title: The Association between Belgian Older Adults' Physical Functioning and Physical Activity: What Is the Moderating Role of the Physical Environment?
abstract: BACKGROUND
  Better physical functioning in the elderly may be associated with higher physical activity levels. Since older adults spend a substantial part of the day in their residential neighborhood, the neighborhood physical environment may moderate associations between functioning and older adults' physical activity. The present study investigated the moderating role of the objective and perceived physical environment on associations between Belgian older adults' physical functioning and transport walking, recreational walking, and moderate-to-vigorous physical activity.
  
  
  METHODS
  Data from 438 older adults were included. Objective physical functioning was assessed using the Short Physical Performance Battery. Potential moderators included objective neighborhood walkability and perceptions of land use mix diversity, access to recreational facilities, access to services, street connectivity, physical barriers for walking, aesthetics, crime-related safety, traffic speeding-related safety, and walking infrastructure. Transport and recreational walking were self-reported, moderate-to-vigorous physical activity was assessed through accelerometers. Multi-level regression analyses were conducted using MLwiN to examine two-way interactions between functioning and the environment on both walking outcomes. Based on a previous study where environment x neighborhood income associations were found for Belgian older adults' moderate-to-vigorous physical activity, three-way functioning x environment x income interactions were examined for moderate-to-vigorous physical activity.
  
  
  RESULTS
  Objectively-measured walkability moderated the association between functioning and transport walking; this positive association was only present in high-walkable neighborhoods. Moreover, a three-way interaction was observed for moderate-to-vigorous physical activity. Only in high-income, high-walkable neighborhoods, there was a positive association between functioning and moderate-to-vigorous physical activity. No functioning x walkability interactions were observed for recreational walking, and none of the perceived environmental variables moderated the positive association between physical functioning and the physical activity outcomes.
  
  
  CONCLUSIONS
  For older adults with better physical functioning, living in a high-walkable neighborhood could be beneficial to engage in more transport walking. Living in high-income, high-walkable neighborhoods and having better functioning might also be beneficial for more engagement in moderate-to-vigorous physical activity. This might suggest a protective role of neighborhood walkability for preventing declining physical functioning and consequently decreasing physical activity levels in older adults. However, given the cross-sectional design of the present study, this suggestion needs to be confirmed through longitudinal assessment investigating over-time changes in the observed associations.
authors.affiliation: Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.|Research Foundation Flanders (FWO), Brussels, Belgium.
authors.forename: Veerle
authors.initials: V
authors.lastname: Van Holle
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.|Department of Human Biometry and Biomechanics, Vrije Universiteit Brussel, Brussels, Belgium.|Research Foundation Flanders (FWO), Brussels, Belgium.
authors.forename: Jelle
authors.initials: J
authors.lastname: Van Cauwenberg
authors.affiliation: Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
authors.forename: Freja
authors.initials: F
authors.lastname: Gheysen
authors.affiliation: Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.|Research Foundation Flanders (FWO), Brussels, Belgium.
authors.forename: Delfien
authors.initials: D
authors.lastname: Van Dyck
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.|Department of Human Biometry and Biomechanics, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Benedicte
authors.initials: B
authors.lastname: Deforche
authors.affiliation: Department of Geography, Ghent University, Ghent, Belgium.
authors.forename: Nico
authors.initials: N
authors.lastname: Van de Weghe
authors.affiliation: Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
authors.forename: Ilse
authors.initials: I
authors.lastname: De Bourdeaudhuij
mesh_terms: D061725:Accelerometry; D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D057187:Independent Living / Q000523:psychology*; D008297:Male; D009043:Motor Activity; D012044:Regression Analysis; D012111:Residence Characteristics; D012938:Social Perception; D011795:Surveys and Questionnaires; D016138:Walking / Q000502:physiology* / Q000523:psychology