Environmental facilitators for outdoor walking and development of walking difficulty in community-dwelling older adults

Abstract

Older adults who report environmental barriers in their neighborhood have a higher risk for walking difficulty. However, environmental facilitators that protect against walking difficulty are not well known. The objective of this study was to identify the effect of environmental facilitators for outdoor walking on development of walking difficulty in community-dwelling older people. This was a prospective study with a 3.5-year follow-up time on 261 community-dwelling people aged 75-81 years, who at baseline were able to walk 0.5 km without difficulty. Environmental facilitators for outdoor walking were self-reported with standardized questionnaires, including having features in one's home which make it easy to access the outdoors, having a park or other green area within a walking distance from home, having outdoor recreational facilities within a walking distance from home, having features in the nearby environment, which are attractive for outdoor activities, and perceiving the surrounding environment or facilities nearby as motivating factors for physical activity. Self-reported difficulty in walking 0.5 km was assessed every 6 months. Of the participants, 46 % developed walking difficulty during the follow-up. Having a park or other green area within a walking distance from home was the most frequently reported facilitator. Environmental facilitators decreased the risk for development of walking difficulty, hazard ratio per item 0.86, (95 % confidence interval 0.73-1.02).The results indicate that the mobility of older communitydwelling people may be promoted with outdoor recreational facilities that are easy to access and located within a walking distance from home.

The impact of measures taken in the outdoor environment on an ageing population: a panel study over a ten-year period

“…Again, this emphasises that selective measures have to be properly maintained and evaluated on a regular basis, to increase usability. This conclusion is in line with results from previous research (Alsnih and Hensher 2003; Eronen et al 2014; Kerr, Rosenberg and Frank 2012; Lavery et al 1996; Phillips et al 2013; Rosenberg et al 2013).…”

Physical Limitations, Walkability, Perceived Environmental Facilitators and Physical Activity of Older Adults in Finland

“…Previous research showed higher numbers of perceived environmental facilitators decreasing the risk for development of walking difficulty [14]. It is possible that those perceiving few environmental facilitators for outdoor mobility at baseline (the reference group), may not move outdoors as frequently, but they may be more adapted to the situation (e.g., by using compensatory strategies) [13,42].…”

“…Subjectively perceived environmental factors reflect the capacity of the individual and the environment used by the individual [12]. Few studies have shown that reporting higher numbers of perceived environmental facilitators for outdoor mobility were associated with higher mobility function in older adults [14,15]. …”

“…According to our knowledge, walkability was previously studied in one project among adults in Sweden [19]. Perceived environmental factors have been studied previously in Finland [14,15], but combined with objective environmental features only in one study on the immediate home environment [20]. Including both objectively assessed and subjective perceptions of the environment is important to provide a comprehensive picture of person-environment associations related to physical activity behavior in older adults.…”

Experiences of mobility device use over time: A multiple case study among very old Latvian women

“…It is important to note that all of the women in these cases were due to limited access to and lack of suitable M Ds unable to get outdoors for some time and that seemed to cause some threat to their perception of well-being and autonomy. Other studies show that different forms of mobility (walking, using public transport) is essential for older people (34); besides outdoors mobility is important for physical health and wellbeing in very old age (5). Even if the present study did not explore and shed light on the subjective perceptions and consequences of such situations, it highlights possible problems.…”