“Benches become like porches”: Built and social environment influences on older adults’ experiences of mobility and well-being

Insights from neighbourhood walking interviews using the Living Environments and Active Aging Framework (LEAAF) in community-dwelling older adults

We aimed to understand whether neighbourhood characteristics are associated with movement and social behaviors using walking interviews with 28 community-dwelling older adults (aged 65+). Results indicated support for each component and each relationship in our proposed "Living Environments and Active Aging Framework". Additional themes such as neighbourhoods with children, moving to neighbourhoods with opportunities for social activity and movement, and lingering effects of pandemic closures provided novel insights into the relationship between the living environment (neighbourhood) and active aging. Future work exploring sex and gender effects on these relationships, and work with equity-deserving groups is needed.

Opportunities and shortcomings of AI for spatial epidemiology and health disparities research on aging and the life course

Established spatial and life course methods have helped epidemiologists and health and medical geographers study the impact of individual and area-level determinants on health disparities. While these methods are effective, the emergence of Geospatial Artificial Intelligence (GeoAI) offers new opportunities to leverage complex and multi-scalar data in spatial aging and life course research. The objective of this perspective is three-fold: (1) to review established methods in aging, life course, and spatial epidemiology research; (2) to highlight some of the opportunities offered by GeoAI for enhancing research on health disparities across life course and aging research; (3) to discuss the shortcomings of using GeoAI methods in aging and life course studies.

"I Go Outdoors for Activities Every Day": Go-Along With Seniors With Slow Walking Speeds to Explore Environmental Factors Influencing Mobility

Objectives

This study aims to: 1) Explore the mobility experiences of seniors with slow walking speeds (SSWS) in urban neighborhoods; and 2) Investigate their environmental barriers and supports.

Methods

Go-along interviews were conducted with 36 SSWS residing in urban neighborhoods of Chongqing City, China. The mobility patterns and built environment factors influencing their mobility were revealed through cartographic analysis and thematic analysis.

Results

SSWS primarily focused their activities within a 400-meter radius of their homes. Built environment themes included topography, neighborhood services, sidewalks, seating, traffic safety, weather, greenery, and lighting. Significant mobility barriers included long stairs, steep slopes, fast-moving objects on sidewalks, road crossings, and fast traffic. Available handrails, nearby food-service places, ample seating, and greenery were identified as supportive factors for their mobility.

Conclusion

This study stands out as the first to specifically examine the mobility of SSWS within the built environment. We suggest that SSWS should be taken into account when establishing a benchmark for general design frameworks. These improvements not only contribute to the mobility of slow walkers but also have positive impacts on the broader population.

A systematic review of audit tools for evaluating the quality of green spaces in mental health research

Research showing the relationship between exposure to green space and health has yielded conflicting results, possibly due to the oversight of green space quality in quantitative studies. This systematic review, guided by the PRISMA framework (registered under Prospero ID CRD42023279720), focused on audit tools for green space quality in mental health research. From 4028 studies, 13 were reviewed, with 77 % linking better mental health outcomes to higher green space quality. Eight tools, especially Public Open Space and Dillen et al. tools demonstrated strong correlations with mental health. Certain green space qualities like grass, pathways, and water elements showed positive health associations. Future research should aim for standardized quality metrics and robust methodologies to support causal inferences and efficient assessments.

The 'Double Risk' of Aging: Examining Vulnerability and (Un)supportive Built Environments in Canadian Cities

The confluence of rapid population aging and the overwhelming desire of older adults to age in place begs the question: Do our cities support the health and well-being of aging populations? Using a neighbourhood-by-neighbourhood approach, this macro-scale investigation explores the "double risk" that many older adults live with - the potential of being disadvantaged by socio-demographic risk factors (being older, living alone, low income) and by living in an unsupportive built environment. It is an integration of what we know about supportive built form for older adults and applies this knowledge to Canadian cities, using a spectrum approach to classifying built environments. We found that most older adults with socio-demographic risk factors are living in unsupportive built environments in Canada; however, the distribution between built environments along the spectrum and between municipalities reveals a variegated landscape of double risk. Previous research suggests that unsupportive built environments can be supplemented with services, small-scale improvements in the built environment, and larger-scale retrofitting of neighbourhoods. Since the spatial distribution of vulnerability varies greatly within the 33 Canadian cities analysed, it highlights the need for this kind of inquiry to target age-friendly policy interventions.

Anthropogenic impacts on urban blue space and its reciprocal effect on human and socio-ecological health

Quantifying anthropogenic impacts on blue space (BS) and its effect on human and socio-ecological health was least explored. The present study aimed to do this in reference to the urban BS transformation scenario of Eastern India. To measure BS transformation, Landsat image-based water indices were run from 1990 to 2021. Anthropogenic impact score (AIS) and 7 components scores of 78 selected BS on 70 parameters related data driven from the field. Total 345 respondents were taken for human and socio-ecological health assessment. For this, depression (DEP), anxiety (ANX), stress (STR), physical activities (PA), social capital (SC), therapeutic landscape (TL) and environment building (EB) parameters were taken. The result exhibited that BS was reduced. About 50% of urban core BS was reported highly impacted. Human and socio-ecological health was identified as good in proximity to BS, but it was observed better in the cases of larger peripheral BS. AIS on BS was found to be positively associated with mental health (0.47-0.63) and negatively associated with PA, SC, TL and EB (-0.50 to -0.90). Standard residual in ordinary least square was reported low (-1.5 to 1.5) in 95% BS. Therefore, BS health restoration and management is crucial for sustaining the living environment.

A Scoping Review of Personal, Financial, and Environmental Determinants of Mobility Among Older Adults

OBJECTIVE

To synthesize available evidence of factors comprising the personal, financial, and environmental mobility determinants and their association with older adults' self-reported and performance-based mobility outcomes.

DATA SOURCES

PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Sociological Abstract, Allied and Complementary Medicine Database, and Cumulative Index to Nursing and Allied Health Literature databases search for articles published from January 2000 to December 2021.

STUDY SECTION

Using predefined inclusion and exclusion criteria, multiple reviewers independently screened 27,293 retrieved citations from databases, of which 422 articles underwent full-text screening, and 300 articles were extracted.

