Living in a walkable neighbourhood an essential element to support an active ageing intervention

Background: While urban built environments might promote active ageing, an infrequently studied question is how the neighbourhood walkability modulates physical activity changes during a physical activity intervention program in older adults. Purpose: We assessed the influence of objectively assessed neighbourhood walkability on the change in physical activity during the intervention program used in the ongoing PREvenci��n con Dieta MEDiterr��nea (PREDIMED)-Plus trial. PREDIMED-Plus is a parallel-group, randomized trial which tested the effect of an intensive lifestyle intervention on cardiovascular disease prevention, in older overweight and obese participants with the metabolic syndrome. Methods: The present study involved 228 PREDIMED-Plus senior participants aged between 55 to 75, recruited in Palma de Mallorca (Spain). Overweight/obese older adults with metabolic syndrome were randomized to an intensive weight-loss lifestyle intervention or a control group (106 intervention and 122 control groups). A home base neighbourhood environment walkability index (residential density, land use mix, intersections density) was calculated using geographic information systems (1km sausage-network buffer). Physical activity was assessed using the accelerometer for seven days, and a REGICOR validated physical activity questionnaire, at baseline and 2 follow-up visits (six-months and one-year later). Generalized Additive Mixed Models (GAMMs) were fitted to estimate the association between the neighbourhood walkability index and physical activity changes during follow-up. Results: Higher neighbourhood walkability (1 z-score increment) was associated with moderate-to-vigorous accelerometer assessed physical activity duration, (�� = 3,44; 95% CI = 0.52;6.36 minutes per day). When analyses were stratified by intervention arm, the association was only observed in the intervention group (�� = 6.357; 95% CI = 2.07;10.64 minutes per day) (p for interaction = 0.055). There were no statistically significant associations between neighbourhood walkability and self-reported physical activity nor brisk walking duration. Conclusions: The results indicate that the neighbourhood's walkability could support a physical activity intervention, helping maintain or increase older adults' objectively measured physical activity. This research may modify evidence on whether environmental factors modify habits acquisition during physical activity intervention programs. Funding: This work was supported by Instituto de Investigaci��n en Salud Carlos III [grant numbers PI14/00853, PI16/00662 and PI17/00525], and Consejer��a de Salud de la Junta de Andaluc��a [grant number PS0358���2016]. Cofounded by FEDER. Institut d'Investigaci�� Sanit��ria Illes Balears fellowship TalentPlus Tech Construyendo Valor Generando Salud [grant numbers #ITS2018���002] to [A.C.]. AstraZeneca Foundation (Young investigator Award 2017 on obesity and type 2 diabetes to [D.R.]. Australian National Health and Medical Research Council fellowship [grant numbers #1121035] to [S.M.]. [J.S.S.], gratefully acknowledges the financial support by ICREA under the ICREA Academia programme.
The Health & Fitness Journal of Canada, Vol. 14 No. 3 (2021): Proceedings from the 8th International Society for Physical Activity and Health Congress