6 Year Study of Seniors Neighborhood Environments, Physical Activity & Function

描述（由申请人提供）：老年人社区环境，身体活动和功能的6年研究已由IOM，CDC和其他人推荐，以改善身体活动（PA）。这种变化可能对老年人等弱势群体最重要，他们最不活跃，也最少被研究。科学家们一直呼吁对建筑环境和PA进行前瞻性研究。这项研究是对老年社区生活质量研究（SNQLS）队列的6年随访，这些队列是66岁以上的社区居民，他们被选择来最大限度地提高步行能力和收入的变化。对现有数据的分析表明，邻里环境与PA和BMI有关。SNQLS在方法上比其他研究更先进，对环境和PA进行了客观和感知的测量，前瞻性随访可以加强因果关系的证据。一个关键的创新是重新评估PA相关的环境特征，包括步行能力（GIS测量的混合使用和街道连通性），微观特征（系统观察和自我报告的街景细节，如人行道质量，街道交叉口的安全性），以及访问高级相关的娱乐设施（GIS和报告）。除了重复加速度计测量外，我们还将增加对社区内移动性的GPS评估。目的1，生态模型的指导下，是解释模式的变化PA从7天加速度超过6年的邻里环境和心理变量的综合措施。次要目标将评估主持人（例如，身体功能）的PA与环境措施的6年变化的关系和环境相关性的6年变化的身体功能，步行运输和娱乐，BMI和久坐时间的验证措施。探索性目标将评估改变住所的影响，并检查GPS测量的流动性及其健康后果的相关性。基于初步数据，我们预计将测量70%（预计随访N=603）在时间点1参与的样本。这项研究将填补有关环境与老年人多种健康结果关系的知识空白。该跨学科团队将利用研究结果推进环境和健康科学，并为设计支持健康老龄化的社区制定循证指南。 公共卫生相关性：这项研究与公共卫生的相关性身体活动不足是美国第四大死亡原因，老年人是人口中最不活跃的部分。包括我们之前的研究在内的横断面研究表明，生活在可以步行到附近商店并有娱乐机会的社区的老年人更活跃，不太可能超重。“支持活动的社区”甚至可以让功能有限的老年人保持独立和活跃。这项拟议中的研究将跟踪老年人超过6年，以检查社区特征是否有助于身体活动，身体功能，超重风险和整体健康的变化。

DESCRIPTION (provided by applicant): 6-Year Study of Seniors' Neighborhood Environments, Physical Activity & Function Built environment changes has been recommended by the IOM, CDC, and others to improve physical activity (PA). Such changes may be most important for vulnerable groups like older adults who are least active and least studied. Scientists consistently call for prospective studies of built environment and PA. The proposed study is a 6-year follow-up of the Senior Neighborhood Quality of Life Study (SNQLS) cohort of 66+ year-old residents of neighborhoods selected to maximize variability in walk ability and income. Analyses of current data show neighborhood environments are related to PA and BMI. SNQLS is more methodologically advanced than other studies, with objective and perceived measures of both environments and PA, and a prospective follow-up can strengthen evidence of causality. A key innovation is re-assessment of the full range of PA-related environmental characteristics, including walk ability (GIS measured mixed use & street connectivity), microscale features (systematically observed and self-reported streetscape details such as sidewalk quality, safety of street crossings), and access to senior-relevant recreation facilities (GIS and reported). In addition to repeating accelerometer measures, we will add GPS assessment of mobility within neighborhoods. Aim 1, guided by ecological models, is to explain patterns of change in PA from 7-day accelerometry over 6 years by comprehensive measures of neighborhood environments and psychosocial variables. Secondary aims will assess moderators (e.g., physical function) of the relationship of 6-year change in PA with environmental measures and environmental correlates of 6-year changes in a validated measure of physical function, walking for transport and recreation, BMI, and sedentary time. Exploratory aims will assess the impact of changing residences and examine correlates of GPS-measured mobility and its health consequences. Based on pilot data, we expect to measure 70% (projected follow-up N=603) of the sample who participated at Time 1. The study will fill many gaps in knowledge about the relation of environments to multiple health outcomes in seniors. The interdisciplinary team will use results to advance the science of environments and health and develop evidence-based guidelines for designing neighborhoods that support healthy aging. PUBLIC HEALTH RELEVANCE: Relevance of this research to public health Physical inactivity is the 4th leading cause of death in the US, and older adults are the least active segment of the population. Cross-sectional studies, including our previous study, show that older adults living in neighborhoods where they can walk to nearby stores and have recreational opportunities are more active and less likely to be overweight. "Activity-supportive neighborhoods" may allow even older adults with limited function to retain their independence and be active. The proposed study will follow older adults over 6 years to examine whether neighborhood characteristics contribute to changes in physical activity, physical function, and risk of overweight, and overall health.