title: Preserving older adults' routine outdoor activities in contrasting neighborhood environments through a physical activity intervention.
abstract: While neighborhood design can potentially influence routine outdoor physical activities (PA), little is known concerning its effects on such activities among older adults attempting to increase their PA levels. We evaluated the effects of living in neighborhoods differing in compactness on changes in routine outdoor activities (e.g., walking, gardening, yard work) among older adults at increased mobility disability risk participating in the LIFE-Pilot PA trial (2003-07; ages 70-89years; from Dallas, TX, San Francisco Bay area, Pittsburgh, PA, and Winston-Salem, NC). Analyses were conducted on the 400 LIFE-Pilot participants randomized to a one-year endurance-plus-strengthening PA intervention or health education control that completed one-year PA assessment (CHAMPS questionnaire). Outcomes of interest were exercise and leisure walking, walking for errands, and moderate-intensity gardening. Neighborhood compactness was assessed objectively using geographic information systems via a subsequent grant (2008-12). PA increased weekly exercise and leisure walking relative to control, irrespective of neighborhood compactness. However, walking for errands decreased significantly more in PA relative to control (net mean [SD] difference=16.2min/week [7.7], p=0.037), particularly among those living in less compact neighborhoods (net mean [SD] difference=29.8 [10.8] minutes/week, p=0.006). PA participants living in less compact neighborhoods maintained or increased participation in gardening and yard work to a greater extent than controls (net mean [SD] difference=29.3 [10.8] minutes/week, p=0.007). The results indicate that formal targeting of active transport as an adjunct to structured PA programs may be important to diminish potential compensatory responses in functionally impaired older adults. Structured endurance-plus-strengthening PA may help older adults maintain or increase such routine activities over time.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier=NCT01072500.
authors.affiliation: Division of Epidemiology, Department of Health Research & Policy, Stanford, CA, United States; Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States. Electronic address: king@stanford.edu.
authors.forename: Abby C
authors.initials: AC
authors.lastname: King
authors.affiliation: Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States. Electronic address: deborah.salvo@uth.tmc.edu.
authors.forename: Deborah
authors.initials: D
authors.lastname: Salvo
authors.affiliation: Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States. Electronic address: jorge.banda@stanford.edu.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Banda
authors.affiliation: Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States. Electronic address: david.ahn@stanford.edu.
authors.forename: David K
authors.initials: DK
authors.lastname: Ahn
authors.affiliation: Urban Design 4 Health, and Schools of Population and Public Health and Community and Regional Planning, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: jchapman@ud4h.com.
authors.forename: James E
authors.initials: JE
authors.lastname: Chapman
authors.affiliation: Department of Medicine, Yale University School of Medicine, New Haven, CT 06504, United States. Electronic address: Thomas.gill@yale.edu.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Gill
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, United States. Electronic address: roger.fielding@tufts.edu.
authors.forename: Roger A
authors.initials: RA
authors.lastname: Fielding
authors.affiliation: Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States. Electronic address: jdemons@wakehealth.edu.
authors.forename: Jamehl
authors.initials: J
authors.lastname: Demons
authors.affiliation: Department of Kinesiology, University of Massachusetts, Amherst, MA 01003, United States; Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States. Electronic address: ctudorlocke@umass.edu.
authors.forename: Catrine
authors.initials: C
authors.lastname: Tudor-Locke
authors.affiliation: Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, 15213, United States. Electronic address: alr143@pitt.edu.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rosso
authors.affiliation: Department of Aging and Geriatric Research, University of Florida, Gainesville, FL 32611, United States. Electronic address: mpahor@ufl.edu.
authors.forename: Marco
authors.initials: M
authors.lastname: Pahor
authors.affiliation: Urban Design 4 Health, and Schools of Population and Public Health and Community and Regional Planning, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: ldfrank@ud4h.com.
authors.forename: Lawrence D
authors.initials: LD
authors.lastname: Frank
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D004779:Environment Design / Q000706:statistics & numerical data*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008297:Male; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States; D016138:Walking
keywords: Aging; Built environment; Compactness; Gardening; Neighborhood design; Older adults; Physical activity; Residential density; Walkability; Walking