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BackgroundSocio-ecological models emphasize the relationship between the physical environment and physical activity (PA). However, knowledge about this relationship in older adults is limited. Therefore, the present study aims to investigate the relationship between area of residence (urban, semi-urban or rural) and older adults' walking and cycling for transportation and recreation. Additionally, relationships between several physical environmental factors and walking and cycling and possible moderating effects of area of residence, age and gender were studied.MethodsData from 48,879 Flemish older adults collected in 2004-2010 through peer research were analyzed. Walking, cycling and environmental perceptions were assessed using self-administered questionnaires. The Study Service of the Flemish Government provided objective data on municipal characteristics. Multilevel logistic regression analyses were applied.ResultsUrban participants were more likely to walk daily for transportation compared to rural (OR = 1.43; 95% CI = 1.22, 1.67) and semi-urban participants (OR = 1.32; 95% CI = 1.13, 1.54). Urban participants were less likely to cycle daily for transportation compared to semi-urban participants (OR = 0.72; 95% CI = 0.56, 0.92). Area of residence was unrelated to weekly recreational walking/cycling. Perceived short distances to services (ORs ranging from 1.04 to 1.19) and satisfaction with public transport (ORs ranging from 1.07 to 1.13) were significantly positively related to all walking/cycling behaviors. Feelings of unsafety was negatively related to walking for transportation (OR = 0.93, 95% CI = 0.91, 0.95) and recreational walking/cycling (OR = 0.95, 95% CI = 0.92, 0.97). In females, it was also negatively related to cycling for transportation (OR = 0.94, 95% CI = 0.90, 0.98).ConclusionsUrban residents were more likely to walk for transportation daily compared to semi-urban and rural residents. Daily cycling for transportation was less prevalent among urban compared to semi-urban residents. Access to destinations appeared to be important for promoting both walking and cycling for transportation and recreation across all demographic subgroups. Additionaly, feelings of unsafety were associated with lower rates of walking for transportation and walking/cycling for recreation in all subgroups and cycling for transportation in females. No clear patterns emerged for other environmental factors.

Population aging forces governments to change their policy on elderly care. Older people, even if they are frail and disabled, are motivated to stay in their own homes and environment for as long as possible. Consequently, the early detection of frail older persons is appropriate to avoid adverse outcomes. Several instruments to detect frailty exist, but none use environmental indicators. This study addresses the development and psychometric properties of the Comprehensive Frailty Assessment Instrument (CFAI). This new self-reporting instrument includes physical, psychological, social and environmental domains. The CFAI showed good fit indices and a high reliability. The underlying structure of the CFAI demonstrates the multidisciplinary nature of frailty. Using the CFAI can stimulate nurses and other community healthcare providers toward a more holistic approach of frailty and can guide them to take appropriate interventions to prevent adverse outcomes such as disabilities or hospitalization.

The number of older Moroccan migrants reaching the age of high risk for dementia is increasing in Belgium. Yet no study has been performed to explore how Moroccan families facing dementia experience and manage the condition. The study employed a qualitative design using semi-structured interviews with 12 informal and 13 formal caregivers to answer this research question. Findings indicate that the experience of dementia includes several invisible realities that challenge the informal and formal caregivers: (1) the invisibility of dementia as a condition; (2) the invisible subtleties of the informal care execution; (3) the invisibility and inaccessibility of care services as explanation for these family's non-use of available services; and (4) the overlooking of culture, migration and religion as invisible influencers of the overall dementia experience. A better understanding of these hidden realities of migrant older people with dementia and their caregivers could lead to interventions to provide effective and tailored person-centred care that is sensitive to the individual's life experiences, culture and religious background.

Developing environments responsive to the aspirations of older people has become a major concern for social and public policy. Policies and programs directed at achieving "age-friendly" communities are considered to require a wide range of interventions, including actions at the level of the social and physical environment. This article compares the age-friendly approaches of two European cities, Brussels and Manchester, with a particular focus on policies and initiatives that promote active aging in an urban context. The article examines, first, the demographic, social, and multicultural contexts of Brussels and Manchester; second, the way in which both cities became members of the World Health Organization Global Network of Age-Friendly Cities and Communities; third, similarities and differences in the age-friendly approaches and actions adopted by both cities; and fourth, opportunities and barriers to the implementation of age-friendly policies. The article concludes by discussing the key elements and resources needed to develop age-friendly cities.

Sedentary behaviors (involving prolonged sitting) can be associated detrimentally with health outcomes. Older adults, the most sedentary age group, are especially at risk due to their high levels of television viewing time. This study examined individual, social, and physical environmental correlates of older adults' television viewing. Data on daily television viewing time, plus individual, social, and physical environmental factors were collected from 50,986 noninstitutionalized older adults (≥ 65 years) in Flanders (Belgium). The results showed significant relationships between television viewing time and individual, social, and physical environmental factors. Subgroups at risk for high levels of television viewing were those who were functionally limited, less educated, widowed, and (semi)urban-dwelling older adults. Our findings illustrate a cross-sectional link between older adults' television viewing time and social composition of their neighborhood, formal participation, access to alternative activities, and safety from crime.

In the last decade, there has been a growing awareness regarding social exclusion. Considering the ageing population and the likelihood of older people being socially excluded, the aims of this article are to: (1) review existing studies concerning social exclusion in later life; and ( 2) identify how environmental and life-course perspectives are presented in studies focusing on social exclusion in later life. A systematic review in seven scientific databases was conducted to explore the peerreviewed evidence. In total, 26 articles were included and analysed. Findings describe the variety of methods, conceptualisation, dimensions and measures used in this recent area of research. Determinants of social exclusion in later life are discussed and life-course and environmental perspectives are examined. The discussion highlights the complex character of the concept and measurement of social exclusion, and the presence of general and age-specific dimensions of social exclusion in later life. The time and context relativity and the need for life-course and environmental perspectives on social exclusion in later life are discussed. Finally, future directions of research are discussed.

Increasingly, policymakers assume that informal networks will provide care for frail older people. While the literature has mainly discussed the role of the family, broader social networks are also considered to be important. However, these social networks can diminish in later life. This systematic review investigates whether the social environment increases the risk of frailty or helps to prevent it. Findings from 15 original studies were classified using five different factors, which denoted five dimensions of the social environment: (a) social networks, (b) social support, (c) social participation, (d) subjective neighborhood experience, and (e) socioeconomic neighborhood characteristics. The discussion highlights that the social environment and frailty are indeed related, and how the neighborhood dimensions and social participation had more consistent results than social support and social networks. Conclusively, recommendations are formulated to contemplate all dimensions of the social environment for further research examining frailty and community care.