Examining the relationships between walkability and physical activity among older persons: what about stairs?

Abstract

BackgroundWalkability is considered an important dimension of healthy communities. However, variable associations between measures of walkability and physical activity have been observed, particularly among older persons. Given the challenges older persons may have navigating stairs on walking routes, the presence of stairs may be an explanatory factor for these mixed associations. The purposes of this scoping review were to determine whether studies examining the relationship between walkability and physical activity included items that assessed stairs and what relationships were found.MethodsSystematic reviews were identified by entering search terms into five database search engines. Eligibility criteria were: a) published between 2008 and 2017, b) examined the relationship between walkability and physical activity, c) included a focus on persons aged 65 years and older, and d) written in English. The full articles for all primary studies included in eligible systematic reviews were then retrieved. Duplicates were removed. Information about where the study took place, walkability measures used, types of walkability data obtained (objective and/or subjective) and questions asked about stairs were extracted from the full text articles.ResultsEleven systematic reviews were identified; seven were eligible. After removing duplicates, 289 primary studies remained for review. Measures of neighborhood walkability were present in 205 studies; a minority (n = 5, 2.4%) included items about stairs. No information was obtained on the structural features of the stairs.ConclusionsThe presence of stairs may deter older persons (and others) from walking outdoors. Standard measures to document the presence and characteristics of stairs, and sampling approaches to select stairs for assessment are needed. The inclusion of these measures would augment the utility and comparability of studies examining relationships between walkability and physical activity and better inform planning and policy decisions.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5945-0) contains supplementary material, which is available to authorized users.

Evaluation of a low-technology system to obtain morphological and mobility trial measurements in dogs and investigation of potential predictors of canine mobility

“…In aging humans, the ability and willingness to use stairs are critical to assessment of frailty, risk of injury, and ability to maintain the activities of daily living, and difficulty with or reluctance to use stairs is commonly observed in older adults who walk without difficulty or reluctance on flat ground. [32][33][34][35][36] Stair ascent involves multiple components (eg, isolated leg and back strength, proprioception, balance, vision, and range of motion), making it a more challenging mobility assessment for older adults than simply walking. [37][38][39][40][41] It is reasonable to assume that the same is true for older companion dogs, and although limited work has been done in this area, the greater range of motion required for stair ascent, compared with trotting across a flat surface, has been confirmed in dogs.…”

Neighborhood Walkability and Housing Prices: A Correlation Study

“…Many studies have revealed a correlation between slope and the level of walkability [56,57]. In particular, the slope was more sensitive to the walking behavior for the elderly [58][59][60]. In this study, the slope is included as an environmental variable and is defined as the mean slope within a 400 m network buffer from the centroid of an apartment complex.…”

Activity-Friendly Built Environments in a Super-Aged Society, Japan: Current Challenges and toward a Research Agenda

“…Some previous studies have shown the positive effects of slope on type 2 diabetes, assumingly through vigorous physical activity [ 46 , 47 ]. However, slope (and subsequently stairs) has been identified as one of the barriers for the elderly to be physically active within their neighborhoods [ 48 , 49 , 50 ]. Most previous studies examining accessibility measures of built environments, such as access to shops, train stations, and parks, in relation with active behaviors, did not take into account the slope factor [ 50 ].…”

“…However, slope (and subsequently stairs) has been identified as one of the barriers for the elderly to be physically active within their neighborhoods [ 48 , 49 , 50 ]. Most previous studies examining accessibility measures of built environments, such as access to shops, train stations, and parks, in relation with active behaviors, did not take into account the slope factor [ 50 ]. Another extreme level of environmental attribute in Japanese cities is residential density.…”