Are objectively-measured environmental correlates of walking also predictive of sitting in older adults? A cross-sectional study

Abstract

PURPOSE: While sitting time has been associated with non-communicable diseases, little is known about the effect of the environment on sitting time in older adults. This study examined associations of objectively-measured neighbourhood environmental attributes deemed to facilitate walking with sitting time in Hong Kong older adults. Neighbourhood attributes encouraging walking may help older adults replace some of the time spent sitting at home with light-to-moderate intensity activities such as strolling around the neighbourhood or walking to/from neighbourhood destinations. Thus, we hypothesized environmental correlates of walking would show associations with sitting time opposite to those seen for walking, and neighbourhood safety and infrastructure characteristics would moderate relationships between sitting time and destinations. METHODS: Ethnic Chinese Hong Kong residents aged 65+ (n= 484) were recruited from membership lists of four Hong Kong Elderly Health Centres representing catchment areas of low- and high-transport-related walkability stratified by socio-economic status (SES). Attributes of participants’ neighbourhood environments where assessed by environmental audits and sitting time ascertained using the International Physical Activity Questionnaire-Long Form (Chinese version). Generalized linear models accounting for neighbourhood-level clustering effects were used to examine objectively-measured associations of neighbourhood environmental characteristics with sitting time. RESULTS: Daily sitting minutes were 283 (SD=128). Prevalence of signs of crime/disorder, streetlights, and public facilities (public toilets and benches) were independently negatively related, and sloping streets positively related, to sitting. Presence of at least one place of worship in the neighbourhood was predictive of more sitting than absence of places of worship. Prevalence of public transit points was negatively related to sitting. Associations between sitting and entertainment destination diversity and prevalence of food/grocery stores were moderated by signs of crime/disorder and path obstructions, respectively. CONCLUSIONS: The findings of this study suggest that diversity of destinations and relatively low cost, minimal impact modifications to the urban form, such as street lighting, public toilets, benches and public transit points, could potentially reduce sitting time and associated negative health outcomes in Hong Kong older adults.