Built environmental correlates of older adults’ total physical activity and walking: a systematic review and meta-analysis

Barnett, David W.; Barnett, Anthony; Nathan, Andrea; Van Cauwenberg, Jelle; Cerin, Ester

doi:10.1186/s12966-017-0558-z

International Journal of Behavioral Nutrition and Physical Activity

Table 1 Characteristics of selected articles (N = 100)

From: Built environmental correlates of older adults’ total physical activity and walking: a systematic review and meta-analysis

Characteristic	Number of articles	%	Article reference
Study design^a
Cross-sectional	95	94	[19,20,21,22,23,24,25, 32, 43,44,45,46,47,48,49,50, 53, 54, 59, 60, 65, 67,68,69,70,71,72,73,74,75,76,77,78,79,80, 87, 92, 93, 100, 118,119,120,121,122,123,124,125,126,127,128,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143,144,145,146,147,148,149,150,151,152,153,154,155,156,157,158,159,160,161,162,163,164,165,166,167,168,169,170,171,172,173]
Longitudinal	5	5	[61,62,63,64,65]
Quasi-experimental	1	1	[66]
Geographical area: continent
Africa	1	1	[25]
Asia	16	16	[19,20,21,22, 60, 73, 75, 80, 124, 139, 142, 146, 160, 164, 169, 173]
Europe	22	22	[50, 66, 74, 79, 87, 119, 120, 123, 129, 136, 137, 147, 148, 152, 154, 156, 157, 162, 163, 165, 166, 170]
North America	46	46	[32, 43,44,45,46,47,48, 53, 54, 61,62,63,64,65, 67,68,69,70, 76, 78, 92, 93, 125,126,127, 130,131,132,133,134,135, 138, 140, 141, 143, 144, 149,150,151, 155, 158, 159, 161, 167, 168, 172]
Oceania	13	13	[49, 59, 71, 72, 77, 100, 118, 121, 122, 128, 145, 153, 171]
South America	2	2	[23, 24]
Geographical area: country
Australia	13	13	[49, 59, 71, 72, 77, 100, 118, 121, 122, 128, 145, 153, 171]
Belgium	2	2	[74, 170]
Brazil	1	1	[23]
Canada	10	10	[54, 61, 62, 78, 125,126,127, 135, 138, 172]
China	1	1	[80]
Colombia	1	1	[24]
Czech Republic, Poland, & Slovakia (pooled analysis)	1	1	[154]
Hong Kong, China	2	2	[73, 124]
Iceland	1	1	[119]
Iran	1	1	[146]
Ireland	2	2	[147, 152]
Japan	7	7	[19,20,21,22, 160, 164, 169]
Lithuania	1	1	[120]
Malaysia	1	1	[139]
Netherlands	4	4	[123, 136, 137, 166]
Norway	1	1	[157]
Singapore	1	1	[142]
South Africa	1	1	[25]
South Korea	2	2	[75, 173]
Thailand	1	1	[60]
United Kingdom	10	10	[50, 66, 79, 87, 129, 148, 156, 162, 163, 165]
United States of America	36	36	[32, 43,44,45,46,47,48, 53, 63,64,65, 67,68,69,70, 76, 92, 93, 130,131,132,133,134, 140, 141, 143, 144, 149,150,151, 155, 158, 159, 161, 167, 168]
Geographical setting
Urban	56	56	[23,24,25, 32, 43,44,45,46,47,48, 50, 53, 59, 61,62,63,64, 66, 71, 72, 74, 80, 87, 92, 93, 100, 120,121,122, 124,125,126,127, 129,130,131, 133, 135,136,137,138, 142, 144, 146, 149, 153, 156,157,158, 161, 164, 165, 167, 170, 172]
Rural	3	3	[67,68,69]
Mixed	32	32	[19, 21, 22, 49, 54, 60, 75, 76, 79, 118,119,120, 123, 128, 132, 134, 139, 143, 145, 147, 148, 150, 152, 155, 159, 160, 162, 163, 166, 169, 171, 173]
Not reported	9	9	[65, 70, 77, 78, 140, 141, 151, 154, 168]
Sample size^b
