Using Walk-Along Interviews to Identify Environmental Factors Influencing Older Adults' Out-of-Home Behaviors in a High-Rise, High-Density Neighborhood

Attitudes and behaviour of elderly in cognisance of transport safety when navigating pedestrian facilities

The number of accidents involving elderly pedestrians has been increasing from year to year, in spite of various road safety initiatives having been implemented. In line with Singapore's ageing population, this presents a worrying trend. This study aims to shed light on possible contributing factors via a human factors analysis. A preliminary investigation was first conducted at traffic junctions identified to have a greater occurrence of accidents involving elderly pedestrians and motorists. This preliminary investigation looked into the efficacy of infrastructure-oriented solutions in reducing the occurrence of such accidents. It was observed that infrastructure alone was inadequate in ensuring safety of elderly pedestrians. Next, a questionnaire was administered in order to gain information regarding traits, attitudes and behaviours pertinent to traffic safety. Subsequently, structural equation modelling was used to analyse the data via exploratory, confirmatory and path analysis. This was followed by an in-depth discussion which explored the relationship between the latent constructs of traits, attitudes and behaviours, as well as social demographic variables such as age, gender and education level. It was found that poor cognitive ability and poor attitudes towards transport safety were both positively correlated with unsafe behaviour; strong psychosocial beliefs were positively correlated with poor attitudes towards transport safety, but negatively correlated with unsafe behaviour. The study concludes with recommendations to improve traffic outcomes for the elderly.

"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.

Impact of Environment on Pain among the Working Poor: Making Use of Random Forest-Based Stratification Tool to Study the Socioecology of Pain Interference

Pain interferes with one's work and social life and, at a personal level, daily activities, mood, and sleep quality. However, little research has been conducted on pain interference and its socioecological determinants among the working poor. Noting the clinical/policy decision needs and the technical challenges of isolating the intricately interrelated socioecological factors' unique contributions to pain interference and quantifying the relative contributions of each factor in an interpretable manner to inform clinical and policy decision-making, we deployed a novel random forest algorithm to model and quantify the unique contribution of a diverse ensemble of environmental, sociodemographic, and clinical factors to pain interference. Our analyses revealed that features representing the internal built environment of the working poor, such as the size of the living space, air quality, access to light, architectural design conducive to social connection, and age of the building, were assigned greater statistical importance than other more commonly examined predisposing factors for pain interference, such as age, occupation, the severity and locations of pain, BMI, serum blood sugar, and blood pressure. The findings were discussed in the context of their benefit in informing community pain screening to target residential areas whose built environment contributed most to pain interference and informing the design of intervention programs to minimize pain interference among those who suffered from chronic pain and showed specific characteristics. The findings support the call for good architecture to provide the spirit and value of buildings in city development.

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.

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.

How different are objective operationalizations of walkability for older adults compared to the general population? A systematic review

Background

Walking is an essential activity for everyone and for older adults in particular, given that it is the most accessible form of physical activity and one of the healthiest transportation modes. Understanding how walkability (the potential of the environment to enable and/or encourage walking) has been objectively measured and analyzed for older adults is critical to create more inclusive, healthy, and sustainable environments and to promote healthy aging. Despite the numerous reviews on physical activity among older adults and its relationship with the built environment, the literature still lacks comparison reviews focusing specifically on objective operationalizations of walkability for older adults vs. the general population.

Methods

We conducted a systematic review of 146 empirical studies that measured walkability objectively in relation to walking-related outcomes. We compared studies focused on older adults (n = 24) and the general population (n = 122). Content analysis included the characteristics of the study design, walkability measures, spatial extent, and associations found between walkability and walking-related outcomes.

Results

In both groups of publications, the majority of studies were conducted in the US, Canada, and Europe, and largely in high-income countries. They were mostly published in health-related journals and used cross-sectional designs, operationalized walkability by using indexes, employed self-reported measures for walking-related outcomes, and found positive associations between walkability and walking outcomes. However, we observed some differences among studies focusing on older adults. Compared to studies focusing on the general population, a larger proportion of studies on older adults was conducted in the Middle East and Asia, and they used longitudinal designs, mixed methods to measure walking-related outcomes, variables related with land-use characteristics, safety from traffic and crime, and greenery, and a larger proportion found positive, as well as no associations between walkability and walking-related outcomes.

Conclusion

Although there is a promising increase in interest in older adults-focused walkability studies in the last decade, there is still a need for more studies focusing on different settings, using wider spatial extents, longitudinal designs, objective or mixed methods to collect outcome data, and specific variables and/or specially created indexes for older adults and for settings.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03233-x.

Older Adults' Perceptions toward Walking: A Qualitative Study Using a Social-Ecological Model

Objectives: In this study, we aimed to investigate older adults’ perceptions of their walking experiences, using the social-ecological model as a guiding framework and to propose future walking intervention content. Methods: Thirty-eight participants (19 women; 47% from private elderly centers; mean age = 72.8 (SD = 7.4 years) took part in semi-structured interviews. Qualitative data analysis software QSR-NVivo was used for thematic coding. Results: Thematic deductive analysis revealed pertinent themes at the individual level (health benefits and barriers, fall risk, perseverance, and walking as a suitable activity for older adults), social environment level (social support and social interaction), physical environment level (density, land-use mix, and connectivity; perceived safety, pedestrian facilities (benches, quality of walking paths and sidewalks, and aesthetics), other pedestrian behaviors, and weather, and policy level (lack of walking programs in the community, and supportive culture for an active lifestyle). Discussion: Our findings provide insights for the planning of future multilevel walking intervention programs for older adults in Hong Kong. It is suggested that future walking intervention should include professionals (e.g., physiotherapist or coach) in a group setting, practical walking recommendations such as proper walking posture, and additional fun activities for older adults.

A Study of Older Adults' Perception of High-Density Housing Neighbourhoods in Singapore: Multi-Sensory Perspective

Associated sensory and cognitive declines progress with ageing and profoundly impact the daily living and quality of life of older adults. In the context of an increased ageing population globally, this paper outlines an exploratory study of socio-sensory properties of two high-density housing neighbourhoods in Singapore and the ways senior local residents perceive their familiar built environments. This study employed exploratory on-site exercises with 44 student researchers (including sensory photo-journeys, documentation of sensory properties and daily activity patterns), and 301 socio-perceptual surveys with local residents, the majority of whom were older adults. The findings reveal important aspects related to sensory assessment and appreciation (e.g., crowdedness, noise, smell, cleanliness), walking experience (e.g., safety, wayfinding) and overall satisfaction with the neighbourhood (e.g., available public amenities, opportunities for inter-generational bonding), some of which correlated with age and reported health condition. Multi-sensory assessment shows the capacity to inform more integrated, empathetic, ability-building and context-specific ageing-friendly neighbourhood design.

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.