DATA EXTRACTION

The 300 articles' information, including study design, sample characteristics including sample size, mean age and sex, factors within each determinant, and their associations with mobility outcomes, were extracted.

DATA SYNTHESIS

Because of the heterogeneity of the reported associations, we followed Barnett et al's study protocol and reported associations between factors and mobility outcomes by analyses rather than by article to account for multiple associations generated in 1 article. Qualitative data were synthesized using content analysis. A total of 300 articles were included with 269 quantitative, 22 qualitative, and 9 mixed-method articles representing personal (n=80), and financial (n=1), environmental (n=98), more than 1 factor (n=121). The 278 quantitative and mixed-method articles reported 1270 analyses; 596 (46.9%) were positively and 220 (17.3%) were negatively associated with mobility outcomes among older adults. Personal (65.2%), financial (64.6%), and environmental factors (62.9%) were associated with mobility outcomes, mainly in the expected direction with few exceptions in environmental factors.

CONCLUSIONS

Gaps exist in understanding the effect of some environmental factors (eg, number and type of street connections) and the role of gender on older adults' walking outcomes. We have provided a comprehensive list of factors with each determinant, allowing the creation of core outcome set for a specific context, population, or other forms of mobility, for example, driving.

Delapré Walk project: Are signposted walking routes an effective intervention to increase engagement in urban parks? -Natural experimental study

Spatial education interventions in the built environment may increase engagement with urban greenspace. This research was a natural experimental study with mixed-method evaluation and repeated cross-sectional design. Twenty-four directional wayfinding signs were installed within an urban park to create a 3 km signposted walking route through the park's amenities in a clockwise direction. Manual counts on one path and bi-directional automated active infrared counts on six paths along the intervention route were conducted at baseline and 12-month follow-up. A QR code accessed intercept survey was open throughout the follow-up phase to capture user experiences, views, and attitudes toward the intervention. There was no consistent difference in manual counts at baseline or 12-month follow-up between intervention and control parks. Automated counts showed no consistent significant change in clockwise footfall between baseline (median automated count range across six counters: 10-130 clockwise counts per day) and follow-up (Autumn to Winter follow-up median automated count range across six counters: 13-103 clockwise counts per day; Spring to Summer follow-up median automated count range across six counters: 13-124 clockwise counts per day). However, 23% (11 out of 48 people) of clockwise travelling route users reported they were following the signs at 12-month follow-up. Intercept survey respondents (n = 27) appeared to be infrequent park users (number of respondents for 'my first visit': 7, and 'one to two times per month: 9), with the new signs making them feel less anxious about exploring unfamiliar areas, while motivating them to walk further than originally planned and helping them to 'take notice' of the landscape. Directional wayfinding for recreational walking appears to help infrequent users engage with urban greenspace.

Third Places for Older Adults' Social Engagement: A Scoping Review and Research Agenda

BACKGROUND AND OBJECTIVES

Neighborhood places that facilitate older residents to meet and interact (third places) receive an increasing research interest as studies have consistently shown the benefits of social engagement for older adults' health. This scoping review synthesized the findings of studies examining the role of third places in older adults' social engagement.

RESEARCH DESIGN AND METHODS

Searching 5 databases (CINAHL, Medline, PsycInfo, Scopus, and Web of Science) in October 2021, this study identified quantitative and qualitative studies that examined the relationships between third places and social engagement (interaction and network) among older adults.

RESULTS

A total of 32 studies (12 quantitative and 20 qualitative studies) met the eligibility criteria. These studies examined 4 types of third place, namely, community facilities, local businesses, open/green spaces, and transition spaces. More than two thirds of the studies reviewed found that access to community facilities, local businesses, and open/green spaces were related to older adults' social interaction. For the relationships between third places and social networks, the importance of accessible local businesses and the quality of open/green spaces was supported by fewer studies.

DISCUSSION AND IMPLICATIONS

The findings of quantitative and qualitative studies suggest that local places that are convenient to visit and comfortable to stay in for older adults are likely to enhance their social interaction and network. However, more specific evidence is needed to inform the planning and design of third places. The review discusses future research topics that address the gaps identified in the current literature.

Making Chile More Pedestrian-Friendly for Older Persons: Expert Perspectives

Walking provides numerous benefits to older persons, but its practice is hindered by social factors and the built environment. This article aims to understand the factors that encourage or discourage older people's walking behaviors, as well as the policies influencing those factors in Chile. It does so by reporting the analysis of twenty-five semi-structured interviews with Chilean policymakers and local leaders. The experts consistently represented walking as a beneficial activity for older persons that, nonetheless, occurs in adverse built environments. They asserted that the absence of older people in the public discussion and a top-down policy-making structure hamper its promotion.

How to Influence Behavioral Intention Toward Age-Friendly Home Modifications in Urban Older People Aged 70

Aging in place with a suitable living environment is essential for the health and well-being of older adults. However, the willingness of older people to modify their housing to meet their needs is not strong. Using the Analytic Network Process (ANP) method, the study first explores the weights of factors, such as perceived behavioral control, policies, and market conditions that influence older adults' behavioral intention. Then, a structural equation modeling (SEM) approach was used to dissect the psychological factors which account for the largest proportion. Using data from 560 people aged 70 or older from Beijing, results suggest that effectiveness perception, cost perception, and subjective norms can influence older people's behavioral intention directly or indirectly through emotional attitudes. Risk perception can moderate the level of behavioral intention triggered by cost perceptions. This study provides new evidence for the impact of factors and interaction mechanism on older adults' behavioral intentions toward age-friendly home modifications.

Protocol for A Mixed-Methods Study: Dementia-Inclusive Streets and Community Access, Participation, and Engagement (DemSCAPE)

Neighbourhoods are known to help maintain functional abilities and enable out-of-home activities and social participation for people living with dementia. Dementia friendly and inclusive communities (DFC) frameworks recognize the importance of developing supportive and empowering environments for people living with dementia and their families. Beyond the core objective of raising awareness and eliminating stigma associated with dementia, most DFC frameworks also focus on improving accessibility and navigability in the neighbourhood environment. Limited research on this topic points to the importance of evidence-based design of the neighbourhood built environment to promote mobility and wayfinding, legibility, familiarity, and safety for people living with dementia. Increased relevance of DFCs for policy and practice calls for expanding this body of knowledge. The proposed study, titled “Dementia-inclusive Spaces for Community Access, Participation, and Engagement (DemSCAPE),” focuses on identifying neighbourhood destinations considered important by people living with dementia, as well as neighbourhood built environmental features relevant for their outdoor mobility, engagement, and social participation. This study protocol paper offers key information on 1) the need for mixed methods research on this topic and its theoretical and methodological underpinnings, 2) study sampling and recruitment strategy, 3) data collection methods, which include a series of structured and semi-structured sit-down interviews and a walk-along interview, 4) procedure for data analysis, 5) ethical and methodological considerations, and 6) measures taken to enhance study rigour.

