Built environment and lower extremity physical performance: prospective findings from the study of osteoporotic fractures in women.

OBJECTIVE

We examined the association between walkability of the built environment and changes in physical performance among women aged 65 or older (n = 1,671, 253 neighborhoods).

METHOD: Street connectivity and street density, markers for neighborhood walkability, were assessed through linkage to secondary data sources. Physical performance was measured with timed-walk and chair-stand tests assessed during follow-up visits about every 2 years for 12 to 14 years. Multilevel models predicted change in physical performance, controlling for age, number of incident comorbidities, self-rated health, and death during follow-up.

RESULTS

Overall, physical performance declined during follow-up (p < .001). Neighborhood walkability had no effect on change in physical performance among women who reported not walking at baseline. However, among women who walked, greater neighborhood walkability was associated with a slower decline in dynamic leg strength, indicated by score on chair stand.

DISCUSSION: Neighborhood walkability may protect against decline in physical performance.