Older adults’ transportation walking: a cross-sectional study on the cumulative influence of physical environmental factors

BACKGROUND The physical environment may play a crucial role in promoting older adults' walking for transportation. However, previous studies on relationships between the physical environment and older adults' physical activity behaviors have reported inconsistent findings. A possible explanation for these inconsistencies is the focus upon studying environmental factors separately rather than simultaneously. The current study aimed to investigate the cumulative influence of perceived favorable environmental factors on older adults' walking for transportation. Additionally, the moderating effect of perceived distance to destinations on this relationship was studied. METHODS The sample was comprised of 50,685 non-institutionalized older adults residing in Flanders (Belgium). Cross-sectional data on demographics, environmental perceptions and frequency of walking for transportation were collected by self-administered questionnaires in the period 2004-2010. Perceived distance to destinations was categorized into short, medium, and large distance to destinations. An environmental index (=a sum of favorable environmental factors, ranging from 0 to 7) was constructed to investigate the cumulative influence of favorable environmental factors. Multilevel logistic regression analyses were applied to predict probabilities of daily walking for transportation. RESULTS For short distance to destinations, probability of daily walking for transportation was significantly higher when seven compared to three, four or five favorable environmental factors were present. For medium distance to destinations, probabilities significantly increased for an increase from zero to four favorable environmental factors. For large distance to destinations, no relationship between the environmental index and walking for transportation was observed. CONCLUSIONS Our findings suggest that the presence of multiple favorable environmental factors can motivate older adults to walk medium distances to facilities. Future research should focus upon the relationship between older adults' physical activity and multiple environmental factors simultaneously instead of separately.