The Impact of Multi-Quality Renewal Elements of Residence on the Subjective Well-Being of the Older Adults - A Case Study of Dalian

Background

With the expansion of comprehensive renovation projects in China's old residential areas, residents' actual sense of access and well-being has become a source of concern. As the population in old residential areas ages, the results of old renovation will have a significant impact on the older adults quality of life and subjective well-being.

Purpose

To date, most relevant studies have focused on urban and community scales, with little discussion of the impact of neighborhood-level renewal outcomes on the well-being of older adults. As a result, the purpose of this research is to optimize the quality renewal elements of existing old residential areas based on the results of their renovation in order to create a more livable living environment for older adults in existing old residential areas.

Methods

Based on a survey of old neighborhoods in Dalian, the study examines the mediating effect of psychological resilience between multi-quality renewal elements and the subjective well-being of the older adults, and it discusses the influence of multi-quality renewal elements on the subjective well-being of the older adults in different residential types.

Results

According to the findings, multi-quality renewal elements of residence positively predicted the subjective well-being of the older adults; there was a significant mediating effect of psychological resilience between the renewal elements and subjective well-being of the older adults. The study confirms that multiple quality renewal elements can contribute to older people's subjective well-being, and that psychological resilience plays an important role in the selection of multiple quality renewal elements and older people's subjective well-being.

Conclusion

The research provides guidance for the establishment of health-oriented approaches to environmental restoration in residential areas for the sustainable development of communities and cities.

What is the impact of nature on human health? A scoping review of the literature

Background

The burden of non-communicable diseases (including poor mental health) is increasing, and some practitioners are turning to nature to provide the solution. Nature-based interventions (NBIs) could offer cost-effective solutions by reconnecting individuals with nature, but the success of these interventions depends partially on the way in which people engage with blue and green spaces.

Methods

We conducted a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and Cochrane guidelines to establish the evidence base for treating poor mental and physical health with NBIs. We searched five databases and the grey literature. Exposure was the active engagement with natural environments. The primary outcome was mental health and the secondary outcome was physical health defined using established metrics. All data were extracted to a charting table and reported as a narrative synthesis.

Results

952 studies were identified, of which 39 met the inclusion criteria. 92% demonstrated consistent improvements across any health outcome where individuals engaged with natural outdoor environments. Mental health outcomes improved across 98% of studies while physical and cognitive health outcomes showed improvement across 83% and 75% of studies respectively. Additionally, we identified 153 factors affecting engagement with nature, 78% of which facilitated engagement compared with 22% that reduced engagement. Aspects such as the sense of wilderness, accessibility, opportunities for physical activity and the absence of noise/ air pollution all increased engagement.

Conclusions

Further research (accompanied by a global improvement in study design) is needed to establish the magnitude and relative effect of nature-based interventions, and to quantify the compounding effect of factors that improve engagement with green and blue spaces. Nevertheless, this review has documented the increasing body of evidence in support of NBIs as effective tools to improve mental, physical, and cognitive health outcomes, and highlighted key factors that improve engagement with the natural world.

Registration

Open Science Framework: https://doi.org/10.17605/OSF.IO/8J5Q3.

Physical Activity Among Older Women Living in Rural Areas in Canada: A Scoping Review

Although there is strong evidence linking physical activity in older age with wellbeing and health benefits, these relationships tend to be under-researched in a rural context. A scoping review was conducted to identify what is known about physical activity among older women living in rural Canada. The search strategy was intentionally broad, with eight databases, academic journals, and websites scanned for research and grey literature related to Canada, in English, from 2000 to 2022. 33 studies, reviews, and reports were included in the final selection. These articles indicate that physical activity among older women living in rural Canada is influenced by a multitude of layers, contexts, conditions, and environments, with outcomes dependent on a mixture of personal, relational, community, societal, and governmental factors. In general, the women are committed to creating and maintaining an active lifestyle, and supporting their local rural community to enable these activities. While the social environment can proscribe physical activity through ageist attitudes and restrictive socio-cultural norms, social support from family and community members mitigates against these constraints. Rural infrastructure, geography, climate (seasons and weather), as well as transportation and policy issues may also impede the physical activity opportunities of the women. Some of the problems related to sustaining and resourcing recreational activity in rural communities are partly addressed through the implications presented in the articles. Among others, these suggestions relate to leadership and learning opportunities, public engagement, and the partnership working involved in supporting physical activity in rural areas. However, further research is long overdue.

A Systematic Review with Framework Synthesis of the Ways That Urban Environments Influence Opportunities for Healthy and Sustainable Mobility in Older Age

Supporting older people's use of sustainable transport is important for both population health and sustainable development, especially in the context of global population ageing. This systematic review identifies individual and environmental factors that influence older people's sustainable transport use and synthesises findings using a framework approach. Factors influencing older people's walking (n = 10 studies), bus use (n = 11), community transport use (n = 1), bicycling (n = 1), and e-bicycling (n = 1) were found to be physical, geographical, facility-based, economic, time-based, fear-based, space-based, information-based, or interpersonal. Many factors were common across transport modes. One reason for this is that environmental features designed to facilitate the use of one particular transport mode also influenced the use of other modes (e.g., bus shelters influence not only bus use but also walking as they provide pedestrian seating). Thus, environments need to be considered from the perspective of multiple, different types of road users. Another reason is that many factors related to the ways individuals experienced their environment (e.g., finding information guiding behaviour in public spaces to be unclear), regardless of any specific transport mode. This review highlights the important need for greater cross-sectoral action and input from older people.