≤ 100	9	9	[19, 25, 53, 61, 66, 118, 127, 135, 161]
101–300	27	27	[32, 43, 53, 59, 60, 67, 69, 76, 87, 119, 120, 122, 123, 129, 132, 133, 140,141,142, 146, 150, 156, 162,163,164,165,166]
301–500	23	23	[23, 47, 63, 64, 68, 71,72,73,74,75, 93, 100, 121, 124, 126, 131, 134, 153, 154, 160, 167, 169, 170]
501–1000	16	16	[44,45,46, 48, 62, 78, 79, 92, 125, 128, 138, 144, 147, 148, 158, 159]
1001–2500	11	11	[20, 22, 24, 50, 54, 77, 130, 151, 155, 172, 173]
> 2500	16	16	[21, 49, 54, 65, 70, 80, 136, 137, 139, 143, 145, 149, 152, 157, 168, 171]
Study with multiple articles
Active Living Study	3	3	[71, 72, 153]
BEPAS Seniors	2	2	[74, 170]
Great Britain older adults 1	2	2	[162, 163]
Health and Wellbeing Surveillance System	2	2	[49, 171]
LL-FDI study (Late-Life Function and Disability Instrument)	2	2	[132, 150]
Melbourne older adults study 1	2	2	[121, 122]
Netherlands Housing Survey (WoON)	2	2	[136, 137]
Nurses’ Health Study	2	2	[70, 168]
PACS (Physical Activity Cohort Scotland)	2	2	[79, 148]
Project OPAL (Older People Active Living)	3	3	[87, 129, 165]
SHAPE (Senior Health and Physical Exercise)	4	4	[32, 63, 92, 93]
SNQLS (Senior Neighborhood Quality of Life Study)	6	6	[43,44,45,46,47,48]
TILDA (The Irish Longitudinal Study on Ageing)	2	2	[147, 152]
VoisiNuAge	2	2	[62, 138]
Single publication (named study)	33	33	[21, 50, 54, 59, 61, 64,65,66, 73, 77, 78, 80, 100, 124, 128, 130, 133,134,135, 139, 140, 143,144,145, 149, 155, 157,158,159, 166, 169, 172, 173]
Single publication (unnamed study)	31	31	[19, 20, 22,23,24,25, 53, 60, 67,68,69, 75, 76, 118,119,120, 123, 125,126,127, 131, 141, 142, 146, 151, 154, 156, 160, 161, 164, 167]
Neighbourhood recruitment stratification^a
Environmental attributes	57	57	[19, 21,22,23,24,25, 32, 44,45,46,47,48,49,50, 54, 60, 63, 66, 68, 71,72,73,74,75,76, 78,79,80, 87, 92, 118, 119, 123, 124, 126, 129, 130, 134, 135, 139, 146,147,148, 151, 153, 155, 159, 160, 162,163,164,165,166, 168, 170,171,172]
Urbanisation	22	22	[19, 21, 22, 49, 54, 60, 68, 75, 78, 80, 118, 119, 123, 134, 139, 155, 159, 160, 166, 168, 171, 172]
Area-level socio-economic status	6	6	[23, 25, 87, 129, 151, 165]
Area-level socio-economic status & walkability	12	12	[44,45,46,47,48, 73, 74, 124, 126, 135, 146, 170]
Area-level socio-economic status & urbanisation	10	10	[50, 63, 76, 79, 92, 130, 147, 148, 162, 163]
Walkability	4	4	[32, 71, 72, 153]
Streetscape	2	2	[66, 164]
Demographics	31	31	[20,21,22, 50, 62, 64, 69, 70, 79, 119, 121, 122, 132,133,134, 136,137,138, 141,142,143,144, 148, 150, 151, 155, 156, 161,162,163, 173]
None	21	21	[43, 53, 59, 61, 65, 67, 77, 93, 100, 120, 125, 128, 131, 140, 145, 149, 154, 157, 158, 167, 169]
Neighbourhood definition^a
Objective
Administrative/census area/postal code	25	25	[19, 54, 65, 68, 70, 74, 80, 118, 134, 136,137,138,139, 142, 145, 146, 148, 149, 157, 158, 160, 166, 170, 172, 173]
Buffer (crow-fly or road-network)
≤ 250 m	3	3	[21, 64, 171]
300 m	1	1	[123]
