Sex Differences in Neighborhood Perceptions and Physical Activity among Older Adults Living in Car-dependent Neighborhoods
Li, Wenjun ; Churchill, Linda C. ; Crouter, Scott ; Kane, Kevin J. ; Cheng, Jie ; Rui, Fuding ; Tian, Jie ; Franklin, Patricia D ; Ockene, Judith K. ; Gurwitz, Jerry H.
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Abstract
INTRODUCTION: Older adults may have more physical limitations and no longer routinely travel outside their neighborhoods to work. Their daily living, health, and well-being may depend on neighborhood resources close to their homes. Therefore, access to resources critical for healthy aging may influence health in various aspects. In this study we investigated differences in neighborhood perceptions (NP) and their influences on physical activity (PA).
METHODS: Between 2012 and 2015, 111 men and 103 women aged 65 years and older living in car-dependent neighborhoods were queried on NP, use of neighborhood resources, and frequency and location of PA. Participants wore an accelerometer for 7 consecutive days.
RESULTS: Compared to women, men had a higher daily step count (mean (SD) 4385 (2122) men vs. 3671(1723) women, p=0.008). Men reported higher frequencies of any PA and moderate-to-vigorous PA, and a lower frequency of PA inside the home. Mean daily step counts and frequency of PA outside the home decreased progressively with age for both genders. Women had a sharper decline in frequencies of self-reported PA. Men had a significant decrease in utilitarian walking, which women did not (p=0.07). Among participants who reported any PA (n=190), more women indicated exercising indoors more often than outdoors (59% vs. 44%, p=0.04). Men perceived their neighborhoods more favorably than women. However, women perceived better accessibility to neighborhood resources. Higher NPs were associated with more frequent total PA and exercise outside the home. Association of NP with recreational walking was limited to men whereas association of NP with utilitarian walking was limited to women.
CONCLUSION: Older men and women differed in levels, types and location preferences of PA, NPs and their influences on PA. Consideration of these sex differences is necessary to improve the effectiveness of active living promotion programs among older adults, especially those targeting NPs.