Characteristics of Physical Activities and Environmental Factor Preferences of Older Adults in Rural Resettlement Community in Ningbo, China

As physical mobility declines, older adults become increasingly dependent on their living environment. The relationship between physical activities and community environments for older adults has been studied to help promote physical and mental health and increase social connections among older adults, thereby improving their quality of life and health status. This study analyzed the daily outdoor physical activities of older adults in Nanyu New Village, China, using behavior mapping and questionnaire research for data collection, and conducting a comprehensive analysis of the spatial, temporal, and environmental elements of the physical activities. This research showed that the physical activity choices of older adults in rural resettlement neighborhoods vary significantly by time, gender, and space. In decreasing order, surrounding support, site security, space convenience, beautiful landscape, and diverse facilities influence the outdoor physical activities of older adults. This study provides new insights into the ongoing debate on age-friendly communities and provides a useful reference for the design of age-friendly retrofitting of outdoor environments in rural resettlement communities.

The impact of social network change due to spousal loss: A qualitative study on experiences of older adults who are aging in place

Spousal loss due to nursing home admission or death is challenging for the well-being of the remaining partner and for aging in place. We explored: "How does social network change due to spousal loss impact older adults who are aging in place?." In-depth interviews were held with six older women who were aging in place and who lost their spouses in the past two years. Narrative analysis was conducted. Results indicate that the impact varies in three dimensions and that variations within dimensions follow three themes. The results emphasize the complexity of impact and the urgent need for a person-centred approach toward older adults after spousal loss.

"We see each other from a distance": Neighbourhood social relationships during the COVID-19 pandemic matter for older adults' social connectedness

Introduction

We extend previous research to illustrate how individual, interpersonal and neighbourhood factors in a high-density urban setting in Vancouver, Canada, shape social connectedness experiences of community-dwelling older adults during the first wave of the COVID-19 pandemic.

Methods

We conducted 31 semi-structured interviews and collected objective measures of loneliness and social connectedness (surveys).

Results

Three dimensions of the neighbourhood environment influenced social connectedness: (i) interactions with neighbours, (ii) involvement with neighbourhood-based organizations, and (ii) outdoor pedestrian spaces. Seventy-one percent of participants felt a strong sense of belonging to their local community, while 39% were classified as high or extremely lonely.

Summary

Many participants leveraged pre-existing social ties to maintain connections during the pandemic. However, volunteer outreach was vital for more isolated older adults. Although many participants felt lonely and isolated at times, the relative ease and accessibility with which they could connect with others in their neighbourhood environment, may have helped mitigate persistent loneliness.

Conclusion

Strategies that foster social connectedness over the longer term, need to prioritize the needs of older adults who face multiple barriers to equitable social participation.

Human Factors and Ergonomics Considerations for Aging-in-Place Part 2: The Intersection of Environment and Technology

This article is part 2 of a two-part series focused on aging-in-place. Aging-in-place is a term that has been increasingly used over the past 40 years to describe the process of remaining in one’s home. In attempt to advance the discussion on the future of aging-in-place, this feature series provides an overview of the grand challenges to aging-in-place with an emphasis on human factors and ergonomics considerations. Part 2 will discuss a variety of ways to conceptualize “place” and describe the need for integrated technology within the home and beyond.

Neighborhood Attributes and Well-Being Among Older Adults in Urban Areas: A Mixed-Methods Systematic Review

Expanding urbanization rates have engendered increasing research examining linkages between urban environments and older adults' well-being. This mixed-methods systematic review synthesizes the evidence for the influence of urban neighborhoods' attributes on older adults' well-being. We searched for literature published up to December 2020 across six databases and performed quality assessment and thematic analysis. The results, based on 39 identified studies, showed that natural areas in neighborhoods and a sense of community are the attributes most often associated with positive effects on well-being. Transit-related variables, urban furniture, and access to healthcare are also positively related to well-being. Neighborhoods may promote well-being more effectively when these elements are considered. However, almost half of the studies did not include all environmental dimensions simultaneously, and self-reported instruments were largely preferred over more objective assessments of the environment. Future research should thus holistically examine physical, social, and service-related attributes to produce more robust evidence.

Ageing Well in Small Villages: What Keeps Older Adults Happy? Environmental Indicators of Residential Satisfaction in Four Dutch Villages

This article aims to contribute to the existing literature about liveability in rural areas by explicitly focusing on the level of residential satisfaction of older adults (55+) in four small Dutch villages. We strive not only to identify the key indicators of residential satisfaction among older villagers but also to better understand how these indicators affect their (daily) life. Moreover, in line with the person–environment fit tradition, we differentiate according to the capabilities and vulnerabilities of older villagers. To this end, we use a mixed-method approach, in which we combine survey data with qualitative data collected with photovoice in the four villages. The findings indicate that older adults’ perceptions of spatial, social and functional aspects of the living environment are related to the degree of residential satisfaction overall. However, these perceptions appear to be strongly intertwined, especially perceptions about spatial characteristics, local identity and connectedness. Older adults who are hindered by health problems in undertaking daily activities experience a lower level of person–environment fit, which is reflected in a lower level of residential satisfaction. However, this relationship between subjective health and residential satisfaction can only be partially explained by different perceptions of the spatial, social and functional environment.

Investigating the Association between Environmental Quality Characteristics and Mental Well-Being in Public Open Spaces

The issues related to the urban environment and mental well-being have become increasingly important in recent decades. Although this association has been mainly investigated in developed countries, there is limited knowledge on whether similar results can be acquired in the urban environments of developing countries like Iran. This study intends to present a new dynamic and active approach to determine the environmental quality characteristics that influence the mental well-being of urban residents and to engage people to healthy urban public environments. In this respect, the research is directed by both qualitative and quantitative surveys in the public open spaces of Kermanshah, Iran. Firstly, the data are collected by Grounded Theory (GT) to identify significant environmental quality characteristics related to mental well-being by applying 24 semi-structured interviews. Secondly, the questionnaire survey based on Structural Equation Modeling (SEM) is applied to examine the association between each characteristic of the developed conceptual framework. The results reveal that the environmental quality characteristics of public open spaces, directly and indirectly, relate to users’ mental well-being. It should be noted that the public open spaces with unique functional and intrinsic features seem to have different impacts on mental well-being.