400–500 m	16	16	[21, 24, 44, 46,47,48,49, 59, 64, 72, 73, 93, 135, 153, 159, 171]
800–1000 m	15	15	[21, 49, 59, 63, 64, 73, 92, 93, 130, 132, 135, 155, 161, 168, 171]
> 1000 m	3	3	[161, 168, 171]
Variable/not fixed	4	4	[32, 135, 151, 164]
Retirement village	3	3	[43, 72, 153]
Unknown (not reported)	3	3	[53, 62, 128]
Perceived
10–20 min walk from home	24	24	[20, 22, 23, 44,45,46, 48, 60, 71, 72, 75, 79, 100, 121, 122, 124, 126, 131, 132, 141, 143, 150, 159, 169]
Other participant delineation	22	22	[24, 25, 32, 50, 61, 62, 67, 69, 76, 78, 87, 120, 125, 129, 133, 140, 147, 151, 152, 154, 165, 167]
Retirement village	2	2	[71, 153]
Unknown (not reported)	6	6	[63, 77, 92, 134, 144, 156]
Physical activity outcome by type of measurement and its operationalisation^a
Total PA (all PA outcomes from all articles)
Continuous outcome	59	55.1	[19, 21, 43,44,45,46,47,48, 54, 59, 60, 62, 63, 65,66,67, 69, 71, 73, 74, 79, 80, 87, 92, 93, 118, 119, 121, 123,124,125, 127, 129, 131, 132, 134,135,136,137,138, 140,141,142,143,144, 147,148,149,150,151, 155, 160, 161, 164,165,166, 170, 173]
Categorical outcome	48	44.9	[20, 22,23,24,25, 32, 49, 50, 53, 54, 61, 64, 65, 68, 70, 72, 75,76,77,78, 80, 93, 100, 120, 122, 124, 126, 128, 130, 133, 135, 139, 144, 146, 152,153,154, 156,157,158,159, 162, 163, 167,168,169, 171, 172]
Objective PA	28	27.2
Continuous outcome	23		[19, 43,44,45,46,47,48, 59, 73, 74, 79, 118, 127, 129, 132, 135, 141, 148, 150, 164,165,166, 170]
Categorical outcome	5		[25, 50, 61, 72, 135, 153]
Self-reported PA	75	73.8
Continuous outcome	37		[19, 21, 54, 60, 62, 63, 65,66,67, 69, 71, 73, 80, 87, 92, 93, 119, 121, 123,124,125, 131, 134, 136,137,138, 140,141,142,143,144, 147, 149, 151, 155, 160, 161, 173]
Categorical outcome	45		[20, 22,23,24,25, 32, 49, 53, 54, 64, 65, 68, 70, 72, 75,76,77,78, 80, 93, 100, 120, 122, 124, 126, 128, 130, 133, 139, 144, 146, 152,153,154, 156,157,158,159, 162, 163, 167,168,169, 171, 172]
Total PA (as detailed in article)	31	27.2
Objective PA	8	8
Continuous outcome	8	8	[48, 79, 129, 135, 148, 150, 164, 166]
Categorical outcome	0	0
Self-reported PA	23	23
Continuous outcome	19	19	[19, 60, 65,66,67, 69, 73, 87, 119, 121, 125, 136, 137, 141, 143, 147, 151, 160, 161]
Categorical outcome	4	4	[65, 70, 126, 157]
Total walking (as detailed in article)	55	48.2
Objective PA	9	9
Continuous outcome	8	8	[19, 118, 127, 129, 132, 135, 141, 165]
Categorical outcome	2	2	[61, 135]
Self-reported PA	47	47
Continuous outcome	19	19	[21, 62, 63, 65, 67, 71, 80, 92, 93, 123, 124, 131, 134, 138, 142, 144, 149, 155, 173]
Categorical outcome	32	32	[20, 22,23,24, 32, 49, 53, 64, 65, 70, 72, 75, 76, 80, 93, 100, 122, 124, 130, 144, 146, 153, 154, 158, 159, 162, 163, 167,168,169, 171, 172]
Total MVPA^c (as detailed in article)	28	24.6
Objective PA	15	15
Continuous outcome	11	11	[43,44,45,46,47,48, 73, 74, 129, 166, 170]
Categorical outcome	4	4	[25, 50, 72, 153]
Self-reported PA	14	14
Continuous outcome	3	3	[54, 140, 173]
