Dataset Information

Contextual Correlates of Physical Activity among Older Adults: A Neighborhood Environment-Wide Association Study (NE-WAS).

ABSTRACT: Background: Few older adults achieve recommended physical activity levels. We conducted a "neighborhood environment-wide association study (NE-WAS)" of neighborhood influences on physical activity among older adults, analogous, in a genetic context, to a genome-wide association study.Methods: Physical Activity Scale for the Elderly (PASE) and sociodemographic data were collected via telephone survey of 3,497 residents of New York City aged 65 to 75 years. Using Geographic Information Systems, we created 337 variables describing each participant's residential neighborhood's built, social, and economic context. We used survey-weighted regression models adjusting for individual-level covariates to test for associations between each neighborhood variable and (i) total PASE score, (ii) gardening activity, (iii) walking, and (iv) housework (as a negative control). We also applied two "Big Data" analytic techniques, LASSO regression, and Random Forests, to algorithmically select neighborhood variables predictive of these four physical activity measures.Results: Of all 337 measures, proportion of residents living in extreme poverty was most strongly associated with total physical activity [-0.85; (95% confidence interval, -1.14 to -0.56) PASE units per 1% increase in proportion of residents living with household incomes less than half the federal poverty line]. Only neighborhood socioeconomic status and disorder measures were associated with total activity and gardening, whereas a broader range of measures was associated with walking. As expected, no neighborhood meaZsures were associated with housework after accounting for multiple comparisons.Conclusions: This systematic approach revealed patterns in the domains of neighborhood measures associated with physical activity.Impact: The NE-WAS approach appears to be a promising exploratory technique. Cancer Epidemiol Biomarkers Prev; 26(4); 495-504. ©2017 AACRSee all the articles in this CEBP Focus section, "Geospatial Approaches to Cancer Control and Population Sciences."

SUBMITTER: Mooney SJ

PROVIDER: S-EPMC5380580 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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Contextual Correlates of Physical Activity among Older Adults: A Neighborhood Environment-Wide Association Study (NE-WAS).

Mooney Stephen J SJ Joshi Spruha S Cerdá Magdalena M Kennedy Gary J GJ Beard John R JR Rundle Andrew G AG

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 20170202 4

<b>Background:</b> Few older adults achieve recommended physical activity levels. We conducted a "neighborhood environment-wide association study (NE-WAS)" of neighborhood influences on physical activity among older adults, analogous, in a genetic context, to a genome-wide association study.<b>Methods:</b> Physical Activity Scale for the Elderly (PASE) and sociodemographic data were collected via telephone survey of 3,497 residents of New York City aged 65 to 75 years. Using Geographic Informati ...[more]

PMID: 28154108

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Project description:BACKGROUND:Context-free outcome measures, such as overall leisure-time physical activity (LTPA), are habitually applied to study the neighborhood built environment correlates of physical activity. This cross sectional study identifies and empirically tests potential methodological limitations related to the use of context-free measures and discusses how these may help in the interpretation of inconsistent associations between participation in moderate-to-vigorous LTPA and objectively measured neighborhood-level built environment attributes. METHODS:We employ a public participation geographic information system (PPGIS), an advanced participatory mapping method, to study the spatial distribution of moderate-to-vigorous LTPA among adult urban Finnish residents (n 1322). Secondary sources of GIS land-use and sport facility data were used to disaggregate respondent-mapped LTPA by the behavioral context, such as indoor and outdoor sport facilities, green spaces, and other public open spaces. Associations between the use of the identified LTPA settings and a range of objectively measured neighborhood built environment attributes were studied with multilevel logistic regression models. RESULTS:Disaggregated by behavioral context, we observed varied and partly opposite built environment correlates for LTPA. The use of indoor and outdoor sport facilities showed no significant associations with their neighborhood availability, but were significantly associated with personal-level attributes. By contrast, participation in LTPA in green and built public open space shared significant associations with access to and availability of neighborhood green space that persisted after controlling for personal-level covariates. Moreover, neighborhood distances up to 1600 m poorly captured participation in moderate-to-vigorous LTPA, as, on average, 40% of visits were located further from home. However, we found the immediate home environment to be an important LTPA setting for the least active participants. CONCLUSIONS:This study demonstrates that LTPA can be a highly heterogeneous measure regarding both the spatial distribution and the environmental correlates of behavioral contexts. The results show that context-free LTPA outcome measures yield inconsistent associations with built environment exposure variables, challenging the applicability of such measures in designing neighborhood-level built environment interventions.

Project description:BackgroundA supportive environment is a key factor in addressing the issue of health among older adults. There is already sufficient evidence that objective and self-reported measures of the neighborhood environment should be taken into account as crucial components of active aging, as they have been shown to influence physical activity; particularly in people aged 60+. Thus, both could inform policies and practices that promote successful aging in place. An increasing number of studies meanwhile consider these exposures in analyzing their impact on physical activity in the elderly. However, there is a wide variety of definitions, measurements and methodological approaches, which complicates the process of obtaining comparable estimates of the effects and pooled results. The aim of this review was to identify and summarize these differences in order to emphasize methodological implications for future reviews and meta analyzes in this field and, thus, to create a sound basis for synthesized evidence.MethodsA systematic literature search across eight databases was conducted to identify peer-reviewed articles examining the association of objective and perceived measures of the neighborhood environment and objectively measured or self-reported physical activity in adults aged ≥ 60 years. Two authors independently screened the articles according to predefined eligibility criteria, extracted data, and assessed study quality. A qualitative synthesis of the findings is provided.ResultsOf the 2967 records retrieved, 35 studies met the inclusion criteria. Five categories of methodological approaches, numerous measurement instruments to assess the neighborhood environment and physical activity, as well as several clusters of definitions of neighborhood, were identified.ConclusionsThe strength of evidence of the associations of specific categories of environmental attributes with physical activity varies across measurement types of the outcome and exposures as well as the physical activity domain observed and the operationalization of neighborhood. The latter being of great importance for the targeted age group. In the light of this, future reviews should consider these variations and stratify their summaries according to the different approaches, measures and definitions. Further, underlying mechanisms should be explored.

Dataset Information

Contextual Correlates of Physical Activity among Older Adults: A Neighborhood Environment-Wide Association Study (NE-WAS).

Publications

Contextual Correlates of Physical Activity among Older Adults: A Neighborhood Environment-Wide Association Study (NE-WAS).

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