Assessing and Qualifying Neighborhood Walkability for Older Adults: Construction and Initial Testing of a Multivariate Spatial Accessibility Model

Population aging and urban development pose major challenges for societies today. Joining the literature assessing urban accessibility, the present exploratory research developed a multivariate accessibility model based on four independent variables—related to formal and structural urban space—that influence walkability for older adults (pedestrian network; facilities and shops; public benches; and slopes and gradients). The model used ArcGIS software. For the accessibility calculations, we selected two suburban neighborhoods in the conurbation of Grenoble (France) and selected three types of older adults’ profiles to reflect the variety of aging: an older adult in good health, an older adult with a chronic disease, and an older adult with reduced mobility. The results suggest that the accessibility of a neighborhood depends not only on its physical and urban characteristics, but it is also influenced by the physical and health characteristics of its inhabitants. The originality of the model lies mainly in its ability to estimate the spatial accessibility of a territory by taking into account, firstly, objective data such as the physical characteristics and the built environment of the neighborhood through objectification variables that consider such original variables as the presence of benches or the slopes and gradients and, secondly, specific data such as the physical and/or health characteristics of the study population. The measurement of geospatial accessibility could be of great value for public health in urban contexts, which is why relevant tools and methodologies are needed to objectively examine and intervene in public spaces in order to make them age-friendly.

Let's Walk It: Mobility and the Perceived Quality of Life in Older Adults

European policy and the research and development landscape put forward a number of arguments in favor of implementing “Active Assisted Living” (AAL) for older adults: it will improve older adults’ quality of life, allow them to age in place, and keep costs for an ageing society down by exploiting new technology markets. The idea is that older adults who are supported by AAL and make use of assistive technologies will enjoy more freedom, autonomy, and mobility and also improved social integration and better communication. Yet, despite a history of more than 10 years of European research and development, the use of AAL applications is not as widespread as expected. To examine older adults’ attitudes to assistive technologies, we conducted a study in Vienna (Austria) between 2018 and 2020 questioning 245 older adults aged 61–93 years (M = 74.27 SD = 6.654) who lived at their private homes and had different support needs (ranging from “no support” to “everyday visit of social and/or care organizations”). The three goals of the study encompassed: (1) examination of their quality of life, (2) their attitudes and use of assistive technologies, and (3) the way they perceive their own and others’ life-course and getting older. AAL as a concept links “ageing in place” and “quality of life”. However, “mobility” is also of major importance here. In this paper, we aim to investigate the relation between the independent variables “Quality of life” and “Mobility” and their possible associations with the following dependent variables: cohabitation, social integration, self-rated health, sportive activities, locomotion, home well-being and safety, physical limitations, falls, and self-perception of their own ageing (compared to others). We calculated multivariate models regressing on these explaining and confounding variables. We found a positive correlation between mobility and quality of life. In detail, our results show a significant positive association between QOL and mobility regarding self-rated health and self-perception. Experiencing vertigo, walking difficulties, and balance problems significantly and negatively influence self-rated health and self-perception compared to others. Our findings can also be read as a clear message that there is a need to improve both health and the culture of ageing and to facilitate positive attitudes toward ageing as an efficient way to enhance the Quality of life of older adults.

Kinetic Values, Mobility (in)equalities, and Ageing in Smart Urban Environments

The idea of the right to mobility has been fundamental to modern Western citizenship and is expressed in many legal and government documents. Although there is widespread acceptance regarding the importance of mobility in older adults, there have been few attempts to develop ethical and theoretical tools to portray mobility (in)equalities in old age. This paper develops a novel conceptualisation of kinetic values focusing on older adults whose ability to move has been restricted for internal and external reasons. Informed by the phenomenological theory of kinaesthesia, I suggest that kinetic values are related to four principal dimensions: self-motion, being-moved, co-motion, and forced movement. I assume that these dimensions can address the key dilemma of human dignity among older adults who suffer from losing their autonomy and agency through their mobility impairments and who are at risk of being confined to their homes. To concretise the formulation of kinetic values, I study movement as part of technological equipment and urban infrastructure to examine what kinds of kinetic values mobility services and assistive robots convey for older adults in smart urban environments. By bridging disciplines, the phenomenological approach provides a novel understanding of mobility and the interplay among assistive technologies, kinaesthesia, and urban technological infrastructure. The approach suggests that kinetic values should be interpreted more comprehensively so that kinaesthesia can become better identified as a positive life-promoting practice.

Occupation in Natural Environments; Health Equity and Environmental Justice : L'occupation dans les environnements naturels ; équité en matière de santé et justice environnementale

Background. Occupations undertaken in natural environments can positively impact physical and mental health, improve cognitive functioning, contribute spiritual and cultural benefits, and increase belonging, self-worth, and the meaningfulness of occupations. However, occupational opportunities in healthy natural spaces are inequitably distributed; and the deleterious effects of climate change and environmental degradation are borne disproportionately by socioeconomically disadvantaged people. Purposes. To highlight evidence that occupational engagement in nature is a determinant of health, foreground environmental injustices and identify some implications for occupational therapy. Key issues. Cross-disciplinary, cross-cultural research and critical environmental justice scholarship indicate that healthy nature is an inequitably distributed determinant of occupation, wellbeing, and human health. This merits critical attention from occupational therapy. Implications. By researching, identifying, and addressing occupational and health inequities arising from environmental degradation, climate change and inequitable access to health-promoting natural environments occupational therapists could contribute valuable, occupational perspectives to initiatives addressing human rights and environmental justice.

The challenge of assessing social cohesion in health impact assessment

Health impact assessment (HIA) is a method by which a policy, programme or project falling outside traditional health fields, may be judged as to its potential effects on the health of a population to mitigate negative impacts and strengthen the positive ones. Proposals are analysed from the perspective of all the determinants of health. In France, HIAs are mainly applied to urban development projects where social cohesion (SCo) is a major issue. Although the HIA method is well structured as a step-by-step process, there are no guidelines for assessing SCo. This article opens with literature review to clarify the concept of SCo and to understand how the built environment influences SCo and how social environment influence health. Drawing on this work, this paper presents an analytical framework to assess SCo, integrating both the spatial and physical dimensions of urban design and the perceptions of the neighbourhood characteristics. Following a brief overview of the key findings from applying this framework to HIA of an urban development project, the paper discusses its related strengths and weaknesses. The framework could be a useful tool for HIA as it embraces knowledge from both urban planning and social sciences. It also allows for an overall analysis of all the indicators without relying on a checklist. Nevertheless, it should be tested further to improve its validity.