Categorical outcome	12	12	[25, 54, 68, 77, 78, 120, 128, 130, 133, 139, 152, 156]
Environmental attribute by type of measurement^a
Objective environment	49	48
Perceived environment	53	52
Walkability	13	13
Objective	11	11	[46, 48, 72,73,74, 146, 153, 155, 167, 171, 172]
Perceived	2	2	[126, 141]
Residential density/urbanisation^d	35	35
Objective	21	21	[19, 21, 47, 54, 65, 70, 73, 80, 92, 118, 119, 123, 128, 134, 139, 148, 158,159,160, 168, 173]
Perceived	15	15	[20, 22, 25, 48, 76, 132, 140, 145, 147, 150, 152, 154, 159, 162, 169]
Street connectivity^d	24	24
Objective	10	10	[21, 24, 43, 53, 73, 93, 159, 161, 166, 168]
Perceived	16	16	[20, 23, 25, 48, 53, 71, 76, 79, 127, 132, 140, 142, 150, 154, 159, 170]
Access to/availability of destinations & services^a	65	65
Objective	29	29
Perceived	45	45
Overall access to destinations & services^d	24	24
Objective	6	6	[21, 53, 62, 93, 135, 168]
Perceived	21	21	[20, 23, 25, 48, 50, 53, 62, 67, 71, 76, 87, 100, 126, 127, 131, 132, 140, 141, 150, 154, 159]
Land-use mix—destination diversity^d	16	16
Objective	8	8	[49, 72, 80, 123, 135, 153, 159, 161]
Perceived	9	9	[25, 48, 67, 76, 125, 132, 150, 159, 170]
Shops/commercial destinations^d	26	26
Objective	17	17	[32, 43, 47, 49, 53, 72, 73, 80, 93, 135, 148, 158, 159, 161, 166, 168]
Perceived	10	10	[22, 23, 32, 75, 129, 141, 142, 156, 165, 169]
Food outlets	11	11
Objective	8	8	[43, 47, 49, 53, 73, 135, 166, 168]
Perceived	3	3	[23, 141, 142]
Government/finance services	8	8
Objective	7	7	[43, 47, 49, 53, 73, 135, 158]
Perceived	1	1	[23]
Education	7	7
Objective	6	6	[21, 132, 135, 158, 161, 168]
Perceived	1	1	[141]
Health & aged care	10	10
Objective	8	8	[43, 49, 53, 72, 135, 153, 158, 166]
Perceived	2	2	[23, 156]
Religious	5	5
Objective	3	3	[43, 135, 161]
Perceived	2	2	[23, 141]
Public transport	18	18
Objective	8	8	[24, 47, 72, 73, 80, 93, 158, 166]
Perceived	10	10	[22, 23, 48, 50, 62, 68, 100, 141, 156, 169]
Parks/public open space^d	30	30
Objective	17	17	[21, 24, 32, 43, 44, 48, 53, 64, 73, 92, 93, 124, 132, 135, 151, 158, 161]
Perceived	15	15	[23, 32, 46, 66, 68, 69, 75, 100, 125, 141, 142, 144, 151, 156, 163]
Recreational facilities	25	25
Objective	10	10	[43, 47, 64, 72, 73, 124, 132, 135, 153, 168]
Perceived	15	15	[22, 23, 46, 60, 63, 68, 77, 78, 92, 120, 125, 142, 156, 169, 170]
Social recreational facilities	13	13
Objective	6	6	[43, 49, 73, 135, 138, 166]
Perceived	7	7	[23, 50, 71, 141, 142, 153, 156]
Other destinations	1	1
Objective	1	1	[43]
Perceived	0	0
Infrastructure & streetscape^a	43	43
Objective	12	12
Perceived	34	34
Overall cycle/walk-friendly infrastructure	8	8
Objective	0	0
Perceived	9	9	[25, 48, 66, 76, 127, 132, 150, 154, 159]
Walk-friendly infrastructure	21	21
Objective	7	7	[43, 47, 80, 93, 124, 132, 161]
Perceived	14	14	[22, 44, 53, 61, 62, 68, 69, 71, 100, 121, 125, 142, 169, 170]
Cycle-friendly infrastructure	4	4
Objective	1	1	[47]
Perceived	3	3	[22, 125, 169]
No physical environmental barriers (e.g., hills)	16	16
