Investigating associations between the built environment and physical activity among older people in 20 UK towns.

Hawkesworth, S; Silverwood, RJ; Armstrong, B; Pliakas, T; Nanchalal, K; Jefferis, BJ; Sartini, C; Amuzu, AA; Wannamethee, SG; Ramsay, SE; Casas, JP; Morris, RW; Whincup, PH; Lock, K; (2017) Investigating associations between the built environment and physical activity among older people in 20 UK towns. Journal of epidemiology and community health, 72 (2). pp. 121-131. ISSN 0143-005X DOI:

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: Policy initiatives such as WHO Age Friendly Cities recognise the importance of the urban environment for improving health of older people, who have both low physical activity (PA) levels and greater dependence on local neighbourhoods. Previous research in this age group is limited and rarely uses objective measures of either PA or the environment.<br/> : We investigated the association between objectively measured PA (Actigraph GT3x accelerometers) and multiple dimensions of the built environment, using a cross-sectional multilevel linear regression analysis. Exposures were captured by a novel foot-based audit tool that recorded fine-detail neighbourhood features relevant to PA in older adults, and routine data.<br/> : 795 men and 638 women aged 69-92 years from two national cohorts, covering 20 British towns, were included in the analysis. Median time in moderate to vigorous PA (MVPA) was 27.9 (lower quartile: 13.8, upper quartile: 50.4) minutes per day. There was little evidence of associations between any of the physical environmental domains (eg, road and path quality defined by latent class analysis; number of bus stops; area aesthetics; density of shops and services; amount of green space) and MVPA. However, analysis of area-level income deprivation suggests that the social environment may be associated with PA in this age group.<br/> : Although small effect sizes cannot be discounted, this study suggests that older individuals are less affected by their local physical environment and more by social environmental factors, reflecting both the functional heterogeneity of this age group and the varying nature of their activity spaces.<br/>

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
Faculty of Public Health and Policy > Dept of Health Services Research and Policy
Faculty of Epidemiology and Population Health > Dept of Medical Statistics
PubMed ID: 29175864


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