Factors Affecting the Intention of Multi-Family House Residents to Age in Place in a Potential Naturally Occurring Retirement Community of Seoul in South Korea

This study reveals residents’ willingness to live in their current homes and communities and analyzes the factors related to their willingness to age in place in South Korea. Using a questionnaire survey method, data of 289 residents aged 55 or older were collected in apartment areas with the potential to become naturally occurring senior communities in Seoul. Data were analyzed using descriptive statistics, correlation tests, t-test, ANOVA, factor analysis, and regression analysis by SPSS 26.0, and the findings were followed up. Housing services are very important in aging communities. Physical environment-oriented residential services promote a safe walking environment, facilities to support the elderly, a secure complex environment, a home-safety accident-prevention diagnosis service, home improvement, and home improvement support. Multiple regression analysis showed that residential services or elderly education and activity support services influence aging in place, which is a novel finding revealed in this study.

Health promotion initiative: A dementia-friendly local community in Sweden

Dementia is a great public health concern worldwide. Despite this, little is known from a health-promoting perspective about dementia in general as a public health issue, in dialog with people living with dementia, applicable at individual, group, and societal levels with regard to policies and practice. This study therefore aims to explore the experiences related to living with dementia in the local community by advancing a health-promoting perspective. Semi-structured individual and group interviews were conducted with participants (n = 22) with lived, professional, and personal experiences of dementia living in a medium-sized municipality in Sweden. Transcripts were analyzed by thematic analysis. Four themes emerged: health promotion through knowledge and public awareness, health promotion through opportunities to be active, health promotion through meaningful meeting places, and health promotion through improvements in the welfare system. We found that more knowledge and public awareness about dementia are needed to advance a health-promoting perspective and increase the prominence of dementia as a public health issue. Further research and policy need to focus more on how professionals in dementia care practice could be involved in promoting health and well-being for people with dementia.

Safety perceptions of older adults on an urban greenway: Interplay of the social and built environment

BACKGROUND

Creating neighbourhood places for older adults to be socially and physically active is a global health priority. Safety is integral to older adult mobility. In greenway research, perceived safety is often only partially or superficially explored. Our study comprehensively examines older adults' experiences and perceived safety for walking on a new urban greenway in Vancouver, Canada-the Arbutus Greenway.

METHODS

We integrated mixed methods: i) observational count data to describe the use and context of the greenway over 3 years (2017; 2018; 2019), and; ii) semi-structured interviews with older adults at two time points (2017, n = 27; 2019, n = 16).

RESULTS

and discussion: We conducted thematic analysis to illuminate older adults' experiences across three safety domains: personal safety, traffic safety, and security. Built environment features such as benches, paving, road markings, and natural foliage buffers intersected with elements of the social environment to influence older adults' perceived safety. While the greenway supported active transportation, leisure, and social engagement for many older adults, certain factors also provoked fears, especially for older adults with mobility limitations. We advocate for a multidimensional lens to better understand how urban interventions influence perceived safety, and identify practical solutions to encourage mobility for all ages and abilities.

Fidelity and utility of GPS loggers as a tool for understanding community participation of older adults

OBJECTIVE

The purpose of this research was to examine the fidelity and utility of global positioning system (GPS) technology for studying community mobility indicators, and to explore implications for community participation for older adults.

METHOD

A longitudinal cohort design with community-dwelling older adults (n = 33) was employed. GPS spatial data and activity logs were collected at baseline and one year later. Data were analysed to evaluate the fidelity of the GPS protocol, the nature and frequency of destinations, and the stability of community mobility over time.

RESULTS

Findings include evidence for high reliability of the GPS loggers to record out-of-home trips when compared to activity logs; utility of the technology for identifying frequency and type of occupational destinations; and the relative stability of two community mobility variables over time. GPS loggers generate key insights into how older adults move in and through their community as they engage in a range of occupations.

CONCLUSION

GPS technology is a robust and useful tool for gathering novel information, especially when combined with qualitative data. GPS loggers may be incorporated in evaluation or to tailor interventions. Community mobility enables social participation, and warrants further research using these methods to support processes of aging in place.

Neighborhood Urban Design and Outdoor Later Life: An Objective Assessment of Out-of-Home Time and Physical Activity Among Older Adults in Barcelona

This study explores how older adults' time out-of-home and physical activity (PA) are associated with the provision of urban open spaces (green spaces, plazas, and boulevards) and microelements (street trees and benches) in their neighborhoods. The authors used data from 103 residents in Barcelona and matched it to official geospatial data. The authors adjusted a set of mixed-effects linear regressions, both for the entire sample and also stratified by age and gender. For the entire sample, the percentage of green spaces showed a positive association with neighborhood time out-of-home and PA, while participants' PA also showed a positive association with the presence of benches. Outdoor time among older women was not associated with any of the measured exposures. For men, the provision of green spaces and benches was positively associated with time out-of-home and PA. These results could inform the design of urban spaces that aim to encourage outdoor activity among older adults.

Features of the social and built environment that contribute to the well-being of people with dementia who live at home: A scoping review

This scoping review summarizes findings from 23 qualitative articles on how social and built environments contribute to the well-being of people with dementia who live at home. Through thematic analysis, two themes were identified: i) connection to society and supportive relationships and ii) interaction with natural environments and public space. Features of the social and built environment contribute to well-being both positively and negatively. Future research should explore how these features intersect in an urban-rural context as a basis to inform the development of dementia-friendly initiatives. Moreover, involving people with dementia in the design of features of built environments, such as infrastructure, will result in more inclusive communities.

Neighborhood Resources Associated With Active Travel in Older Adults-A Cohort Study in Six European Countries

OBJECTIVES

To study associations between perceived neighborhood resources and time spent by older adults in active travel.

