title: Built environment and lower extremity physical performance: prospective findings from the study of osteoporotic fractures in women.
abstract: OBJECTIVE
  We examined the association between walkability of the built environment and changes in physical performance among women aged 65 or older (n = 1,671, 253 neighborhoods).
  
  
  METHODS
  Street connectivity and street density, markers for neighborhood walkability, were assessed through linkage to secondary data sources. Physical performance was measured with timed-walk and chair-stand tests assessed during follow-up visits about every 2 years for 12 to 14 years. Multilevel models predicted change in physical performance, controlling for age, number of incident comorbidities, self-rated health, and death during follow-up.
  
  
  RESULTS
  Overall, physical performance declined during follow-up (p < .001). Neighborhood walkability had no effect on change in physical performance among women who reported not walking at baseline. However, among women who walked, greater neighborhood walkability was associated with a slower decline in dynamic leg strength, indicated by score on chair stand.
  
  
  CONCLUSIONS
  Neighborhood walkability may protect against decline in physical performance.
authors: Drexel University School of Public Health, Department of Epidemiology and Biostatistics, Philadelphia, PA19102, USA. michaely@drexel.edu
authors: Yvonne L
authors: YL
authors: Michael
authors: Rachel
authors: R
authors: Gold
authors: Nancy A
authors: NA
authors: Perrin
authors: Teresa A
authors: TA
authors: Hillier
mesh_terms: D000368:Aged; D004779:Environment Design; D005080:Exercise Test; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000502:physiology*; D058866:Osteoporotic Fractures; D010809:Physical Fitness; D011446:Prospective Studies; D016138:Walking