How design of places promotes or inhibits mobility of older adults: realist synthesis of 20 years of research.
OBJECTIVE
The objective of this study was to determine the environmental features that best support aging in place.


METHODS
We conducted a realist synthesis, a theory-driven interpretive method of evidence synthesis, of 120+ articles (published 1991-2011) that attempts to explain how place may influence older adults' decisions about mobility (e.g., physical activity). We developed an initial program theory, reviewed the literature, identified outcomes, analyzed and synthesized patterns, and created a final program theory.


RESULTS
Safety was a central mechanism, serving as one of the bridges between environmental components (e.g., connectivity, aesthetics, retail and services) and decisions about mobility. Population density, sidewalk presence, and park proximity did not emerge as key factors.


CONCLUSIONS
Safety considerations are one of the most prominent influences of older adults' decisions about mobility. Street connectivity, pedestrian access and transit, and retail and services were also important. These factors are amenable to change and can help promote mobility for older adults.
University of California, San Francisco, USA irene.yen@ucsf.edu.
Irene H
IH
Yen
University of California, Berkeley, USA.
Johnna
J
Fandel Flood
University of California, San Francisco, USA.
Hannah
H
Thompson
Centers for Disease Control and Prevention, Atlanta, GA, USA Rollins School of Public Health, Atlanta, GA, USA.
Lynda A
LA
Anderson
Barts and the London School of Medicine and Dentistry, London, UK.
Geoff
G
Wong
D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D003657:Decision Making; D004779:Environment Design / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D011582:Psychological Theory; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012449:Safety; D016138:Walking / Q000523:psychology
built environment; mobility; neighborhood; realist synthesis