Activities Of Daily Living ◽

Daily Living ◽

Low Cost ◽

Study Groups ◽

Functional Independence ◽

Essential Components ◽

Significant Difference ◽

Movie Therapy ◽

The Mean

Background: The daily living activities are among the essential components of life and reflect an important aspect of functional independence in older adults. This study aimed to determine the effect of Group Movie Therapy (GMT) on the Activities of Daily Living (ADL) in older adults. Methods: A randomized clinical trial was conducted on 48 older adults referred to Urban Comprehensive Health Service Centers of Kashan City, Iran. The study subjects were enrolled by a convenience sampling method and were randomly assigned to the intervention (n=24) and control (n=24) groups. GMT was performed in 6 weekly sessions. The Lawton’s ADL Scale was used for data collection. The obtained data were analyzed by the Chi-Squared test, Fisher’s Exact test, and Independent Samples t-test using SPSS. Results: There was no significant difference in the mean scores of Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL) before the intervention between the study groups. A significant difference was found in the mean scores of IADL after the intervention between the study groups (P=0.001); however, there was no significant difference in the BADL values of the groups after the intervention. Conclusion: GMT is a non-invasive, low-cost, and non-risky way to improve the elderly’s autonomy in performing IADL. Thus, GMT is recommended as a method of behavior therapy.

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Physical Activity and Function in Assisted Living Residents

Western Journal of Nursing Research ◽

10.1177/0193945918764448 ◽

2018 ◽

Vol 40 (12) ◽

pp. 1734-1748 ◽

Cited By ~ 5

Author(s):

Barbara Resnick ◽

Elizabeth Galik ◽

Marie Boltz ◽

Erin Vigne ◽

Sarah Holmes ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Data Collection ◽

Assisted Living ◽

Barthel Index ◽

Daily Living ◽

Reliability And Validity ◽

The Mean ◽

Additional Support ◽

And Function

The purpose of this study was to consider the feasibility, reliability, and validity of MotionWatch 8. A total of 249 residents were recruited from 26 assisted living settings. Data collection included demographics, comorbidities, function (Barthel Index), physical activity (MotionWatch 8), and falls. The mean age of participants was 86.86 ( SD = 7.0), the majority were women 179 (74%) and White ( N = 232, 96%). A total of 86% of participants wore the MotionWatch 8. There were no significant differences in physical activity over 3 days of testing. The MotionWatch 8 findings were significantly associated with activities of daily living (ADL) function. There were no significant differences in ADL function or physical activity between those who did and did not fall. The study provides additional support for the feasibility, reliability, and validity of the MotionWatch 8 and confirms that older adults living in assisted living settings spend the majority of their time in sedentary activity.

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Factors Associated With Adherence to an Accelerometer Protocol in Older Adults

Journal of Physical Activity and Health ◽

10.1123/jpah.8.8.1152 ◽

2011 ◽

Vol 8 (8) ◽

pp. 1152-1159 ◽

Cited By ~ 9

Author(s):

Erin Gemmill ◽

Constance M. Bayles ◽

Kathleen McTigue ◽

William Satariano ◽

Ravi Sharma ◽

...

Keyword(s):

Older Adults ◽

Daily Living ◽

Mini Mental State Examination ◽

Multivariate Model ◽

Lower Body ◽

Aging Effects ◽

Factors Associated ◽

The Mean ◽

State Examination ◽

Predictors Of Adherence

Background:Adherence to protocols of accelerometer use by participants of research studies is crucial to ensure the most accurate measure of their physical activity.Methods:We used data from a study of 201 individuals 65 years of age and older to examine whether aging effects on physical and cognitive health limit the ability of an older adult to be adherent to an accelerometer protocol.Results:A comparison of participants who met the adherent person criteria with those who did not showed that the percentage of participants whose income is $20,000 or greater, the percentage of participants who reported white race, and the mean number of school grades completed were significantly different between the 2 groups. Logistic regression analyses showed that the best multivariate model to predict being a valid person included Instrumental Activities of Daily Living score, while the best multivariate model to predict being an adherent person included Modified Guralnik Lower Body Score and Mini-Mental State Examination Score.Conclusions:This study found that certain measures of physical and cognitive functioning were the best predictors of adherence to an accelerometer protocol among older adults.

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