Perceived neighbourhood environment and health-related outcomes among older adults
de Melo, Lucelia
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The purpose of this study was to examine whether perceived neighbourhood characteristics and personal characteristics in 2007/2008 predicted health-related outcomes: steps taken per day, life-space mobility, physical function, body mass index (BMI), and body composition-related health benefits in 2010/2011 among community-dwelling older adults. The total sample consisted of 341 men and women above the age of 62 years. Steps per day were measured using pedometers for a 3-day period and the change score was reported as a binary outcome: increased steps and decreased steps. Life-space mobility was assessed using the Life-Space Assessment and the outcome was the life-space score as a continuous variable. Physical function was assessed using the Late Life Function and Disability Instrument. The outcome was the total score as a continuous variable. BMI was assessed using the index of the participants’ self-reported weight divided by the height squared. Body composition-related health benefits were assessed using the participants’ BMI refined by the participants’ self-assessed waist circumference. The independent variable was the perception of the neighbourhood environment assessed using select items of the Neighbourhood Environment Walkability Scale in four categories: presence and maintenance of sidewalks; aesthetics; walkability safety; and traffic safety. Demographic and health information (sex, age, self-rated health, physical function limitations, number of chronic conditions and body mass index) were also collected. Regression analysis showed that although more positive perceptions of neighbourhood characteristics such as walkability safety, traffic safety and sidewalks were associated with health-related outcomes, overall, the perceived neighbourhood environment was not a strong predictor of health-related outcomes among community-dwelling older adults. These outcomes were mostly predicted by demographic and health status variables (i.e. chronic conditions, self-rated health, body mass index, physical function limitations). Initiatives targeted at the neighbourhood environment should consider the health-related outcome of interest (i.e. walking, mobility, physical function or obesity), the specific age group (i.e. old age or very old age and oldest old age), and the importance of demographic and health variables in shaping the relationship between the neighbourhood environment and these outcomes.