METHODS

Respondents in six European countries, aged 65-85 years, reported on the perceived presence of neighborhood resources (parks, places to sit, public transportation, and facilities) with response options "a lot," "some," and "not at all." Daily active travel time (total minutes of transport-related walking and cycling) was self-reported at the baseline (n = 2,695) and 12-18 months later (n = 2,189).

RESULTS

Reporting a lot of any of the separate resources (range B's = 0.19-0.29) and some or a lot for all four resources (B = 0.22, 95% confidence interval [0.09, 0.35]) was associated with longer active travel time than reporting none or fewer resources. Associations remained over the follow-up, but the changes in travel time were similar, regardless of the neighborhood resources.

DISCUSSION

Perceiving multiple neighborhood resources may support older adults' active travel. Potential interventions, for example, the provision of new resources or increasing awareness of existing resources, require further study.

Using micro-geography to understand the realisation of wellbeing: A qualitative GIS study of three social enterprises

Social enterprises are promoted as a method of welfare reform, to transition people out of disadvantage by addressing poverty, unfulfilled capabilities and social exclusion. This study explores how three Work Integration Social Enterprises (WISEs) in Australia help to realise wellbeing for their employees by mapping their micro-geographical experience of wellbeing. By mapping the sites within a social enterprise where wellbeing is realised, we provide a practical, empirical and replicable methodology that is useful for gaining insights into where and how wellbeing realisation occurs. This situates wellbeing as an upstream place-based resource likely to influence downstream health outcomes.

The clinical experiences of Nigerian physiotherapists in managing environmental and socioeconomic determinants of mobility for older adults

Study Aim: To describe how physiotherapists in northern Nigeria managed the environmental and socioeconomic determinants of mobility for older adults.Methods: We adopted a qualitative description approach, purposely selected and conducted telephone interviews with 20 physiotherapists from Abuja [the Federal Capital Territory], four of the six states in North-central, and one state in the North-west regions of Nigeria. Data were analyzed using qualitative content and constant comparative analyses.Result: The physiotherapists had between 5 and 11 years practice experience in managing older adults with mobility limitations. Three iterative stages of identification, intervention, and documentation emerged as clinical experiences of Nigerian physiotherapists in managing environmental and socioeconomic determinants of mobility for older adults. Identification stages included determining older adults with mobility limitation through patients'/physiotherapists' reports and identifying the environmental (e.g. staircase location, floor types, furniture, and the urban built environment) and socioeconomic (e.g. education, income, and occupation) factors. The clinical decision of the "best" individualized approach to intervention, providing reassurance and education during and after the intervention were sub-stages for the intervention stage. There is a potential gap in the documentation process of these stages as most of the physiotherapists (n = 15; 75%) reported not doing so.Conclusion: This study suggested three iterative stages of identification, intervention, and documentation of the environmental and socioeconomic determinants of mobility for older adults. While there was a potential gap in regard to documentation of these stages in patients' case notes, physiotherapists especially in North-central Nigeria believed that co-developing a pragmatic set of clinical questions focusing on these determinants of mobility could encourage physiotherapists to explicitly document them. As the approach used in our research is purely descriptive, a grounded theory approach would potentially provide more detailed sub-stages that could be a more effective guide for physiotherapists to use during clinical practice.

"The Social Side Is as Important as the Physical Side": Older Men's Experiences of Physical Activity

North American “hegemonic masculinity” values strength, autonomy, independence, and resilience among its ideals. As men age, their capacity is increasingly challenged and demands that they adapt to new physical and social realities. Although some reports on effective health-promoting programs for men are emerging, there is a need to better understand older men’s experiences with their mobility and physical activity. This is a photovoice study with men (N = 14) who were enrolled in a choice-based activity program for low active men. Based on in-depth interviews and analysis of over 800 photographs, three key themes emerged: the importance of social connectedness, supportive environments, and positive attitude toward the future. Findings are presented via a theoretical view of masculinities as socially constructed through relational behaviors and norms. Analyses provide insight into older men’s motivation to be physically active and highlight the need for programs and policies customized to promote physical activity of older men.

Translating Urban Walkability Initiatives for Older Adults in Rural and Under-Resourced Communities

The built environment can promote physical activity in older adults by increasing neighborhood walkability. While efforts to increase walkability are common in urban communities, there is limited data related to effective implementation in rural communities. This is problematic, as older adults make up a significant portion of rural inhabitants and exhibit lower levels of physical activity. Translating lessons from urban strategies may be necessary to address this disparity. This review examines best practices from urban initiatives that can be implemented in rural, resource-limited communities. The review of the literature revealed that simple, built environment approaches to increase walkability include microscale and pop-up infrastructure, municipal parks, and community gardens, which can also increase physical activity in neighborhoods for urban older adults. These simple and cost-effective strategies suggest great potential for rural communities.

Causal evaluation of urban greenway retrofit: A longitudinal study on physical activity and sedentary behavior

Studies of the built environment and physical activity (PA) have primarily been cross-sectional. Evidence on the causal impacts of transportation improvements on PA and sedentary behavior (SB) is lacking. This study assessed the effect of retrofitting an urban greenway on PA and SB in Vancouver, Canada. A sample of 524 participants (median age of 44; 57% female) were divided into experimental and control groups, and the effect of exposure to the greenway was examined by using different distance thresholds. Self-report measures of moderate-to-vigorous PA (MVPA) and SB were collected using the International Physical Activity Questionnaire (IPAQ-SF) before (baseline; 2012-2013) and after (follow-up; 2014-2015) construction of the Comox-Helmcken Greenway in 2013. Mixed-effects models estimated the impacts of greenway on MVPA and SB. For participants living near the greenway (≤300 m), the odds of achieving an average of 20 min of daily MVPA doubled (OR = 2.00; 95% CI = 1.00, 3.98) after the greenway's opening. The odds of being sedentary for >9 h declined by 54% (OR = 0.46; 95% CI = 0.25, 0.85) after opening. PA benefits from the greenway declined with distance from 100 m to 500 m. Reduction in SB was lowest at 100 m and greatest at 300 m. Retrofitting an urban residential neighborhood through greenway interventions can be successful in promoting physical activity while reducing sedentary behavior. Recommendations for future longitudinal research include the use of objective PA measures, studying different neighborhood contexts, collecting more representative samples, and minimizing attrition.

