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Background and Objectives The number of people with memory problems who desire or are forced to age in place has been growing rapidly. Coronavirus disease 2019 (COVID-19) has brought significant challenges to the ability of those with memory problems to stay active and age in place. This study investigated the roles of neighborhood environments in helping community-dwelling people with memory problems maintain physical activity during the COVID-19 pandemic. Research Design and Methods We used retrospective online survey data from 75 caregivers who responded on behalf of their care recipients with memory problems living in Texas communities. We used difference-in-difference (DID) estimations based on zero-inflated negative binomial regression models to examine the changes in recreational walking and moderate-to-strenuous exercise before and during the COVID-19 pandemic and whether such changes vary by diversity of walkable neighborhood destinations. Results In the total sample, there was a significant reduction in both recreational walking (Δ change = −45.16 min/week, p  < .001) and exercise (Δ change = −36.28 min/week, p  = .03) after the COVID-19 outbreak. The pandemic's impact on exercise varied by diversity of neighborhood destinations (DID = 0.81, p  = .03). Those living in neighborhoods with diverse walkable destinations experienced less decline in physical activity compared to those living in areas with limited destinations. Discussion and Implications These findings suggest that the impact of the COVID-19 pandemic on physical activity among people with memory problems may be partially explained by neighborhood land-use characteristics. Destination-rich, mixed-use neighborhood environments can help people with memory problems stay active even during pandemics such as COVID-19 in the United States and potentially elsewhere. [ABSTRACT FROM AUTHOR]

Aim: We aimed to identify how the COVID-19 lockdown affected changes, including the potential for longer term sustained changes, in physical activity, as compared to immediately prior to the pandemic. Background: Physical activity's significant role in overall health is known to be influenced by the surrounding environment, such as one's neighborhood, prompting this study of physical activity and its relationship with individual-level and neighborhood-level factors within the pandemic timeline. Methods: A statewide online survey assessed adults' self-reported weekly minutes of moderate-to-vigorous physical activity (MVPA) comparing a typical week immediately prior to the pandemic and during the pandemic (prewidespread vaccination) using negative binomial models. Results: Overall, MVPA decreased during the pandemic, though the decrease was driven largely by the reduction in MVPA outside one's neighborhood. In contrast, MVPA done within one's neighborhood increased over time. This change in MVPA done within one's neighborhood was not uniform across several characteristics including income level favoring those with the highest income (p <.05) and race/ethnicity favoring those self-reporting as non-Hispanic White (p <.05). While several factors, including higher Walk Scores, were associated with higher levels of MVPA without evidence of change over time, evidence of a differential effect over time was seen for other key indicators of social and structural determinants of health including income and race/ethnicity. Conclusions: This study can add to the existing literature surrounding not only COVID-19 but also neighborhood built environmental research seeking to identify factors associated with changes in MVPA, a known indicator of overall health and health-related outcomes. [ABSTRACT FROM AUTHOR]

Background: Hazardous environmental exposures are recognized risk factors for falls among older adults. However, the gender differences in the associations of falls with indoor and outdoor environmental hazards are scarce. This study examined the indoor and outdoor environmental risk factors for falls and compared the data for men and women among U.S. older adults using nationally representative data.Methods: We used the 2011 National Health and Aging Trends Study (NHATS) for a cross-sectional analysis of 6680 community-dwelling adults aged ≥65 years in the United States. A series of logistic regressions was used to identify the indoor and outdoor environmental hazards associated with falls stratified by gender after adjusting for sociodemographic, health, and behaviors. We also tested for significant interactions with gender.Results: Compared to men, women had a higher prevalence of falls. In the model adjusted for sociodemographic, health, and behavioral conditions, there were gender differences in the association of falls with the presence of indoor and outdoor environmental hazards. Gender-specific analyses showed that women with the presence of indoor environmental hazards (OR = 1.37, 95% CI = 1.04.-1.79) had higher odds of falls, whereas for men, the presence of outdoor environmental hazards (OR = 1.34, 95% CI = 1.02-1.75) was associated with falls. We also found a significant interaction term between outdoor environmental hazards and gender (OR = 0.65, 95% CI = 0.47-0.90). The interaction plot indicated that the presence of outdoor environmental hazards increased the risks of falling in men but not in women.Conclusions: Significant gender differences exist in the association of falls with indoor and outdoor environmental hazards among older men and women. Our findings suggest that gender-tailored prevention programs to increase awareness of the environmental hazards and gender-specific environmental interventions are needed to help prevent falls. [ABSTRACT FROM AUTHOR]

Fear of falling is a major health concern among older adults. Although several studies have addressed general fear of falling in relation to personal factors, little is known about the specific relationship between fear of outdoor falling and perceptions of the outdoor environments. This study is to identify perceived environmental factors and outdoor exposure associated with fear of outdoor falling among assisted living residents aged 65 or older stratified by the amount of time spent outdoors. This study used survey data collected from a multiregional study conducted in 2007 that surveyed residents in 68 assisted living facilities in Houston, Texas; Chicago, Illinois; and Seattle, Washington. Out of 1,043 total participants, this study used a subset of 907 residents who used outdoor areas at least five minutes a day. Multivariate logistic regression was used after controlling for covariates. Approximately 31% of the participants reported having worried about falling while using the outdoor areas in their assisted living community. Multivariate analyses showed that adequately designed walkways (OR = 0.614, 95% CI = 0.405–0.931), comfort levels in using outdoor areas (OR = 0.657, 95% CI = 0.437–0.989), and frequency of outdoor usage (OR = 0.538, 95% CI = 0.368–0.787) were associated with decreased fear of outdoor falling after adjusting for individual factors (i.e. age, sex, health condition, fall history, vision problems, mobility aids). Improved walkways and comfort levels when using outdoor areas, as well as the amount of time spent outdoors, would be helpful in reducing fear of outdoor falling, which can help promote healthy lifestyle among assisted living residents. [ABSTRACT FROM AUTHOR]

Neighborhood environments have been increasingly associated with incidents of falling and the fear of falling. However, little is known about the causal impact of neighborhood environments on falling. This study identifies whether changes in outdoor environmental attributes over a one-year period are associated with the occurrence of recent falls among community-dwelling older adults aged 65 and older in the United States. Data were obtained from 4802 adults aged 65 years or older from the National Health and Aging Trends Study (NHATS). Logistic regression analyses were performed to identify neighborhood risk factors linked to the odds of experiencing recent falls at the one-year follow-up. Almost one in ten subjects (9.7% of 4802 subjects) who had not fallen before reported experiencing recent falls after one year. After adjusting for sociodemographic, health, and walking-related behavioral covariates, these subjects were more likely to reside in areas with higher environmental barriers on sidewalks/streets and uneven walking surfaces or broken steps, compared to non-fallers. Our findings suggest that safe and well-maintained outdoor environments may help prevent falls among community-dwelling older adults who engage in outdoor activities. Clinical and environmental interventions for promoting both safe walking and safe environments are warranted.