Hilly environment and physical activity among community-dwelling older adults in Japan: a cross-sectional study

BMJ Open. 2020 Mar 26;10(3):e033338. doi: 10.1136/bmjopen-2019-033338.

Abstract

Objectives: We investigated whether a moderate-to-vigorous physical activity (MVPA) level and walking time were associated with a hilly environment in rural Japanese older adults.

Design: Cross-sectional study.

Setting: Unnan city, Ohnan and Okinoshima towns in Shimane, Japan.

Participants: Data were collected from 1115 adults from the Shimane CoHRE study, who were aged 60 years and older and living in rural Japan in 2012.

Measures: We measured the total time spent on MVPA and walking using a Japanese short version of the International Physical Activity Questionnaire. The land slope in 400 or 800 m network buffers was assessed using the geographic information system. A multivariable Poisson regression model examined the prevalence ratios (PR) and 95% CIs of walking time or MVPA levels meeting the WHO guideline (>150 min/week) in the land slope categories (low, middle and high), adjusted for confounders.

Results: Engaging in the recommended level of MVPA was significantly associated with middle land slope (PR=1.07; p=0.03) and high land slope (PR=1.06; p=0.07) compared with low land slope in the 400 m network buffer, as well as with middle land slope (PR=1.02; p=0.48) and high land slope (PR=1.04; p=0.25) compared with the low land slope in the 800 m network buffer. Walking time was significantly associated with middle land slope (PR=1.13; p=0.04) and high land slope (PR=1.17; p=0.01) compared with low land slope in the 400 m network buffer, and with middle land slope (PR=1.09; p=0.16) and high land slope (PR=1.17; p<0.01) compared with low land slope in the 800 m network buffer. The sensitivity analysis found only a positive association between walking time and land slope in the 400 and 800 m network buffers.

Conclusions: This study showed that a hilly environment was positively associated with walking time among older adults living in rural Japan.

Keywords: elderly; neighbourhood environment; physical activity; public health; rural community.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cities
  • Cross-Sectional Studies
  • Environment Design*
  • Female
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Residence Characteristics*
  • Walking*