Video for Knowledge Translation: Engaging Older Adults in Social and Physical Activity

Une vaste majorité des Canadiens âgés ne pratiquent pas suffisamment d'activité physique. Le développement de stratégies originales et innovantes encourageant et appuyant les modes de vie actifs est donc urgent. La vidéo est un outil prometteur pour l'application de connaissances (AC) visant l'engagement de divers publics dans la discussion et l'adoption de comportements favorisant la santé. L'Approche systématique pour les vidéos fondées sur des données probantes (Systematic Approach to Evidence-informed Video, SAEV), qui fournit un cadre pour guider et structurer le développement de vidéos ayant pour objectif l'AC, a été utilisée pour la création et la diffusion d'un documentaire de 19 minutes, I'd Rather Stay (https://vimeo.com/80503957). Quarante-huit participants âgés de 60 ans et plus ont visionné la vidéo, participé à des groupes de discussion et rempli des questionnaires concernant cette vidéo. Les données ont été recueillies après le visionnement et lors d'un suivi organisé six mois plus tard. La vidéo a éduqué, encouragé et mobilisé les personnes âgées sur les questions liées à l'autonomie, à l'activité physique et aux liens sociaux. Nous encourageons les chercheurs à adopter des stratégies d'AC auxquelles les personnes âgées peuvent s'identifier, qui sont accessibles et par lesquelles elles peuvent s'engager à un niveau critique, autant sur le plan émotionnel qu'intellectuel, comme les vidéos basées sur des preuves scientifiques.

Most older Canadians do not engage in sufficient physical activity. There is an urgent need for outside-the-box strategies that encourage and sustain active lifestyles. Video is a promising knowledge translation (KT) tool to engage diverse audiences in discussion and action around health promoting behaviours. We adopted a KT framework to inform a structured process of video development we have named systematic approach to evidence-informed video (SAEV). This guided the creation and dissemination of a 19-minute documentary video: I’d Rather Stay (https://vimeo.com/80503957). Following screenings, we collected focus group and questionnaire data from 48 participants aged 60 years and older at baseline and 6-month follow-up. The video educated, encouraged, and activated older people around issues such as independence, physical activity and social connectedness. We encourage researchers to adopt KT strategies – and to use evidence-informed video – that older adults can relate to and critically engage with on an accessible, emotional, and intellectual level.

Environmental, Individual and Personal Goal Influences on Older Adults' Walking in the Helsinki Metropolitan Area

Physical activity is a fundamental factor in healthy ageing, and the built environment has been linked to individual health outcomes. Understanding the linkages between older adult’s walking and the built environment are key to designing supportive environments for active ageing. However, the variety of different spatial scales of human mobility has been largely overlooked in the environmental health research. This study used an online participatory mapping method and a novel modelling of individual activity spaces to study the associations between both the environmental and the individual features and older adults’ walking in the environments where older adult’s actually move around. Study participants (n = 844) aged 55+ who live in Helsinki Metropolitan Area, Finland reported their everyday errand points on a map and indicated which transport mode they used and how frequently they accessed the places. Respondents walking trips were drawn from the data and the direct and indirect effects of the personal, psychological as well as environmental features on older adults walking were examined. Respondents marked on average, six everyday errand points and walked for transport an average of 20 km per month. Residential density and the density of walkways, public transit stops, intersections and recreational sports places were significantly and positively associated with older adult’s walking for transport. Transit stop density was found having the largest direct effect to older adults walking. Built environment had an independent effect on older adults walking regardless of individual demographic or psychological features. Education and personal goals related to physical activities had a direct positive, and income a direct negative, effect on walking. Gender and perceived health had an indirect effect on walking, which was realized through individuals’ physical activity goals.

‘Overjoyed that I can go outside’: Using walking interviews to learn about the lived experience and meaning of neighbourhood for people living with dementia

This study explores the relationships between people living with dementia and their neighbourhood as they venture out from home on a regular and often routine basis. Here, we report findings from the Swedish field site of an international 5-year project: Neighbourhoods: our people, our places. The aims of this study were to investigate the lived experience of the neighbourhood for people with dementia and through this to better understand the meaning that neighbourhood held for the participants. In this study, we focus on the walking interviews which were conducted with 14 community-dwelling people with dementia (11 men and 3 women) and were analysed using an interpretative phenomenological method. Four themes were revealed from these interviews: life narratives embedded within neighbourhood; the support of selfhood and wellbeing through movement; the neighbourhood as an immediate social context; and restorative connections to nature. These themes were distilled into the ‘essence’ of what neighbourhood meant for the people we interviewed: A walkable area of subjective significance and social opportunity in which to move freely and feel rejuvenated. We have found that the neighbourhood for community-dwelling people with dementia holds a sense of attachment and offers the potential for freedom of movement. Our research indicates that a dementia diagnosis doesn’t necessarily reduce this freedom of movement. The implications for practice and policy are considered: future research should explore and pay closer attention to the diverse living conditions of people living with dementia, and not least the particular challenges faced by people living alone with dementia.

‘It makes your life worthwhile. It gives you a purpose in living’: mobility experiences among active older adults with low income

The World Health Organization claims that mobility is vital to healthy ageing and is the best guarantee of older adults being able to cope and remain in their homes and communities. Mobility enables older adults to maintain their physical health, independence and participation in society. In general, mobility is examined objectively, from a quantitative perspective where mobility is measured as physical movement (e.g.physical activity) and/or travel behaviour (e.g.trips, modes and distances). The predominant focus on the functional aspects of mobility tends to overlook the subjective (e.g.perceptions, attitudes and motivations) and temporal dimensions of older adults’ mobility experiences. Using a constructivist grounded theory methodology, we conducted 24 in-depth interviews with six highly active community-dwelling older adults with low income, aged 65 or over, over a period of four years. Our analysis identified the following themes: maintaining a sense of self, being resourceful, openness to engagement, engaging in superficial contact, experiencing social capital, accessing transportation, leaving the immediate neighbourhood and facing affordability. Findings illustrate that intrapersonal factors, in addition to environmental (built, social and cultural) and temporal-level factors, play a crucial role in mobility. In the future, this gained knowledge can be incorporated into approaches to study the multiple interrelated factors and their interrelations that influence older adults’ mobility.