Association of the Built Environment With Physical Activity and Obesity in Older Persons
Ethan M. Berke, MD, MPH,
Thomas D. Koepsell, MD, MPH,
Anne Vernez Moudon, Dr es Sc,
Richard E. Hoskins, PhD, MPH and
Eric B. Larson, MD, MPH
At the time of the study, Ethan M. Berke was with the Department of Family Medicine, University of Washington, Seattle. Thomas D. Koepsell is with the Departments of Epidemiology, Health Services, and Medicine, and Anne Vernez Moudon is with the Department of Urban Design and Planning, University of Washington. Seattle. Richard E. Hoskins is with the Departments of Epidemiology and Medical Education and Biomedical Informatics, University of Washington, Seattle, and is with the Washington State Department of Health, Olympia, Wash. Eric B. Larson is with the Department of Medicine, University of Washington, Seattle, and with the Group Health Cooperative Center for Health Studies, Seattle.
Correspondence: Requests for reprints should be sent to Ethan M. Berke, MD, MPH, Department of Community and Family Medicine, Dartmouth Medical School, 35 Centerra Parkway, Rm 206, Lebanon, NH 03756 (e-mail: ethan.m.berke{at}dartmouth.edu).
Objective. We examined whether older persons who live in areasthat are conducive to walking are more active or less obesethan those living in areas where walking is more difficult.
Methods. We used data from the Adult Changes in Thought cohortstudy for a cross-sectional analysis of 936 participants aged65 to 97 years. The Walkable and Bikable Communities Projectpreviously formulated a walkability score to predict the probabilityof walking in King County, Washington. Data from the cohortstudy were linked to the walkability score at the participantlevel using a geographic information system. Analyses testedfor associations between walkability score and activity andbody mass index.
Results. Higher walkability scores were associated with significantlymore walking for exercise across buffers (circular zones aroundeach respondents home) of varying radii (for men, oddsratio [OR]=5.86; 95% confidence interval [CI]=1.01, 34.17 toOR=9.14; CI=1.23, 68.11; for women, OR=1.63; CI=0.94, 2.83 toOR=1.77; CI=1.03, 3.04). A trend toward lower body mass indexin men living in more walkable neighborhoods did not reach statisticalsignificance.
Conclusions. Findings suggest that neighborhood characteristicsare associated with the frequency of walking for physical activityin older people. Whether frequency of walking reduces obesityprevalence is less clear.
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