Objective	8	8	[21, 24, 32, 43, 47, 72, 124, 164]
Perceived	9	9	[23, 32, 66, 71, 100, 125, 142, 169, 170]
Pavement/footpath quality	8	8
Objective	2	2	[47, 124]
Perceived	6	6	[23, 24, 66, 121, 142, 163]
Street lighting	6	6
Objective	1	1	[124]
Perceived	5	5	[23, 53, 69, 75, 122]
Greenery & aesthetically pleasing scenery^d	33	33
Objective	6	6	[32, 43, 47, 80, 124, 161]
Perceived	28	28	[20, 22, 23, 25, 32, 44, 48, 53, 61, 71, 75, 76, 79, 100, 122, 125, 127, 132, 137, 142, 147, 150, 154, 156, 159, 163, 169, 170]
Pollution (air)	3	3
Objective	1	1	[124]
Perceived	2	2	[23, 156]
Safety	46	46
Objective	7	7
Perceived	40	40
Traffic/pedestrian safety	28	28
Objective	4	4	[47, 72, 93, 124]
Perceived	24	24	[22,23,24,25, 45, 48, 53, 61, 69, 71, 75, 76, 79, 92, 100, 125, 132, 136, 142, 150, 156, 159, 169, 170]
Crime/personal safety^d	41	41
Objective	5	5	[43, 93, 124, 149, 157]
Perceived	37	37	[22, 23, 25, 45, 48, 50, 53, 61, 63, 66, 68, 69, 71, 75, 76, 79, 100, 121, 122, 125, 132,133,134, 137, 140, 142,143,144,145, 150, 156, 157, 159, 163, 167, 169, 170]
Moderator of environmental attribute-PA association^a	39	39
Individual factors	24	24	[20,21,22,23, 44, 45, 48,49,50, 59, 69, 70, 73, 77, 79, 100, 122, 125, 131, 144, 152, 155, 157, 159]
Socio-demographics	16	16	[20,21,22,23, 45, 49, 50, 69, 70, 73, 122, 125, 144, 152, 155, 157]
Health status/functionality	7	7	[59, 73, 77, 100, 131, 155, 159]
Psychosocial factors	3	3	[44, 79, 100]
Driving status/car ownership	2	2	[48, 73]
Duration of residency	1	1	[21]
Environmental factors	18	18	[19, 21, 25, 45, 46, 64, 66, 74,75,76, 92, 100, 141, 146, 155, 160, 162, 168]
Socioeconomic status/area-level income	5	5	[25, 45, 64, 74, 146]
Residential density/urbanisation	6	6	[19, 75, 76, 160, 162, 168]
Infrastructure and streetscape aspects (e.g., walkability)	3	3	[46, 92, 100]
Intervention	2	2	[66, 100]
Geographical scale (e.g., 400 m buffer)	6	6	[21, 64, 73, 93, 135, 161]
Tested, but unknown	1	1	[24]
None	61	61	[32, 43, 47, 53, 54, 60,61,62,63, 65, 67, 68, 71, 72, 78, 80, 87, 93, 118,119,120,121,122,123,124, 126,127,128,129,130, 132,133,134,135,136,137,138,139,140,141,142,143, 145, 147,148,149,150,151, 153, 154, 156, 158, 163,164,165,166,167, 169,170,171,172,173]

Notes:
^aMultiple options allowed in single articles
^bTwo articles had instances where environmental attributes were associated with different sample sizes ([53, 54]). Hence, the total number of articles added up separately is 2 units more than the total number of articles. Notably, this was adjusted for in our analysis
^cOne article ([25]) had both objective and self-reported physical activity measures. Hence, the total number of articles is 1 unit smaller than the sum of the articles in these cases
^dMultiple articles had both objective and perceived environmental measures. Hence, the total number of articles is 1, 2, or 3 unit/s smaller than the sum of the articles in these cases

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